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ECG > Revison Session > Flashcards

Revison Session Flashcards

1
Q

What controls the heart rate?

A

SNS

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2
Q

What can cause broad ventricular complex?

A

Bundle beach block (SA node, tachy rate, PR ratio 1:1)
Ventricular ectopic (140 bpm, pacemaker faster then SA node)
Packer originates in the bundle of His due to failure of atrial pacemaker (20-40 bpm, ventricular pacemaker)

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3
Q

What does broad ventricular complex show?

A

Some of the heart is not depolarising

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4
Q

What does narrow ventricular complex show?

A

Impulse starts in the atria

Both bundle branches are working

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5
Q

What does a regular rhythm mean?

A

There is only one pacemaker

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6
Q

What does an irregular rhythm mean?

A

There are several pacemakers

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7
Q

What is important to remember about absent P waves?

A

Just because there are no P waves, doesn’t mean there is no atrial beat. Do a 12 lead ECG to make sure

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8
Q

When does a nodal beat occur?

A

Before the QRS complex

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9
Q

When does a junctional beat occur?

A

After the QRS complex

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10
Q

What does a long PR interval mean?

A

There is a change in AV conduction

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11
Q

What are the most common rhythms?

A

Af, AV blocks and VT

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12
Q

What are the 2 reasons for prolonged PR interval?

A
  1. AV node conduction problem (normally diseased) - shown as narrow complex QRS (40-60), treat with atropine to speed up AV node
  2. 1 bundle branch dead and 1 bundle branch ischeamic, causing conduction to take longer - shown as broad complex QRS. Can lead to full block
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13
Q

What is the key characteristic of 1st degree AV block?

A

Prolonged PR interval

Narrow complex

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14
Q

What is the cause of 1st degree AV block?

A

Inferior infarcts

Drugs: adenosine, beta blockers, digoxin

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15
Q

What does 3rd degree AV block normally look like?

A

Broad complex due to damage in bundle branches and pacemaker below bundle of His Junction

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16
Q

What are the potential causes of 3rd degree AV block?

A

AV node died (narrow complex)

Both bundle branches died (more complex)

17
Q

What is the treatment for 3rd degree AV block?

A

Pace the rhythm

18
Q

What is the main characteristic of 2nd degree type 1 AV block?

A

PR interval increases each beat, then the ventricular beat drops, then the sequence repeats
Normally narrow complex

19
Q

What are the key characteristics of 2nd degree type 2 AV block?

A

Broad complex due to bundle block, leading to a conduction problem lower down the bundle of His
Normal PR interval meaning AV node is ok
PR ratio = equal distances apart (measure PP interval), >1:1

20
Q

What does 2nd degree type 2 AV block normally mean?

A

One bundle branch dead and one diseased which could block any minute

21
Q

What is the main treatment for 2nd degree type 2 AV block?

A

Pacing - aim for elective pacing

22
Q

What are the key characteristics of 3rd degree AV block?

A

Regular P waves
No PR interval so no PR ratio as the P waves are different every time
Narrow complex = conduction mode failure
Broad complex = higher atrial rate, low pacemaker (bundle branch)

23
Q

What are the 3 things that mean a rhythm strip can only be sinus rhythm?

A
  1. Rhythm starts in the SA node causing an upright P wave
  2. Rate = 60-170 (higher rate due to low BP and low O2)
  3. PR ratio = 1:1
24
Q

What is the treatment for 3rd degree AV block?

A

Pacing

25
Q

What is the cause of AF?

A

Pacemaker beats that come from the pulmonary vein root causing multiple beats, eventually leading to fibrosis

26
Q

What are the risk factors of AF?

A

Age

Genetics - fat tissue pockets

27
Q

Why is AF so dangerous for pts?

A

AF can lead to clot formation due to congealed blood, eventually leading to a PE or stroke
Atrial kick is also lost

28
Q

How do you diagnose AF?

A

Do a 12 lead ECG

Listen to the heart for an apex beat and feel for the pulse at the same time - it will be mismatched

29
Q

What are the key characteristics of AF

A

Rhythm = very irregular

No P wave

30
Q

What are the characteristics of rapid response AF?

A

Doesn’t look like AF
Rhythm = irregular
Complex is the same shape so the impulse is coming from the same place
Can’t see fibrillation waves easily

31
Q

What is the treatment of AF?

A

Warfrinise the pt for a month then synchronise cardioversion
Long term = ablation of the pulmonary vein (PVI) - forms scar tissue which contain the AF conductors and last for up to 1-2 years

32
Q

What is important to remember about the rhythm of VT?

A

Always regular

33
Q

What is important to remember about VF rhythm?

A

All the complexes are different shapes

ECG (19 decks)

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