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Yr3Sem2 Exercise for Health and Disease Prevention > Week 02 - ECG (heart block) > Flashcards

Week 02 - ECG (heart block) Flashcards

1
Q

First degree heart block is the delay between …?

A

atrial and ventricular depolarisation (longer PR interval)

- 1:1 ratio of P wave to QRS

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2
Q

Second degree heart block occurs when …?

A

excitation intermittently fails to pass through the AV node or bundle of His

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3
Q

Mobitz type 2 is when one __ wave not….?

A

P wave is not followed by a QRS complex

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4
Q

Wenckebach type 2:

A
  • progressive lengthening of PR interval
  • timing issue
  • One non conducted P wave
  • Next conducted beat has a shorter PR interval than the preceding conducted beat
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5
Q

2:1 type 2:

A
  • Two P waves per QRS complex
  • Normal, constant, PR interval in conducted beats
  • P wave in the T wave can be identified because of its regularity
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6
Q

Third degree heart block is also known as ___ heart block

A

complete

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7
Q

Third degree heart block

A
  • Atrial contraction normal but no conduction through to the ventricles
  • Ventricle depolarisation occurs within the ventricles
  • Called ‘escape rhythm’, results in wide QRS
  • PR interval will be variable, and no relationship between P waves and QRS complexes
  • May be chronic and due to fibrosis around bundle of His
  • Can also be caused by block of both bundle branches
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8
Q

Right Bundle Branch Blocks

A
  • No conduction through R bundle branch
  • L ventricle depolarised before R
  • Takes longer than normal to depolarise the R ventricle
  • Causes a second R wave in V1 and a wide / deep S wave in V6 (aka RSR pattern)
  • Best vied : V1
  • Reaches back to baseline
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9
Q

Left Bundle Branch Blocks

A
  • No conduction down L bundle branch
  • R ventricle depolarised before L ventricle
  • LBBB is best seen in lead V6: shape of M (doesn’t reach back to baseline)
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10
Q

What is this??

  • Often seen in normal people
  • Acute myocardial infarction and acute rheumatic fever can be possible causes
  • No specific action needed
A

First degree heart block

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11
Q

What is this??

- Usually indicates heart disease; often seen in acute MI

A

Second degree heart block

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12
Q

Mobitz type 2 and Wenckebach block treatment?

A

Do not need specific treatment

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13
Q

2:1, 3:1 and 4:1 block treatment and indications?

A

May indicate a need for temporary or permanent pacing, especially if the ventricular contraction is slow

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14
Q

Third degree block treatment and indicaition?

A
  • Always indicates conducting tissue disease – more often fibrosis than ischemia
  • Consider a permanent or temporary pacemaker
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15
Q

Finding Heart Rhythm: __ lead ECG is better than rhythm strip (V2) for detecting arrhythmias

A

12

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16
Q

Finding Heart Rhythm: Locate …?

A

lead showing best P waves

17
Q

Finding Heart Rhythm: Relationship between P waves and QRS complex should be ____

A

1:1

18
Q

Finding Heart Rhythm: QRS width?

A

Width of QRS complex <120ms

19
Q

Sinus Arrhythmia (HRV) is…

A
  • Good arrhythmia
  • Non pathological; high HRV (not continuous beats, pattern, not even, heart rate variability high) = better health
  • RR interval different distance each beat
20
Q

Abnormal Rhythms can begin in….

A
  • atrial muscle
  • region around the AV node
  • Ventricular muscle
21
Q

Abnormal Rhythms are divided into….(2)?

A
  • Supraventricular arrhythmias
    • Normal QRS complexes (<120ms)
  • Ventricular arrhythmias
    • wide QRS complexes
22
Q

Bradycardias

A

Aka escape rhythm/beat:

  • Occur as fail safe mechanism when SA fails to depolarise
  • Can occur at the atria, AV node or in the ventricles
  • Takes time to kick in
23
Q

Extrasystoles

A
  • Premature contraction, early
  • Any part of the heart can occur early
  • Can occur at the atria, AV node or in the ventricles
24
Q

Types of Tachycardias…

A
  • Atrial tachycardia
  • Atrial flutter
  • Ventricular tachycardia
25
Q

Atrial tachycardia:

A
  • Atria depolarises > 150 times / min

- P waves may be superimposed on preceding T waves, but not always

26
Q

Atrial flutter:

A
  • atria depolarises > 250 times/min
  • Not all P waves conducted
  • Similar the 2nd degree heart block, but includes tachycardia
27
Q

Ventricular tachycardia:

A
  • Excitation occurs by an abnormal path through to the ventricles
  • QRS complexes become wide and abnormal
  • Seen in all leads
  • High frequency ventricular depolarizations
28
Q

Fibrillation

A
  • Muscle fibres contact independently
  • Can occur in atria or ventricles
  • Atrial or ventricular
29
Q

Atrial Fibrillation:

A
  • No P waves, just irregular line

- Irregular but normally shaped QRS complexes

30
Q

Ventricular Fibrillation:

A
  • aka cardiac arrest
  • No QRS complexes; ECG totally disorganized
  • Ventricles cannot contract
  • Patient will lose consciousness
  • First aid: AED, CPR, Precordial thump
31
Q

Abnormally wide QRS–>

A

bunch branch block, ventricular escape beats, extrasystoles, tachycardia

32
Q

Abnormalities: ___: hypertrophy of R atrium
_____: hypertrophy of L atrium

A

Pealed, Broad / bifid

33
Q

Increased height of QRS: L ventricular hypertrophy:

A
  • Tall R wave in leads V5/V6
  • inverted T waves in leads I, VL, V5, V6 and sometime V4
  • L axis deviation
  • Seen in endurance athletes but also hypertensive people
34
Q

Abnormal Q waves

A
  • Depolarisation of septum
  • If Q wave is wider than 40ms and deeper than 2mm indicates a previous MI
  • Q wave abnormality is usually permanent
  • Death of heart muscle = no electrical activity
35
Q

Abnormal ST segment

A
  • ST should return to baseline (isoelectric) after each beat

- Elevation of ST = having an acute MI

36
Q

ST-segment elevation MI (STEMIs):

A
  • Full thickness
  • see elevation
  • T wave inversions can be permanents
37
Q

Non-ST-segment elevation MI (NSTEMIs):

A
  • Not full thickness

- No ST segment elevation

Yr3Sem2 Exercise for Health and Disease Prevention (7 decks)

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