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Phase 1b - Cardiovascular & Respiratory Medicine > Electrocardiography and Rhythm Disorders > Flashcards

Electrocardiography and Rhythm Disorders Flashcards

1
Q

What are these?

A

Electrodes

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2
Q

What are these?

A

Cables/wires

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3
Q

What are these?

A

Leads

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4
Q

What are the 12 leads of ECG?

A

Lead I
Lead II
Lead III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6

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5
Q

Where is Lead I placed?

A

Right Arm to Left Arm

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6
Q

Where is Lead II placed?

A

Right Arm to Left Leg

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7
Q

Where is Lead III placed?

A

Left Arm to Left Leg

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8
Q

Where is aVR placed?

A

Perpendicular to Lead III

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9
Q

Where is aVL placed?

A

Perpendicular to Lead II

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10
Q

Where is aVF placed?

A

Perpendicular to Lead I

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11
Q

Where is V1 placed?

A

Right sternal border in the 4th intercostal space

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12
Q

Where is V2 placed?

A

Left sternal border in the 4th intercostal space

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13
Q

Where is V3 placed?

A

Halfway between V2 and V4

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14
Q

Where is V4 placed?

A

Mid-clavicular line in the 5th intercostal space

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15
Q

Where is V5 placed?

A

Anterior axillary line at the level of V4

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16
Q

Where is V6 placed?

A

Mid-axillary line at the level of V4

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17
Q

What view of the heart does Lead I observe?

A

Lateral

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18
Q

What view of the heart does Lead II observe?

A

Inferior

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19
Q

What view of the heart does Lead III observe?

A

Inferior

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20
Q

What view of the heart does aVR observe?

A

N/A

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21
Q

What view of the heart does aVL observe?

A

Lateral

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22
Q

What view of the heart does aVF observe?

A

Inferior

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23
Q

What view of the heart does V1 observe?

A

Septal

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24
Q

What view of the heart does V2 observe?

A

Septal

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25
Q

What view of the heart does V3 observe?

A

Anterior

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26
Q

What view of the heart does V4 observe?

A

Anterior

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27
Q

What view of the heart does V5 observe?

A

Lateral

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28
Q

What view of the heart does V6 observe?

A

Lateral

29
Q

Which artery does Lead I observe?

A

Left Circumflex Artery

30
Q

Which artery does Lead II observe?

A

Right Coronary Artery

31
Q

Which artery does Lead III observe?

A

Right Coronary Artery

32
Q

Which artery does aVR observe?

A

N/A

33
Q

Which artery does aVL observe?

A

Left Circumflex Artery

34
Q

Which artery does aVF observe?

A

Right Coronary Artery

35
Q

Which artery does V1 observe?

A

Left Anterior Descending Artery

36
Q

Which artery does V2 observe?

A

Left Anterior Descending Artery

37
Q

Which artery does V3 observe?

A

Left Anterior Descending Artery

38
Q

Which artery does V4 observe?

A

Left Anterior Descending Artery

39
Q

Which artery does V5 observe?

A

Left Circumflex Artery

40
Q

Which artery does V6 observe?

A

Left Circumflex Artery

41
Q

Given the conditions:
Calculate the cardiac axis.

A

Opposite side (II) is 2 mm
Adjacent side (aVL) is 4.5 mm
Tan θ = opposite / adjacent
Tan θ = 2 / 4.5
Tan θ = 0.444
θ = Tan-1 x 0.444
θ = 24o (Subtract from 60o)
θ = 36o

42
Q

What are the characteristics of a normal sinus rhythm ECG?

A
  • Each P-wave is followed by a QRS wave (1:1)
  • Rate is regular (even R-R intervals) and normal (83 bpm)
43
Q

What are the characteristics of bradycardia ECG?

A
  • Each P-wave is followed by a QRS wave (1:1)
  • Rate is regular (even R-R intervals) and slow (56 bpm)

Can be healthy, caused by medication or vagal stimulation

44
Q

What are the characteristics of tachycardia ECG?

