ECG Blocks Flashcards

1
Q

What is a first degree block?

A

When the electrical signal starts at SAN, but is delayed at the AVN.

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2
Q

What are the causes of a first degree block?

A
  • AVN damage
  • Hypoxia
  • Increased vagal tone
  • Drug toxicity
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3
Q

What is the key characteristic that is shown in a first degree block?

A
  • P-R interval is >0.2
  • P-R interval is consistently delayed
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4
Q

What is a Type 1 second degree heart block?

A

Where the electrical signal that starts at the SAN gradually increases in delayed att the AVN, till a point where it is not passed through the AVN. This eventually reverts back to normal complex.

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5
Q

Define a Second degree, type 2 block?

A

Where the AVN conducts most beats, but blocks every 2nd, 3rd or 4th beath.

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6
Q

What are the characteristics of a Secondary degree, type block?

A
  • Rate normal/slow
  • P waves normal,
  • Not every P has a QRS
  • Atrial regular, ventricular irregular
  • P - R interval is normal,
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7
Q

Define 2:1 AV block.

A

Where the AVN conducts every second signal from the SAN.

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8
Q

What occurs with the hearts conductive pathway in a 3rd degree heart block?

A
  • There is no signal passed through the AVN, meaning ventricles depolarise autonomsly.
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9
Q

What are the characteristics for a 3rd degree bundle branch block?

A
  • Vertricular rate 20-40
  • Atrial and ventricular rate regular
  • Radial pulse feels bradycardic
  • No relationtionship between the P waves and the QRS complex.
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10
Q

What are the causes of 3rd degree heart block?

A
  • Mi
  • Conductive system damage
  • Drug toxicity
  • Increased vagal tone
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11
Q

What is the clinical significance of a 3rd degree heart block?

A
  • Decreased Cardiac output
  • Hypotenssion
  • Hypoperfusion
  • May progress quickly to VF
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12
Q

What is the pre-hospital treatment for 3rd degree heart block?

A
  • Atropine may increase SAN and AVN activity
  • Treatment of bradycardia symptoms,
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13
Q

In what direction does the septum depolarise?

A
  • Left to right
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14
Q

Why does the QRS get wider in bundle branches?

A

Delay going down the bundle branches, due to areas not conducting impulse.

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15
Q

What leads are right bundle branch most likely to show in?

A
  • V1 and V2
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16
Q

What leads are likely to show left bundle branch block?

A
  • V5, V6 and L1
17
Q

What are the characteristics of a right bundle branch block?

A
  • QRS >0.21 (210ms)
  • V1 shows RSR complex
  • V1 and V6 show slurred S wave
18
Q

What are the common causes or right bundle branch block?

A
  • Diseases of the right side of the heart,
  • Diseases of the lings (PE, Pulmonary hypotension)
19
Q

What is the clinical significance of a right bundle branch block?

A
  • Can be normal
  • Can indication problems of the right side of the heart,
  • Can be a sign of atrial septal defect
20
Q

What are the characteristics of a left bundle branch block?

A
  • QRS ?0.12 (120ms)
  • V1 is broad and monomorphic
  • L1 and V2 broad complex R wave, with no Q wave
21
Q

In a left bundle branch block, which side of the septum depolarises first?

A

Right side

22
Q

What are the common causes of Left bundle branch block?

A
  • Hypertension
  • Coronary atery disease
  • infiltrative diseases of the heart
  • dilated cardio myopathy
  • Rheumatic heart diseases
  • Benighn/ Idiopathic causes