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BRS Flashcards (Y2) > Electrocardiography And Rhythm Disorders > Flashcards

Electrocardiography And Rhythm Disorders Flashcards

1
Q

What are the 3 classes of abnormalities in the heart?

A

Conduction abnormalities
Structural abnormalities
Perfusion abnormalities

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2
Q

What are the advantages of ECGs?

A

Relatively cheap and easy to undertake
Reproducible between people and centres
Quick turnaround on results and reports

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3
Q

What is meant by a vector?

A

A quantity that has both magnitude and direction

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4
Q

What does an isoelectric line for a lead represent, with reference to relative vector position to lead?

A

No net change in voltage
Vectors are perpendicular to lead

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5
Q

What does an upwards deflection mean about the position of the vector relative to the lead?

A

Travelling towards positive electrode

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6
Q

What does a downwards deflection mean about the position of the vector relative to the lead?

A

Travelling towards negative electrode

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7
Q

What does the steepness and width of the line denote?

A

Steepness - Velocity of an action potential
Width - Duration of an event

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8
Q

What does the P wave show?

A

Electrical signal that stimulates contraction of the atria

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9
Q

What does the QRS complex show?

A

Electrical signal that stimulates contraction of the ventricles (ventricular systole)

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10
Q

What does the T wave show?

A

The electrical signal that signifies relaxation of the ventricles (ventricular repolarisation)

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11
Q

What part of an ECG wave reflects atrioventricular node activity?

A
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12
Q

What part of an ECG wave reflects Bundle of His activity?

A
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13
Q

What part of an ECG wave reflects bundle branches activity?

A
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14
Q

What part of an ECG wave reflects Purkinje fibres activity?

A
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15
Q

What part of an ECG shows fully depolarised ventricles?

A
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16
Q

In the image below, add where the leads I, II, III, aVR, aVL, aVF would go?

A
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17
Q

Where do the leads V1-6 go?

A

V1 - Right sternal border in the 4th intercostal space
V2 - Left sternal border in the 4th intercostal space
V3 - Halfway between V2 and V4
V4 - Mid-clavicular line in the 5th intercostal space
V5 - Anterior axillary line at the level of V4
V6 - Mid-axillary line at the level of V4

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18
Q

Which leads represent the Left Circumflex Artery?

A

Lead I
Lead aVL
Lead V5
Lead V6
(Lateral leads)

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19
Q

Which leads represent the Right Coronary Artery?

A

Lead II
Lead III
Lead aVF
(Inferior leads)

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20
Q

Which leads represent the Left Anterior Descending Artery?

A

Lead V1
Lead V2
Lead V3
Lead V4
(Anteroseptal leads)

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21
Q

What plane are the limb leads in?

A

Coronal

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22
Q

What plane are the chest leads in?

A

Horizontal

23
Q

How do you calculate the heart rate from an ECG?

A

300/(No. of big squares in R-R interval)

24
Q

A P-R interval below what is abnormal?

A

3 small squares

Note : A normal PR interval is 0.12-0.2s = 3 to 5 small squares!

25
Q

What are the average rates for different intervals/rates on an ECG?

A
26
Q

Outline the ECG reporting procedure

A
27
Q

What is the heart rate interval in normal sinus rhythm generally?

A

60-100bpm

28
Q

What is sinus rhythm characterised by?

A

Each P-wave is followed by a QRS complex (1:1)
Rate is regular

29
Q

What is the heart rate interval in sinus bradycardia generally?

A

Under 60bpm

30
Q

Can sinus bradycardia be healthy and what is it caused by?

A

Yes
Medication or vagal stimulation

31
Q

Can sinus tachycardia be healthy?

A

Yes often a secondary physiological response

32
Q

What defines sinus arrhythmia?

A

Rate is irregular - variable R-R intervals
R-R interval varies with breathing cycle

33
Q

Is heart rate normal in sinus arrhythmia?

A

Relatively normal
65-100 bpm

34
Q

How would you describe the ECG in atrial fibrillation?

A

Oscillating baseline - atria contracting asynchronously

35
Q

Would the rhythm and rate be affected in atrial fibrillation?

A

Rhythm can be irregular
Rate may be slow

36
Q

Why does atrial fibrillation increase clot risk?

A

Turbulent blood flow

37
Q

In atrial flutter, how would you describe the ECG?

A

Regular saw-tooth pattern in baseline (II, III, aVF)

38
Q

What is the ratio of atrial to ventricular beats in atrial flutter?

A

2:1 or 3:1 or higher

39
Q

Is Saw-tooth pattern visible in all leads?

A

Not always

40
Q

How would you describe the ECG changes in first degree heart block?

A

Prolonged P-R segment/interval caused by slower AV conduction however regular rhythm (1:1 P wave to QRS)

41
Q

Is first degree heart block a progressive disease of ageing?

A

Yes

42
Q

What are the ECG changes in second degree heart block Mobitz I?

A

Gradual prolongation of PR interval until beat skipped
Most P-waves followed by QRS complex but some are not
Regularly irregular

43
Q

What is second degree heart block caused by?

A

Diseased AV node

44
Q

How would you describe the changes in second degree heart block Mobitz II?

A

P waves are regular but only some are followed by QRS
No P-R prolongation
Regularly irregular: successes to failures (2:1) or random
Can rapidly deteriorate into third degree heart block

45
Q

What are the changes in ECG caused by third degree (complete) heart block?

A

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

46
Q

Is there sinus rhythm in third degree heart block?

A

Non-sinus rhythm - back-up pacemaker required

47
Q

In ventricular tachycardia, how would you describe the ECG?

A

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

48
Q

What is dangerous about ventricular tachycardia?

A

High risk of deteriorating into fibrillation (cardiac arrest)
Shockable rhythm - defibrillators widely available

49
Q

In ventricular fibrillation, how would you describe the changes in the ECG?

A

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

50
Q

Does ventricular fibrillation have a shockable rhythm?

A

Yes - defibrillators widely available

51
Q

How would you describe the ECG changes in ST elevation?

A

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

52
Q

What causes ST elevation?

A

Infarction - tissue death caused by hypoperfusion

53
Q

How would you describe the changes in ECG during ST depression?

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

54
Q

What causes the ST depression?

A

Myocardial ischaemia (coronary insufficiency)

BRS Flashcards (Y2) (79 decks)

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