Mimincs & Morphology

Question 1

Morphology of Left Bundle Branch Block

Answer 1

1) Wide complex QRS
2) Daggered S wave in V1
3) Monophasic R wave in 1 & V6

Question 2

Morphology of Right Bundle Branch Block

Answer 2

1) Wide complex QRS
2) rSR complex / bunny ears in V1
3) slurred S wave in 1 & V6

Question 3

What is an IVCD

Answer 3

Intraventricular conduction delay caused by electrolyte balance
Seen as mixture of RBBB and LBBB morphology

Question 4

Morphology of hyperkalimia

Answer 4

1)Wide complex QRS (IVCD criteria)
2)Pesky T waves in any leads
3)Flattened or widened P waves
4)Prolonged PR interval (0.2s +)

Question 5

Morphology of Wolf Parkinson white

Answer 5

1) Shortened PR interval (less than 0.12s)
2) Delta wave (curved R wave)

Question 6

Right ventricular hypertrophy

Answer 6

Dominant (upright) R wave in V1 (>7mm)
Right axis deviation

Question 7

Left ventricular hypertrophy

Answer 7

Tallest S wave in V1 or V2
Tallest R wave in V5 or V6
= 35mm or more (5 big boxes)

Question 8

Left atrial enlargement morphology

Answer 8

1) lead V1 = Biphasic P wave w/ negative deflection
2) lead I & II = >0.12 wide ‘camel hump’ P wave

Question 9

Right atrial enlargement morphology

Answer 9

1) V1 = biphasic P wave w/ positive deflection
2) I & II = more than 2.5mm tall P wave ‘teepee tent’

Question 10

Normal axis deviation

Answer 10

Lead I = +
Lead aVF = +

Question 11

Left axis deviation

Answer 11

Lead I = +
Lead aVF = -

Question 12

Right Axis Deviation

Answer 12

Lead I = -
Lead aVF = +

Question 13

Extreme right axis deviation

Answer 13

Lead I = -
Lead aVF = -