Abnormal ECGs

Question 1

what is a supraventricular rhythm

Answer 1

any rhythm which originats above the av node, whether conducted through it or not

Question 2

what do you usually see in an ecg on a supraventricular rhythm

Answer 2

narrow qrs

Question 3

what are the main types of supraventricular rhythms

Answer 3

sinus rhythm afib aflutter sinus arrhythmia svt wandering atrial pacemaker Atrioventricular nodal reentry tachycardia (AVNRT) WPW

Question 4

what is sinus arrhythmia

Answer 4

meets all the criteria for of sinus rhythm but the rhythm itself is irregular

Question 5

what causes sinus arrhythmia

Answer 5

physiological changes in cardiac timing caused by respiration

Question 6

afib occurs due to

Answer 6

disorganised electrical activity of the atria

Question 7

aflutter occurs due to

Answer 7

re-entry circuit within the atria

Question 8

saw tooth baseline

Answer 8

aflutter

Question 9

irregularly irregular

Answer 9

afib

Question 10

what is junctional rhythm

Answer 10

impulse begins in the av node instead of the sa node

Question 11

what is the main thing seen on ecg in junctional rhythm

Answer 11

inverted p waves

Question 12

what is svt

Answer 12

tachy that originates above or involves the av node

Question 13

what does svt generally involve

Answer 13

an accessory pathway like in wpw

Question 14

what is seen on an ecg of supraventricular ectopics

Answer 14

differing morphologies of p waves with varying pr and rr intervals

Question 15

supra/ventricular rhythms are always pathological

Answer 15

ventricular

Question 16

are ventricular rhythms broad or narrow qrs complexes

Answer 16

broad >120ms

Question 17

what are the 5 ventricular rhythms

Answer 17

ventricular premature complexes ventricular tachy polymorphic ventricular tachy ventricular escape rhythm ventricular fib

Question 18

what are ventricular complexes - bigeminy

Answer 18

1 sinus beat coupled with a vpc

Question 19

what are ventricular complexes - trigeminy

Answer 19

1 sinus beat coupled with 2 vpc

Question 20

what is a capture beat

Answer 20

a sinus beat conducted through the av node and beats the next vt beat - results in early narrow complex beat

Question 21

what are fusion beats

Answer 21

fusion between a sinus beat and the next vt beat

Question 22

a good predictor of svt is pre-existence of

Answer 22

lbbb or rbbb

Question 23

a good predictor of vt is pre existing

Answer 23

coronary disease

Question 24

capture and fusion beats are almost diagnostic of

Answer 24

vt

Question 25

what is heart block

Answer 25

block in conduction nbetween atria and ventricles

Question 26

what causes heart block

Answer 26

av nodal dysfunction due to drugs ischaemia or age

Question 27

1st degree heart block

Answer 27

prolongued pr \>200ms

Question 28

2nd degree heart block Mobitz type 1

Answer 28

progressive pr prolongation until drop in qrs

Question 29

2nd degree heart block Mobitz type 1 treat

Answer 29

not treated unless severe or accompanied with collapse or heamodynamic compromise

Question 30

2nd degree Mobitz type 2

Answer 30

constant pr p wave without a qrs

Question 31

2nd degree Mobitz type 2 treat

Answer 31

needs intervention

Question 32

3rd degree heart block

Answer 32

no relationship between p and qrs - no communication between atria and ventricle

Question 33

3rd degree heart block treat

Answer 33

needs intervention

Question 34

what are fascicles

Answer 34

av node lahb lphb rt bundle branch

Question 35

what is bifascicular block

Answer 35

blockade of two fascicles

Question 36

what are the criteria for biphasicular block

Answer 36

pr\>200ms left axis deviation rbbb

Question 37

what are the criteria for triphasicular block

Answer 37

pr\>200ms left axis deviation rbbb or alternation rbbb and lbbb

Question 38

what are the main rhythms associated with circulatory arrest

Answer 38

vfib vtach complete av block pea

Question 39

vtach arrhythmias untreated can turn into

Answer 39

vtach vfib asystole

Question 40

focus on what changes in isxhaemia and infarction

Answer 40

st t q

Question 41

purple? pink? green?

Answer 41

Question 42

what are the main t wave changes seen in ischaemia

Answer 42

tall biphasic inverted flattened

Question 43

st depression is a marker of

Answer 43

deep ischaemia

Question 44

what are pathological q waves

Answer 44

Question 45

other causes of st elevation

Answer 45

Question 46

what is a good alternative to thrombolysis if the patient does not look like they have had an mi

Answer 46

cath lab

Question 47

how to diagnose stemi in presence of lbbb

Answer 47

Question 48

st segment depression in v1-3

Answer 48

posterior infarct

Question 49

pericardial inflammation secondary to MI or infection leads to symptoms of ...

Answer 49

pleuritic chest pain fever pericardial rub

Question 50

ecg changes consistent with pericardial inflammation

Answer 50

Question 51

what causes physiological hypertrophy of the heart

Answer 51

exercise or pregnancy

Question 52

unhealthy cardiac myopathy is in response to

Answer 52

hypertension, heart muscle injury, neurohormones, and heart failure