ECGs

Question 1

how to work out rate

Answer 1

300/big sqaures

or no. of big complex x6

Question 2

how to look at rhythm

Answer 2

p waves present?
every p followed by QRS?
regular RR?

Question 3

axis of ECG

Answer 3

reaching in 1 and 3 = right

leaving in 1 and 3 = left

Question 4

what makes a regular rhythm

Answer 4

p wave followed by a QRS wave

Question 5

causes of regularly irregularly rhythm

Answer 5

sinus arrhythmia (ectopics)
wenckebach/motibz 1 = progressively lengthening PR until one dropped

Question 6

causes of irregularly irregular rhythm

Answer 6

AF

Question 7

causes of absent p waves

Answer 7

AF

Question 8

causes of dissociated p waves

Answer 8

complete heart block

Question 9

causes of p mitrale

Answer 9

(bifid p waves) LAH = AS, MR, MS

Question 10

causes of p pulmonale

Answer 10

(peaked p waves) RAH = pulmonary HTN and COPD

Question 11

causes of prolonged PR

Answer 11

heart block

Question 12

what is the normal PR

Answer 12

0.12-0.2

Question 13

causes of shorted PR

Answer 13

WPW, HOCM

Question 14

causes of depressed PR

Answer 14

pericarditis

Question 15

what is the normal QRS

Answer 15

0.12

Question 16

cause of wide QRS

Answer 16

BBB

Question 17

cause of narrow QRS

Answer 17

SVT

Question 18

cause of pathological q waves

Answer 18

full thickness MI

Question 19

cause of an elevated ST

Answer 19

> 1mm
STEMI
prizmentals angina
pericarditis (saddle shape)

Question 20

cause of depressed ST

Answer 20

> 0.5mm
ischaemia (flat)
digoxin (down sloping)
MI

Question 21

cause of tall T waves

Answer 21

hyperkalaemia

MI

Question 22

cause of flat/inverted T waves

Answer 22

hypokalaemia
MI
BBB
anxiety, smoking, tachycardia, haemorrhage, shock

Question 23

when can inverted T wave be normal

Answer 23

V1, V2, aVR

Question 24

what does RR measure

Answer 24

ventricular rate

Question 25

causes of short QT

Answer 25

digoxin, BB, phenytoin

Question 26

cause of long QT

Answer 26

``` TIMME toxins (macrolides, TCAs, antiarrhytmias) inherited ischaemia myocarditis/MVP electrolytes = low Mg, K, Ca hypothermia ```

Question 27

causes of osborne/j waves

Answer 27

hypothermia SAH hypercalcaemia

Question 28

what is the trio criteria for acute coronary syndrome

Answer 28

chest pain ecg change cardiac markers

Question 29

ecg change in acute coronary syndrome

Answer 29

ST elevation >1mm in 2 contiguous leads with reciprocal ST depression and new LBBB

Question 30

what is the p wave

Answer 30

atrial depolarisation

Question 31

what is the PR interval

Answer 31

time it takes for electrical activity to move from atria to ventricles

Question 32

what is the QRS

Answer 32

depolarisation of ventricles

Question 33

what is the QT

Answer 33

time for the ventricle depolarisation and repolarisation

Question 34

what is T wave

Answer 34

repolarisation of ventricles

Question 35

what is the ST

Answer 35

time between depolarisation of ventricles and depolarisation of ventricles

Question 36

artery involved for lateral

Answer 36

left circumflex

Question 37

artery involved in anterior

Answer 37

left anterior descending

Question 38

artery involved in inferior

Answer 38

right coronary artery

Question 39

ECG in AF

Answer 39

tachycardia irregularly irregular absent p waves

Question 40

causes of LBBB

Answer 40

CAD, HTN, HF, LVH

Question 41

causes of RBBB

Answer 41

RVH, IHD, rheumatic heart disease, Fallots

Question 42

what is 1st degree heart block

Answer 42

PR >200 but always followed by QRS

Question 43

treatment of 1st degree heart block

Answer 43

benign - its just a delayed impulse

Question 44

what is 2nd degree heart block mobitz 1 wenckebach

Answer 44

Progressively increasing PR until one p wave is not conducted

Question 45

treatment of 2nd degree HB mobitz 1

Answer 45

only treat if Sx if Sx - use atropine pacemaking is rare

Question 46

what is 2nd degree heart block mobitz 2

Answer 46

Constant PR then non conducted p wave | Usually 2:1 or 3:1 block

Question 47

treatment of 2 degree heart block mobitz 2

Answer 47

pacemaker as more likely to be haemodynamically compromised

Question 48

what is 3rd degree heart block

Answer 48

P waves and QRS waves independent of each other

Question 49

treatment of 3rd degree heart block

Answer 49

urgent cardiac monitoring and pacemaker insertion

Question 50

ECG in LBBB

Answer 50

Wide QRS >120 Top notched M in v5/6 T wave inversion in lateral leads V1 – dominant s wave

Question 51

treatment of LBBB

Answer 51

thrombolysis

Question 52

ECG in RBBB

Answer 52

Wide QRS RSR pattern in v1– up first wide slurred s in lateral leads

Question 53

what is a bifascicular block

Answer 53

RBBB+LAD

Question 54

what is trifascicular block

Answer 54

RBBB+LAFB+1st degree AV block

Question 55

treatment of RBBB

Answer 55

invasive coronary angioplasty, treatment of HTN and Dmx

Question 56

causes of AF

Answer 56

``` PIRATES PE ischaemia respiratory atrial enlargement (VSD, MS, MR) as alters muscle and causes defective atrial contraction thyroid ethanol sepsis ```

Question 57

ECG in VF

Answer 57

shapeless, rapid oscillations, no organised complexes

Question 58

ECG in flutter

Answer 58

tachycardia saw tooth normal QRS

Question 59

ECG in WPW

Answer 59

delta wave wide QRS short PR

Question 60

ECG in VT

Answer 60

monomorphic

Question 61

ECG in torsades de pointes

Answer 61

polymorphic, similar to VT

Question 62

ECG in Brugada

Answer 62

coved ST elevation v1-v3 | RBBB

Question 63

ECG in digoxin toxicity

Answer 63

reverse tick down sloping ST depression T wave inversion

Question 64

ECG in PE

Answer 64

tachycardia AF S1Q3T3 - deep s wave in lead 1 , q wave in lead 3, t wave inversion in lead 3

Question 65

ECG in hyperkalaemia

Answer 65

tall tented t waves wide QRS absent p waves

Question 66

ECG in hypokalaemia

Answer 66

flat t wave St depression prolonged QT u wave

Question 67

ECG in bradycardia

Answer 67

<60bpm

Question 68

what is a capture beat

Answer 68

SAN transiently captures ventricles to produce normal QRS