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DMST 253 Adult Echocardiography 1 > Module 3: ECG And Common Arrythmia > Flashcards

Module 3: ECG And Common Arrythmia Flashcards

1
Q

What is the normal range for PR segments?

A

<200 ms

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2
Q

What is the normal range for the QRS complex?

A

<100ms

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3
Q

What is the 5 step method for diagnosing Rhythms?

A
  1. Heart rate
  2. Rhythm
  3. P waves
  4. PR intervals
  5. QRS complex
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4
Q

In the 5 step method what should we look for in terms of heart rate?

A

Is it normal? Normal heart rate is 60-100 bpm

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5
Q

In the 5 step method what should we look for in terms of rhythm?

A

Regular or irregular

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6
Q

What should we look in the 5 step method for P waves?

A

Is it uniform? One P per QRS

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7
Q

What should we look for in the 5 step method for diagnosing rhythms for PR intervals?

A

Is it normal? <200ms

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8
Q

What should we look for in terms of QRS complex in terms of the 5 step method?

A

Is it normal? <100ms

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9
Q

What is normal sinus rhythm (NSR)? (where it originates and where it goes)

A

Impulse is originating from the SA node and travels through the normal conduction pathway through the heart at a normal rate

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10
Q

What is abnormal sinus rhythm examples? 2

A
  1. Sinus bradycardia
  2. Sinus tachycardia
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11
Q

What is the range for sinus bradycardia?

A

<50-60 bpm

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12
Q

What is the range for sinus tachycardia?

A

> 90-100 bpm

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13
Q

What are bundle branch blocks?

A

A bundle branch block refers to signal slowing up, or being blocked at either the right or left bundle branches. remember the conduction pathway

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14
Q

What two examples of bundle branch blocks?

A
  1. RBBB
  2. LBBB
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15
Q

What is something that we notice about the ECG for a abnormal bundle branch block?

A

The impulse can now go no further

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16
Q

What does the RBBB look like?

A

Rabbit ear appearance

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17
Q

What is an AV block?

A

A disturbance in the conduction at the AV node level.

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18
Q

As the degree increases what happens to the AV block?

A

It gets worse

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19
Q

How many levels of AV blocks are there?

A
  1. First degree
  2. Second degree
  3. Third degree (complete/ AV dissociation)
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20
Q

For a second degree AV block, what are the subcategories?

A
  1. Type I Mobitz/ wenkebach
  2. Type II Mobitz II
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21
Q

What does a 1st degree AV block look like? 2

A
  1. Prolonged PR interval >200ms (1 big square)
  2. One P wave before each QRS
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22
Q

What is a 2nd degree AVB- Mobitz I (wenkenbach) look like?

A

Gradually lengthening PR interval until there is a dropped QRS complex

23
Q

What does the 2nd degree AVB- Mobitz II look like? 2

A
  1. Normal PR interval This is the biggest distinguished
  2. Has P wave with no QRS following
24
Q

What does the 3rd degree AV block (AV dissociation) look like (Think P waves and QRS)? What happens with the ventricles? What does this mean for the patient?

A
  1. There is no association between P waves and QRS complexes
  2. Ventricles are coming up with their own breathing rate
  3. P waves are completely unrelated to the QRS
  4. The patients need a pacemaker
25
Q

What is the AV heart block poem =D

A
26
Q

What are the three types of atrial arrhythmias?

A
  1. Premature atrial contractions
  2. Atrial flutter
  3. Atrial fibrillation
27
Q

Which arrhythmias is the most benign?

A

PAC - Premature atrial contraction

28
Q

What is PAC - Premature atrial contraction?

A

When atrial muscle tissue produces its own impulse leading to atrial contraction followed by ventricular contraction

29
Q

What may premature atrial contraction (PAC) be a result of?

A

Too many catecholamines

30
Q

During a premature atrial contraction what happens during the compensatory pause?

A

The timing is “reset” with the SA node taking over the rhythm again

31
Q

For abnormal atrial contractions, pacemakers set the heart rate how?

A

Very high! At 300bpm

32
Q

What does Atrial flutter look like?

A

AV node cannot handle this high heart rate and only lets through some of the impulses

33
Q

Can a atrial flutter be regular?

A

Every 2nd, 3rd, 4th, etc.

34
Q

For atrial flutter, what is the normal response?

A

1:1 when in normal sinus rhythm

35
Q

What is atrial fibrillation (A- Fib) caused by?

A

Caused by very disorganized atrial contraction
Atria quiver rather than contract

36
Q

What does A-fib look like?

A
  1. Many ectopic atrial electrical signals competing to pace the heart.
  2. Rhythm is very irregular
37
Q

What is A-fib associated with? 2

A
  1. Atrial enlargement
  2. Patient will lose their “atrial kick”
38
Q

What are three types of ventricular arrhythmias?

A
  1. Premature ventricular contractions
  2. Ventricular tachycardia
  3. Ventricular fibrillation
39
Q

PVC - Premature ventricular contraction looks similar to what?

A

PAC

40
Q

What may cause PVC - Premature ventricular contraction? 2

A
  1. Catecholamines, stress are the most often cause
  2. May also be caused by a partially blocked artery causing a zone of ischemia
41
Q

What is PVC - premature ventricular contraction usually followed by?

A

Compensatory pause

42
Q

What does the zone of ischemia look like?

A

It has altered ions within it which alters the impulse formation and propagation properties leading to PVC

43
Q

For a PVC - Premature ventricular contraction, because QRS is early, what happens?

A

No preceding P wave

44
Q

Is multiple PVCs significant findings?

A

No!

45
Q

Multiple PVC can occur in what kind of intervals? 3

A
  1. 2s (couplets)
  2. 3s (triplets)
  3. 4s (quadruplets)
46
Q

Wha this does Ventricular tachycardia (VT) look like)?

A
  1. Very rapid, but coordinated ventricular beats
  2. Re- entry loop through the ventricles only
47
Q

What is Ventricular arrhythmias caused by? (conditions)

A

Myocardial infarctions

48
Q

What is a sustained ventricular tachycardia? (Think urgency)

A

Medical emergency

49
Q

What happens during ventricular fibrillation (VF)? 2

A
  1. Very rapid, incoordinate motion
  2. Ventricles cannot beat, but rather quiver
50
Q

What kind of situation is Ventricular fibrillation?

A

Extremely emergent situation

51
Q

What are some misc ECG findings? 4

A
  1. ST segment changes
  2. Wolff- Parkinson’s- white syndrome
  3. Asystole
  4. Bigeminy
52
Q

What does ST segment depression indicate?

A

Myocardial ischemia

53
Q

If the ST segment is elevated it indicates what?

A

Myocardial infarction

54
Q

How do we compare the level of the ST segment?

A

With the PR segment

DMST 253 Adult Echocardiography 1 (27 decks)

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