F - ECG Collections of Clinical Significance

Question 1

What wave is associated with atrial enlargement?

Answer 1

P wave
P-pulmonale wave - Right atrium
P-mitrale wave - Left atrium

Question 2

What does a P-mulmonale P wave look like?

Answer 2

The P wave is peaked with amplitude > .25 mv
in leads II, III, aVF
> .1 mv in lead V1 and V2

Question 3

What is a P-mitrale wave?

Answer 3

Left atrial enlargement (LAE)
P wave it broad, notched and .11 seconds
Causes - MS, MR

Question 4

What is the most common cause of LVH?

Answer 4

(Left ventricular hypertrophy)
Hypertension
Other causes: AS, AI, hypertrophic cardiomyopathy and coarctation of aorta

Question 5

What are the defining characteristics of LVH?

Answer 5

Wall of LV is thicker so impulse will take longer to transverse it
Voltage and interval of QRS complex will increase producing deeper S waves over RV and taller R waves over LV

Question 6

What are the 3 measurements for Sokolow Lyon Criteria for LVH?

Answer 6

R in I + S in III > 25 mm
R in aVL > 11 mm
R in V6 > 26 mm

Question 7

What are the causes of RVH?

Answer 7

COPD - most common
RVOT obstruction, VSD
Congenital - tetralogy of Fallot, pulmonic stenosis, transposition of great vessels
Mitral stenosis, tricuspid regurg

Question 8

ECG changes associated with RVH?

Answer 8

R waves assume prominence in R precordial leads and deep S waves develop in L precordial leads
R:S ratio greater than 1 in V1

Question 9

Causes of Sinus Tach?

Answer 9

Phys/path process
Look for cause to treat
Emotion, hyperthyroid, fever, preggo, anemia, CHF, hypovolemia

Question 10

Atrial fibrillation

Answer 10

Irregular rhythm
-continuous chaotic atrial spikes
-irregular ventricular rhythm
*absence of P wave - replaced with irreg 'f' waves
Normal QRS, irreg in time

Question 11

Combination of A.fib + RAD =

Answer 11

Mitral stenosis

Until proven otherwise

Question 12

What are the ECG characteristics of Atrial Flutter?

Answer 12

Saw tooth ‘F’ waves in inferior leads (2,3,aVF)
Sharp P-like wave in V1
Normal QRS in a 2:1 - 8:1 AV ratio
T wave may distort the F wave pattern

Question 13

Multifocal atrial tach

Answer 13

(MAT)
3 or more different P waves (freq PAC's)
P-R interval varies
Irregular rhythm
Associated with lung disease, drugs

Question 14

Characteristics of ventricular premature beats

Answer 14

(PVC’s, VPB’s) aka ectopic beat, extra systole
Consider the setting - normal, stress, hypoxia, drugs
CHF, MI, Low K+, Low Mg+, cardiomyopathy

Question 15

Characteristics of ventricular premature beats ECG

Answer 15

Premature
QRS prolonged
ST segment slope is away in opposite to QRS
Following PVC long pause that compensates for the prematurity

Question 16

Which ecg looks like a sawtooth?

Answer 16

Atrial flutter

Question 17

Which ecg has 3 or more types of P waves?

Answer 17

Multifocal atrial tachycardia

Question 18

Which ecg has premature beats and compensatory pause

Answer 18

PVC - premature ventricular contractions

Question 19

Which ecg has continuous atrial spikes and no P waves?

Answer 19

Atrial fibrillation

Question 20

Ventricular tachycardia characteristics?

Answer 20

At least 3 consecutive bizarre QRS complexes
120-200 / minute
P wave often lost, if seen no relationship to QRS

Question 21

Which ecg has straight row or QRS?

Answer 21

V tach

Question 22

Characteristics of ventricular fibrillation

Answer 22

No regular rate or pattern, course

Ventricles ineffective in pumping blood, terminal unless shocked