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Cardio > ECGs > Flashcards

ECGs Flashcards

1
Q

What are the lateral leads and what coronary arteries do they correspond to?

A

I, aVL, V5 and V6

Left circumflex and diagonal of LAD

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2
Q

What are the inferior leads and what coronary arteries do they correspond to?

A

II, III and aVF

Right coronary artery via posterior descending artery

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3
Q

What are the anterior/ septal leads and what coronary arteries do they correspond to?

A

V1 to V4

LAD

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4
Q

What is the normal range for the P wave?

A

80-100ms

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5
Q

What is the normal range for the PR interval?

A

120-200 ms

3-5 little squares

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6
Q

What is the normal range for the QRS complex?

A

60-109 ms

>120 = BBB

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7
Q

What is the normal range for the T wave?

A

120-160 ms

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8
Q

how much is each little square?

A

40ms

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9
Q

What are the axis for each lead?

A 
I= 0
II= +60
III = +120
aVF = +90
avL= -30
aVR = -150
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10
Q

What is the normal axis?

A

-30 to +90

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11
Q

What is the PR interval and what is the QT interval?

A

start P to beginning QRS

begin Q to end of T

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12
Q

What is the normal QT interval length?

A

QTc is prolonged if > 440ms in men or > 460ms in women

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13
Q

What is the normal number of big squares between QRS complexes?

A

Either 3, 4 or 5 squares (100, 75, 60 BPM)

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14
Q

What indicates LAD?

A

lead I positive and lead II negative (leaving each other)

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15
Q

What indicates RAD?

A

Lead I negatives and lead III positive (reaching towards each other)

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16
Q

What do you find in RBBB?

A

rSR/ rR waves in V1 and V1 and V2 “bunny ears”

prolonged QRS and T wave inversion V1

17
Q

What can cause RBBB?

A

Can be normal; R heart overload eg PE, pulomary htn, ASD, lung disease

18
Q

How do you diagnose VT over SVT?

A

If V1-V6 is made of monophasic S or R waves = VT
If have RS complexes that are over 100 ms = VT
If there is any AV disocciation (i.e. P waves separate/ superimposed onto QRS)/ fusion beats

19
Q

What occurs to the P waves during left atrial enlargement?

A

P-mitrale in lead II where the P wave has a second hump in a “M” shape

20
Q

Which lead is best for looking at the atria?

A

lead II

21
Q

What occurs to the P waves during right atrial enlargement?

A

P-pulmonale, increased P wave amplitude on lead II

22
Q

From V1 to V6 which waves get bigger/ smaller?

A

R waves get bigger and S waves get smaller

23
Q

What do you see on LBBB?

A

Unlike RBBB always shows organic heart disease!!

LV depolarisation delay → broad QRS (over 3 squares/ 120ms) in lateral leads

Broad monophasic (no Q or S waves) in leads I, avL, v5 and v6 (laterals),

ST and T negative in I and aVL, positive in v1 to 3

Dominant S wave in V1

Prolonged R wave peak time > 60ms in leads V5-6

24
Q

What would you see on wolf-parkinson-white ecg?

A

Upsloping of QR (delta wave)

Short PR interval

25
Q

What is an epsilon wave?

A

Important ECG sign which indicates arrythmogenic right ventricular cardiomyopathy which can be cause of sudden death –> bump between S and T wave on V1 and V2

26
Q

What is the osborn wave?

A

aka J wave of hypothermia

notch between R and T

27
Q

What is brugada syndrome?

A

Sodium channelopathy in heart
Coved ST segment elevation >2mm in >1 of V1-V3 followed by a negative T wave.
WITH
VF/ fhx sudden cardiac death/ syncope/ nocturnal agonal respiration

28
Q

What ECG changes occur post MI - in terms of hrs to days to months

A

hrs: ST elevation
hrs to days: Loss R wave, Q wave formation
days: T wave inversion
weeks to months: pathological Q waves

29
Q

Describe a pathological Q wave

A

Q waves that are deep and broad in aVF, V1-3 are pathological
ALSO if deeper than 2 small squares and wider than 1 small square

30
Q

What would you see on a postero/lateral STEMI?

A

ST depression in V1 to V4 as a mirror image of ST elevation that would occur if there were V7 to V9 leads around the back

31
Q

What are some other causes of ST elevation?

A

benign early repolarisation

pericarditis (saddleback and global)

32
Q

Appearance of hypokalaemic ecg?

A

flattened T waves

prominent U wave

33
Q

Appearance of hyperkalaemic ecg?

A

QRS broad
T waves peaking
loss P
prolonged PR

34
Q

How does digoxin effect ecg?

A

Bowl shaped inverted T wave

35
Q

What is Left anterior hemi-block?

A

Left axis deviation; rS (small r and large S) in II, III and aVF; qR complexes in leads I, aVL; QRS <120 ms

36
Q

What is Left posterior fascicular block?

A

Left posterior fascicular block: right axis deviation; rS complex I and avL, qR in II, III, aVF

37
Q

What is Bifasicular block?

A

RBBB with left anterior fascicular block (LAFB), manifested as left axis deviation (LAD)
OR

RBBB and left posterior fascicular block (LPFB), manifested as right axis deviation (RAD) in the absence of other causes

38
Q

What is trifasicular block?

A

Trifasicular block: bifascicular block and AV block

Cardio (5 decks)

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