Cardiac Rhythm and Recognition Flashcards

1
Q

What are self-adhesive pads used for?

A

Monitor rhythm in a collapsed patient as quickly as possible

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2
Q

What are some features of 3 lead monitors?

A

Display rhythm in real time

One lead on each shoulder and one on the abdomen = red for right, yellow for left, green for abdomen

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3
Q

When is a 12 lead monitor used?

A

If the rhythm is persisting = gives 3D view of the heart

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4
Q

What does the P wave on the ECG represent?

A

Atrial depolarisation

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5
Q

What does the QRS complex represent?

A

Depolarisation of the ventricular myocardium

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6
Q

What does the T wave represent on the ECG?

A

Ventricular repolarisation

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7
Q

How is a regular heart rate calculated?

A

300/number of large squares in R-R interval

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8
Q

How is an irregular heart rate calculated?

A

Multiply the number of cardiac cycles in 30 large squares by 10

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9
Q

What are the six stages of reading the rhythm strip?

A

Is there electrical activity?
What is the QRS rate?
Is the QRS rate rhythm regular or irregular?
Is the QRS width narrow or broad?
Is atrial activity present?
How is atrial activity related to ventricular activity?

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10
Q

What does the width of the QRS indicate?

A
Narrow = rhythm comes from SA node
Wide = comes from ventricular myocardium
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11
Q

Why is it difficult to tell of atrial activity is present?

A

Largely obscured by QRS complex on ECG

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12
Q

What are some features of normal sinus rhythm?

A

Rate 60-100 bpm
Regular P wave to every regular QRS complex
Normal P wave appearance
Normal and constant PR interval

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13
Q

What are some features of atrial flutter?

A

Atrial rate 250-350 bpm
Usually regular QRS
Classic sawtooth appearance
Most commonly 2:1 conduction = 150bpm ventricular and 300bpm atrial

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14
Q

What are some features of atrial fibrillation?

A

Irregularly irregular QRS
Fast or slow AV conduction
No P waves = atrial rate > 350 bpm
Irregular baseline

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15
Q

What are some features of ventricular tachycardia?

A

Rate 100-200 bpm
Regular
Occasional dissociated P waves
Wide bizarre QRS

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16
Q

What are some features of Torsades de pointes?

A
Twisting of axis 
May revert to VF or back to sinus rhythm
Regular or irregular
Associated with electrolyte abnormalities
Sinusoidal pattern
17
Q

What are some features of first degree heart block?

A

Rate depends on underlying rhythm
Physiologic block in AV node
Regular
Prolonged PR interval > 0.2s

18
Q

What are some causes of first degree heart block?

A

Medication, vagal stimulation, disease

19
Q

What are some features of Mobitz type 1 second degree block?

A
Dropped beat
Regularly irregular
Cycle starts over 
Increasing PR interval
Diseased AV node with long refractory period
20
Q

What are some features of Mobitz type 2 second degree block?

A

Same PR interval for all conducted beats
P waves usually regular
Some P waves not conducted
May be 2:1, 3:1 or 4:1 etc

21
Q

What can Mobitz type 2 progress to?

A

Complete heart block

22
Q

What are some features of complete heart block?

A

Atrioventricular dissociation

Regular P waves and QRS complexes but no relationship between the two

23
Q

What is used to treat complete heart block?

A

A pacemaker

24
Q

What leads view the inferior surface of the heart?

A

Leads II, III and AVF

25
Q

What leads view the lateral wall of the left ventricle?

A

Leads I, AVL, V5 and V6

26
Q

What leads view the septal surface of the heart?

A

V1 and V2

27
Q

What leads view the anterior wall of the right and left ventricles?

A

V3 and V4

28
Q

How does right bundle branch block appear on the ECG?

A

Positive R wave in V1

29
Q

How does left bundle branch block appear on the ECG?

A

Negative in V1 and positive in V6

30
Q

What leads view the right coronary artery?

A

Leads II, III, AVF

Also V3 and V4

31
Q

What leads view the circumflex artery?

A

Leads I, AVL, V5 and V6

32
Q

What leads view the lateral anterior descending artery?

A

V1 and V2