Section Three: 3 Lead ECG (15 marks) Flashcards
Rate: 50 bpm
Rhythm: Regular
P Wave: Rounded, upright and precedes every QRS
P-R Interval: Normal
QRS Interval: Normal
Interpretation: SINUS BRADYCARDIA
Everything is normal except the rate is <60bpm
Rate: 100bpm
Rhythm: Regular
P Wave: Rounded, upright and precedes every QRS
P-R Interval: Normal
QRS Interval: Normal
Interpretation: SINUS TACHYCARDIA
Everything is normal except the rate is 100 - 150 bpm
Rate: 80 bpm
Rhythm: Irregular
P Wave: Rounded, upright and precedes every QRS
P-R Interval: Normal
QRS Interval: Normal
Interpretation: SINUS DYSRHYTHMIA
All waves and complex’s are normal except the rhythm is irregular.
Rate: 60 bpm
Rhythm: Irregular
P Wave: Normal
P-R Interval: Prolonged
QRS Interval: Normal
Interpretation: SINUS ARREST
SA node fails to form an impulse. The P-R interval is >2 small boxes in difference (>3 sec standstill)
Rate: 70 bpm
Rhythm: Irregular
P Wave: Abnormal - Inconsistently upright, some inverted or not upright and rounded.
P-R Interval: Where P wave is present it is normal
QRS Interval: Normal
Interpretation: WANDERING ATRIAL PACEMAKER (WAP)
Transient shift between the SA node, atria and AV junction. P waves differ (above isoelectric line/ flattened/ inverted)
Rate: 80
Rhythm: Underlying rhythm is regular
P Wave: Abnormal - disformed/biphasic
P-R Interval: Normal
QRS Interval: Normal
Interpretation: NSR W/ PREMATURE ATRIAL CONTRACTION (PAC)
Extra beat, underlying rhythm is regular, P waves differ to usual morphology
Rate: 210bpm
Rhythm: Irregular
P Wave: Abnormal
P-R Interval: Prolonged
QRS Interval: Normal
Interpretation: ATRIAL TACHYCARDIA
Rate: 90
Rhythm: Regular
P Wave: Absent
P-R Interval: Abnormal
QRS Interval: Normal
Interpretation: ATRIAL FLUTTER.
Sawtooth flutter ‘f’ waves.
Rate: 90
Rhythm: Irregular
P Wave: Absent
P-R Interval: Absent
QRS Interval: Normal
Interpretation: ATRIAL FIBRILLATION
Rate: 210 bpm
Rhythm: Regular
P Wave: Hidden
P-R Interval: Abnormal - Shortened
QRS Interval: Normal
Interpretation: SUPRAVENTRIVULAR TACHYCARDIA (SVT).
Rate of 150-250bpm. Ectopic P waves or hidden P waves.
Rate: 40 bpm
Rhythm: Underlying regular rhythm
P Wave: not present before every QRS
P-R Interval: Prolonged
QRS Interval: Normal
Interpretation: JUNCTIONAL ESCAPE COMPLEX.
An escaped beat after a period of sinus arrest.
Rate: 70
Rhythm: Regular
P Wave: Rounded, upright and precedes every QRS
P-R Interval: Prolonged >5 squares / 0.20 seconds
QRS Interval: Normal
Interpretation: NSR W/ 1ST DEGREE AV BLOCK
Rate: 60
Rhythm: Irregular
P Wave: Up right and rounded
P-R Interval: prolonged
QRS Interval: Normal
Interpretation: 2ND DEGREE AV BLOCK - TYPE 1.
“Ps on the run, it must be type 1”.
PR interval constantly getting greater until failed impulse then the cycle resumes.
Rate: 40 bpm
Rhythm: Regular
P Wave: Up right and rounded - disassociated to QRS.
P-R Interval: Abnormal/absent
QRS Interval: Normal
Interpretation: 2ND DEGREE AV BLOCK - TYPE 2.
“P without a Q, it must be type two”. Extra P waves without QRS complexes (failed impulses). PR interval increased but constant.
Rate: 40
Rhythm: Regular
P Wave: Up right and rounded - not associated with QRS
P-R Interval: Prolonged
QRS Interval: Wide
Interpretation: 3RD DEGREE AV BLOCK.
No association between P and QRS. Ventricular rate <60bpm. Can have wide QRS.
Rate: 40
Rhythm: Regular
P Wave: Absent
P-R Interval: Absent
QRS Interval: Wide and bizarre
Interpretation: VENTRICULAR ESCAPE RHYTHM.
Rate: N/A
Rhythm: Underlying typically regular
P Wave: Normal
P-R Interval: Normal
QRS Interval: Wide and bizarre
Interpretation: _____ WITH A PREMATURE VENTRICULAR COMPLEX (PVCS).
Can be Unifocal or Multifocal.
Single ectopic beat.
Premature = no pause leading into them.
Top image: Ventricular Bigeminy
Bottom image: Ventricular Trigeminy
Rate: 70 bpm
Rhythm: Irregular
P Wave: Inverted
P-R Interval: Shortened
QRS Interval: Normal
Interpretation: ________ W/ PREMATURE JUNCTIONAL COMPLEX (PJC).
Inverted P wave before QRS.
Rate: 180
Rhythm: Regular
P Wave: Absent
P-R Interval: Absent
QRS Interval: Wide and bizarre
Interpretation: VENTRICULAR TECHYCARDIA (VT).
Rate 100-250 bpm. typically regular rhythm. No P waves seen.
Rate: N/A
Rhythm: Irregular
P Wave: Absent
P-R Interval: Absent
QRS Interval: Wide and bizarre
Interpretation: TORSADES DE POINTE.
200 - 250 bpm. Irregular rhythm. No P or T waves distinguishable.
Rate: N/A
Rhythm: N/A
P Wave: Absent
P-R Interval: Absent
QRS Interval: Wide and bizarre
Interpretation: VENTRICULAR FIBRILLATION.
Rate 300-500 bpm
Top Image: Fine VF <3mm amplitude
Bottom Image: Coarse VF >3mm amplitude
Rate: N/A
Rhythm: N/A
P Wave: Absent
P-R Interval: Absent
QRS Interval: Absent
Interpretation: ASYSTOLE.
No electrical activity
Rate: 60 bpm
Rhythm: Regular
P Wave: Absent
P-R Interval: Absent
QRS Interval: Normal
Interpretation: PACEMAKER RHYTHM (dual chamber)
Spike before P wave
