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SEM 5: SAM 1 > Electrocardiography and Arrhythmias > Flashcards

Electrocardiography and Arrhythmias Flashcards

1
Q

What is the normal pathway of impulse transmission through the heart?

A
  1. Starts at the SA node in the RA
  2. Fires throughout RA causing atrial depolarization and contraction (atrial systole)
  3. Impulse slows at AV node
  4. Rapidly conducted through Bundle of His
  5. Rapidly conducted through Purkinje fibers to ventricles (ventricular systole)
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2
Q

Match the ECG wire color to the correct location:

Red-
Green-
Black-
White-

A

Red - LH
Green- RH
Black - LF
White - RF

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3
Q

Right front leg (-) compared to left front leg (+). Which ECG lead?

A

Lead 1

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4
Q

Right front leg (-) compared to left hind leg (+). Which ECG lead?

A

Lead II

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5
Q

Left front leg (-) compared to left hind leg (+). Which ECG lead?

A

Lead III

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6
Q

What wave shows atrial depolarization?

A

P wave

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7
Q

What wave shows ventricular repolarization?

A

T wave

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8
Q

What does the QRS complex represent?

A

Ventricular depolarization

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9
Q

What wave represents LV depolarization specifically?

A

R wave

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10
Q

What wave represents RV depolarization specifically?

A

S wave

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11
Q

What does the R wave of the QRS complex represent?

A

Left ventricular depolarization

(Left ventricular systole/contraction)

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12
Q

What does the S wave of the QRS complex represent?

A

Right ventricular depolarization

(Right ventricular systole/contraction)

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13
Q

What does the PR interval represent?

A

Atrial depolarization and conduction through the AV node

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14
Q

What does the QT interval represent?

A

Ventricular depolarization and repolarization

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15
Q

What does the RR interval represent?

A

Time between ventricular depolarizations

(Time between 2 heartbeats)

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16
Q

What does the ST segment represent?

A

Time between the end of ventricular depolarization and the beginning of repolarization

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17
Q

What does the PR segment represent?

A

Time between the end of atrial depolarization and the beginning of ventricular repolarization

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18
Q

On a 25 mm/s paper speed the width of each small box is _____

A

0.04 s (40ms)

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19
Q

On a 50 mm/s paper speed the width of each small box is _____

A

0.02 s (20ms)

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20
Q

If the amplitude of the ECG paper is 10 mm/mv, the height of each small box is _______

A

0.1 mV

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21
Q

If the amplitude of the ECG paper is 5 mm/mv, the height of each small box is _______

A

0.2 mV

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22
Q

What is the 1st negative deflection after the P wave?

A

Q wave

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23
Q

What is the 1st positive deflection after the P wave?

A

R wave

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24
Q

What is the 1st negative deflection after the R wave?

A

S wave

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25
Q

What wave can be represented as a positive or negative deflection?

A

T wave

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26
Q

Calculate the HR

Paper speed: 25 mm/s
5 QRS complexes spanning 30 large boxes

A

5 x 10 = 50 beats/min

When the paper speed in 25 mm/s, count the QRS complexes that span 30 large boxes and multiply by 10

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27
Q

Calculate the HR

Paper speed: 50 mm/s
5 QRS complexes spanning 30 large boxes

A

5 x 20 = 100 beats/min

When the paper speed in 50 mm/s, count the QRS complexes that span 30 large boxes and multiply by 20

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28
Q

Varying ___ intervals = irregular rhythm

A

RR

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29
Q

What is the normal duration of the PR interval in dogs?

A

60-130 msec

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30
Q

What is the normal duration of the PR interval in cats?

A

50-90 msec

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31
Q

What is the normal duration of the QRS interval in dogs?

A

< 60 msec

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32
Q

What is the normal duration of the QRS interval in cats?

A

< 40 msec

33
Q

Which of the following would be considered a normal duration for a PR interval in a dog?

A. 50 msec
B. 90 msec
C. 40 msec
D. 140 msec

A

B. 90 msec

(60-130 msec)

34
Q

Which of the following would be considered a normal duration for a PR interval in a cat?

A. 60 msec
B. 100 msec
C. 40 msec
D. 120 msec

A

A. 60 msec

(50-90 msec)

35
Q

Which of the following would be considered a wide QRS interval in a cat?

A. 15 msec
B. 35 msec
C. 45 msec
D. 25 msec

A

C. 45 msec

(Normal for cat: <40 msec)

36
Q

Which of the following would be considered a wide QRS interval in a dog?

A. 35 msec
B. 45 msec
C. 55 msec
D. 65 msec

A

D. 65 msec

(Normal for dog: <60 msec)

37
Q

How can you interpret a wide P wave?

A

left atrial enlargement

38
Q

How can you interpret a wide R wave?

A
  • Left ventricular enlargement
  • Left BBB
    OR
  • Ectopic ventricular impulse originating in the RV
39
Q

How can you interpret a wide S wave?

A
  • Right ventricular enlargement
  • Right BBB
    OR
  • Ectopic ventricular impulse originating in the LV
40
Q

What is the ECG criteria for a wandering pacemaker?

A
  • Variation in P wave amplitude (height)
  • Consistent PR intervals

(often seen with Respiratory sinus arrhythmia (RSA))

41
Q

T/F: Wandering pacemaker is more commonly seen in cats than dogs

A

False

Rare in cats, normal in resting/calm dogs

42
Q

What is the ECG criteria for a sinus bradycardia?