A
  • Each P-wave is followed by a QRS wave (1:1)
  • Rate is regular (even R-R intervals) and fast (107 bpm)

Often a physiological response (i.e. secondary)

45
Q

What are the characteristics of a sinus arrhythmia ECG?

A
  • Each P-wave is followed by a QRS wave
  • Rate is irregular (variable R-R intervals) and normal-ish (65-100 bpm)
    • R-R interval varies with breathing cycle
46
Q

What are the characteristics of an atrial fibrillation ECG?

A
  • Oscillating baseline – atria contracting asynchronously
  • Rhythm can be irregular and rate may be slow

Turbulent flow pattern increases clot risk
Atria not essential for cardiac cycle

47
Q

What are the characteristics of an atrial flutter ECG?

A
  • Regular saw-tooth pattern in baseline (II, III, aVF)
  • Atrial to ventricular beats at a 2:1 ratio, 3:1 ratio or higher

Saw-tooth not always visible in all leads

48
Q

What are the characteristics of a first degree heart block ECG?

A
  • Prolonged PR segment/interval caused by slower AV conduction
  • Regular rhythm: 1:1 ratio of P-waves to QRS complexes

Most benign heart block, but a progressive disease of ageing

49
Q

What are the characteristics of a second degree heart block (Mobitz I) ECG?

Also called Wenckebach

A
  • Gradual prolongation of the PR interval until beat skipped
  • Most P-waves followed by QRS; but some P-waves are not

Regularly irregular: caused by a diseased AV node

50
Q

What are the characteristics of a second degree heart block (Mobitz II) ECG?

A
  • P-waves are regular, but only some are followed by QRS
  • No P-R prolongation
  • Regularly irregular: successes to failures (e.g. 2:1) or random

Can rapidly deteriorate into third degree heart block

51
Q

What are the characteristics of a third degree heart block ECG?

A
  • P-waves are regular, QRS are regular, but no relationship
  • P waves can be hidden within bigger vectors

A truly non-sinus rhythm – back-up pacemaker in action

52
Q

What are the characteristics of ventricular tachycardia ECG?

A
  • P-waves hidden – dissociated atrial rhythm
  • Rate is regular and fast (100-200 bpm)

At high risk of deteriorating into fibrillation (cardiac arrest)
Shockable rhythm – defibrillators widely available

53
Q

What are the characteristics of ventricular fibrillation ECG?

A
  • Heart rate irregular and 250 bpm and above
  • Heart unable to generate an output

Shockable rhythm – defibrillators widely available

54
Q

What are the characteristics of ST elevation ECG?

A
  • P waves visible and always followed by QRS (1:1)
  • Rhythm is regular and rate is normal (85 bpm)
  • ST-segment is elevated >2mm above the isoelectric line

Caused by infarction (tissue death caused by hypoperfusion)

55
Q

What are the characteristics of ST depression ECG?

A
  • P waves visible and always followed by QRS
  • Rhythm is regular and rate is normal (95 bpm)
  • ST-segment is depressed >2mm below the isoelectric line

Caused by myocardial ischaemia (coronary insufficiency)

56
Q

Identify the ECG.

A

Sinus rhythm

57
Q

Identify the ECG.

A

Sinus bradycardia

58
Q

Identify the ECG.

A

Sinus tachycardia

59
Q

Identify the ECG.

A

Sinus arrhythmia

60
Q

Identify the ECG.

A

Atrial fibrillation

61
Q

Identify the ECG.

A

Atrial flutter

62
Q

Identify the ECG.

A

First degree heart block

63
Q

Identify the ECG.

A

Second degree heart block (Mobitz I)

64
Q

Identify the ECG.

A

Second degree heart block (Mobitz II)

65
Q

Identify the ECG.

A

Third degree heart block

66
Q

Identify the ECG.

A

Ventricular tachycardia

67
Q

Identify the ECG.

A

Ventricular fibrillation

68
Q

Identify the ECG.

A

ST elevation

69
Q

Identify the ECG.

A

ST depression

Phase 1b - Cardiovascular & Respiratory Medicine (21 decks)

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