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Endo, Cardio and Neuro > Electrocardiogram & rhythm disorders > Flashcards

Electrocardiogram & rhythm disorders Flashcards

1
Q

why is ECG used?

A

cheap
easy to undertake
reproducible
quick turnaround on results/reporting

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2
Q

what is ECG used to view/diagnose?

A

conduction abnormalities
structural abnormalities
perfusion abnormalities

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3
Q

what are ECG electrodes?

A

sticky pads placed on body

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4
Q

what are ECG cables/wires?

A

cables with coloured ends attached to machine and body

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5
Q

what are ECG leads?

A

heart perspectives based on where the electrodes are placed

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6
Q

what do the characteristics of deflections on the leads mean?

A

width of deflection - duration of event
steepness of line - velocity of action potential
downward deflection - towards -ve electrode
upward deflection - towards +ve electrode

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7
Q

what are the normal deflections on an ECG?

A

P wave - small upwards
QRS complex - tiny down large up tiny down
T wave - small but long upwards

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8
Q

what does the P wave of an ECG tell you?

A

conduction of sinoatrial node and atrial depolarisation

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9
Q

what does the pause between P and Q on an ECG represent?

A

atrioventricular node depolarisation

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10
Q

what is represented by the isoelectric line just before Q on an ECG?

A

rapid conduction down bundle of His

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11
Q

what is represented by the Q complex on an ECG?

A

bundle branches depolarisation/septal depolarisation

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12
Q

what is represented by the R wave of an ECG?

A

apex of heart purkinje fibre depolarisation

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13
Q

what is represented by the S wave of an ECG?

A

purkinje fibres depolarising up the side of the myocardium

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14
Q

what is represented by the isoelectric line between S and T waves on an ECG?

A

fully depolarised ventricles

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15
Q

what represents the T wave on an ECG?

A

ventricular repolarisation

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16
Q

what is the electrode placement for an ECG?

A 
V1 - right sternal border of 4 IC space
V2 - left sternal border of 4 IC space
V3 - midway between V2/4
V4 - mid clavicular line of 5 IC space
V5 -  midway between V4/6
V6 - mid axillary line of 5 IC space
electrodes on both limbs on both sides
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17
Q

what lead goes between right and left arm?

A

rule of Ls - lead I

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18
Q

what lead goes between right arm and left leg?

A

rule of Ls - lead II

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19
Q

what lead goes between left arm and left leg?

A

rule of Ls - lead III

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20
Q

how do you read ECG findings?

A 
rate&rhythm
P wave/P-R interval
QRS duration
QRS axis
ST segment
QT interval
T wave
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21
Q

what is sinus rhythm on an ECG?

A

each P wave followed by QRS
normal and regular rate
otherwise unremarkable

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22
Q

what is sinus bradycardia on an ECG?

A

each P wave followed by QRS
rate is regular and slow
healthy, caused by medication or vagal stimulation

23
Q

what is sinus tachycardia on an ECG?

A

each P wave followed by QRS
rate is regular and fast
often due to physiological response

24
Q

what is sinus arrythmia?

A

each P wave followed by QRS
rate is irregular and normal
R-R varies with breathing cycle

25
Q

what is atrial fibrillation on an ECG?

A

oscillating baseline - atria contracting asynchronously

rhythm may be irregular and rate slow

26
Q

what is atrial flutter on an ECG?

A

regular saw tooth pattern in baseline (II,III,aVF) not always in all leads
atrial to ventricular beats at a 2:1 ratio, 3:1 ratio or higher

27
Q

what is first degree heart block on an ECG?

A

prolonged P-R interval/segment
regular rhythm and rate
P waves followed by QRS complexes

28
Q

what is second degree heart block mobitz I on an ECG?

A

gradual prolongation of PR interval until a beat skips
some P waves not followed by QRS
regularly irregular rhythm

29
Q

what is second degree heart block mobitz II on an ECG?

A

regular P waves, only some are followed by QRS
no P-R prolongation
regularly irregular

30
Q

what is third degree (complete) heart block on an ECG?

A

P waves regular, QRS regular but no relationship to each other
P waves can be hidden by other, larger vectors
non-sinus rhythm

31
Q

what is ventricular tachycardia on an ECG?

A

P waves hidden
rate is regular and fast
no isoelectric line
but shockable rhythm

32
Q

what is ventricular fibrillation on an ECG?

A

rate irregular and 250bpm+

shockable rhythm

33
Q

what heart rhythms are shockable?

A

ventricular tachycardia

ventricular fibrillation

34
Q

what is ST elevation on an ECG?

A

P waves visible followed by QRS
regular rate and rhythm
ST segment depressed >2mm below isoelectric line in leads related to obstructed vessel
myocardial infarction

35
Q

what is ST depression on an ECG?

A

regular rate rhythm
ST segment depressed 2mm below isoelectric line
myocardial ischaemia - not infarction

36
Q

what does a saw tooth pattern in II, III and aVF indicate?

A

atrial flutter

37
Q

what does a gradual prolonging of PR interval until a beat dropped indicate?

A

2nd degree heart block Mobitz I

38
Q

what does a prolonged PR interval with some dropped QRS indicate?

A

2nd degree heart block mobitz II

39
Q

what does an ECG with no isoelectric baseline, no P waves indicate? massive waves with small wave on top

A

ventricular tachycardia

40
Q

how to read cardiac axis

A

lead I and aVF

41
Q

what is right axis deviation

A

lead I negative
lead aVF positive
+90°- +180°
right reaching

42
Q

what is left axis deviation

A

lead I positive
lead aVF negative
−30° - −90°
left leaving

43
Q

what is normal cardiac axis

A

lead I positive

aVF positive

44
Q

when may left axis deviation be normal

A

tall thin people

due to lungs rotating heart straighter

45
Q

when may right axis deviation be normal

A

short wide people

due to more space in the mediastinum

46
Q

what may be a cause of left axis deviation

A

left ventricular hypertophy - more working cardiac muscle to have electrical activity
myocardial infarction in right side - muscle dies so less activity on that side, shifts left

47
Q

what is a long PR interval

A

bigger than 1 big square

48
Q

investigations for suspected blocked coronary artery

A

coronary angiogram

49
Q

treatment for coronary artery blockage

A

CABG - coronary artery bypass graft (harvest another vessel and pop it on)
PCI - percutaneous coronary intervention (basically a stent)

50
Q

what does a STEMI/NSTEMI in lead II, III and aVF indicate

A

inferior ischaemia/infarction

right coronary artery involvement

51
Q

what does a STEMI/NSTEMI of lead I, aVL and V5,V6 indicate

A

lateral ischaemia/infarction

left circumflex artery

52
Q

what does a STEMI/NSTEMI in V1 2 indicate

A

septal ischaemia/infarction

left anterior descending artery

53
Q

what does a STEMI in V3, V4 indicate

A

damage to anterior heart

left anterior descending artery blockage

54
Q

How to calculate rate if ecg is irregular rhythm

A

Rhythm strip QRS complexes x 6

Endo, Cardio and Neuro (22 decks)

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