A
  • Normal sinus rhythm with an abnormally low HR (long RR intervals)
43
Q

Primary cause of sinus bradycardia?

A

Disease of dysfunction of the sinus node

Ex: sick sinus syndrome

44
Q

Secondary cause of a sinus bradycardia?

A

Increased/high vagal (parasympathetic) tone

more common than primary

45
Q

Calculate the HR

  • Paper speed: 25 mm/s
  • 15 small boxes between consistent RR intervals
A

1500/15 = 100 beats/min

When the paper speed is 25 mm/s, divide 1500 by the # of small boxes between consistent RR intervals

46
Q

Calculate the HR

  • Paper speed: 50 mm/s
  • 15 small boxes between consistent RR intervals
A

3000/15 = 200 beats/min

When the paper speed is 50 mm/s, divide 3000 by the # of small boxes between consistent RR intervals**

47
Q

Non pathologic causes of high vagal tone?

A
  • Sleep/rest
  • Athleticism
  • Brachycephalics
48
Q

What is the ECG criteria for sinus tachycardia?

A

Sinus rhythm with an abnormally high HR (short RR intervals)

49
Q

Physiologic sinus tachycardia rarely exceeds ____ bpm in dogs or ____ bpm in cats

A

220, 280

50
Q

Secondary cause of a sinus tachycardia?

A

Increased sympathetic tone

(more common than primary tachycardia)

51
Q

Primary cause of sinus tachycardia?

A

Disease or dysfunction in the sinus node

52
Q

What is the pattern of sinus tachycardia on ECG?

A

Normal rhythm, Short RR intervals, P waves very close to T wave

53
Q

Causes of supraventricular premature complex?

A
  • Atrial dilation (MOST COMMON)
  • Atrial tumor
  • Metabolic diseases
  • Drugs
  • Age
54
Q

What is the ECG criteria for supraventricular premature complex?

A
  • No P waves
  • Premature QRS
  • QRS is narrow
55
Q

ECG criteria for supraventricular tachycardia?

A
  • > 3 consecutive SVPC (premature QRS)
  • Narrow QRS
  • Regular rhythm
56
Q

ECG criteria for atrial fibrillation?

A
  • Irregularly irregular rhythm
  • No P waves, instead fibrillation waves
57
Q

ECG criteria for atrial flutter?

A
  • Saw tooth appearance
  • No P waves
58
Q

How can you differentiate Sinus tachycardia vs SVT vs A flutter?

A
  • Do vagal maneuver by providing ocular pressure or a carotid sinus massage to try and increase PNS and dec HR
  • If HR decreases its sinus tachycardia
  • Sinus tachycardia doesn’t exceed 220 bpm in dogs and 280 bpm in cats
59
Q

_________ is a fatal rhythm

A

Ventricular fibrillation

60
Q

ECG criteria for VPC?

A
  • Wide QRS
  • QRS not associated with P wave (AV dissociation)
  • QRS can be positive or neg
61
Q

ECG criteria for ventricular tachycardia?

A
  • > 3 consecutive VPCs
  • Wide QRS
  • QRS not associated with P wave (AV dissociation)
62
Q

ECG criteria for Accelerated Idioventricular Rhythm (AIVR)?

A
  • Same as vtach but not fast
  • Wide QRS
  • QRS not associated with P wave (AV dissociation)
  • No P wave
63
Q

Most common cause of a VPC?

A

Cardiomyopathies

64
Q

ECG criteria for 1st degree AV block?

A
  • Prolonged PR intervals
  • Everything else normal
65
Q

ECG criteria for 2nd degree AV block?

Mobitz Type 1 vs Type 2

A
  • Not every P has a QRS

Mobitz Type 1:
- prolongation of the PR interval before the block
- PR gets longer and longer and then P wave with no QRS

Mobitz Type 2:
- No prolongation of the PR interval before the block
- Normal rhythm and then sudden P wave with no QRS

66
Q

Most common cause of 1st degree AV block?

A

High vagal (PNS) tone
(brachycephalics)

67
Q

Most common cause of Mobitz Type 1 2nd degree AV block?

A

High vagal (PNS) tone
(brachycephalics)

68
Q

Atrial fibrillation is commonly seen in what breeds?

A

Giant dog breeds with a large atrium

69
Q

_________ has a saw tooth appearance on ECG

A

Atrial flutter

70
Q

DDX for a wide QRS complex on ECG?

A
  • Ventricular premature complex
  • Ventricular tachycardia
  • Accelerated Idioventricular Rhythm (AIVR)
71
Q

How can you interpret a TALL P wave?

A

Right atrial enlargement

72
Q

How can you interpret a TALL R wave?

A

left ventricular enlargement

73
Q

How can you interpret a DEEP S wave?

A

Right ventricular enlargement

74
Q

ECG criteria in a calm dog at the vet:

  • Variation in the P wave amplitude
  • PR intervals are consistent
  • Normal HR

Whats going on?

A

Wandering pacemaker

75
Q

Lub - whoosh - dub

What murmur?

A

Systolic click

76
Q

Lub-dub-whoosh

What murmur?

A

Gallop

Diastolic murmur heard during S3/S4

77
Q

Diastolic murmur heard with the bell in a cat, what is the underlying cause?

A

HCM

78
Q

Diastolic murmur heard with the bell in a dog, what is the underlying cause?

A

DCM

SEM 5: SAM 1 (35 decks)

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