Cardio

Question 1

Which ECG leads monitor the inferior aspect of the heart?

Answer 1

II, III, aVF

Question 2

Which ECG leads monitor the lateral aspect of the heart?

Answer 2

I, aVL, V5, V6

Question 3

Which ECG leads monitor the anterior aspect of the heart?

Answer 3

V3, V4

Question 4

Which ECG leads monitor the septal aspect of the heart?

Answer 4

V1, V2

Question 5

What is the normal QRS axis?

Answer 5

-30 to +90

Question 6

What is the range for Left axis deviation?

Answer 6

-30 to - 90

Question 7

What is the range for right axis deviation?

Answer 7

+90 to +180

Question 8

What is the usual cause of right axis deviation?

Answer 8

Right ventricular hypertrophy

Question 9

What is the usual cause of left axis deviation?

Answer 9

Conduction defects

Question 10

How do you work out the heart rate for regular rhythms?

Answer 10

300 / number of big boxes

1500 / number of small boxes

Question 11

How do you work out the heart rate for irregular rhythms?

Answer 11

Count beats on rhythm strip and x6

Question 12

What does the P wave represent?

Answer 12

Atrial depolarisation - combination of left and right

Question 13

What does right atrial enlargement look like on an ECG?

Answer 13

Taller P wave >2.5mm

Question 14

What does a P wave taller than >2.5mm suggest?

Answer 14

Right atrial enlargement

Question 15

What does left atrial enlargement look like on an ECG?

Answer 15

Wider P wave >120ms (3 small squares)

May be M shaped - P. mitrale

Question 16

What does a wide P wave >120ms suggest?

Answer 16

Left atrial enlargement

Question 17

What is the PR interval?

Answer 17

Start of P wave until end of QRS

Question 18

What does the PR interval represent?

Answer 18

Conduction through the AV node

Question 19

What is the normal duration of a PR interval?

Answer 19

120-200ms

3-5 small squares

Question 20

What does a PR interval >200ms suggest?

Answer 20

First degree heart block - delayed conduction through AV node

Question 21

What do progressively increasing PR intervals suggest?

Answer 21

2nd degree heart block (Mobitz I) - not all atrial impulses reach vetricles

Question 22

What does a PR interval <120ms suggest?

Answer 22

Wolff-Parkinson-White syndrome - accessory pathway allows early activation of the ventricle

Question 23

What is the PR segment?

Answer 23

End of P wave until start of QRS

Question 24

What does a normal PR segment look like?

Answer 24

Flat, isoelectric

Question 25

What is PR segment depression suggestive of?

Answer 25

Pericarditis

Question 26

What does the QRS complex represent?

Answer 26

Contraction of the ventricles

Question 27

What does a normal QRS complex look like?

Answer 27

70-100ms wide | S wave <30mm deep

Question 28

What does a narrow QRS complex (<70ms) suggest?

Answer 28

Originating supraventricularly - SAN, AVN, atria | Third degree Hid bundle heart block

Question 29

What does a broad QRS (>100ms) suggest?

Answer 29

BBB, Hyperkalaemia, W-P-W syndrome, Hypothermia

Question 30

How do you determine Left ventricular hypertrophy on an ECG?

Answer 30

S wave in V1 > 35mm | R wave in V5/6 > 35mm

Question 31

What does a Q wave represent?

Answer 31

Left-to-right depolarisation of the interventricular septum

Question 32

When is a Q wave pathological?

Answer 32

>40ms wide >2mm deep or >25% depthy of QRS complex Seen in leads V1-3 Absent in V5-6

Question 33

What is the ST segment?

Answer 33

End of S wave until beginning of T wave

Question 34

What does the ST segment represent?

Answer 34

Time between ventricular depolarisation and repolarisation

Question 35

What is the J point?

Answer 35

Point between QRS and ST segment

Question 36

What does ST elevation suggest?

Answer 36

Myocardial infarction - STEMI Prinzmetal's angina Pericarditis LBBB

Question 37

What does ST depression suggest?

Answer 37

Right ventricular hypertrophy | RBBB

Question 38

What does the T wave represent?

Answer 38

Ventricular repolarisation

Question 39

What do abnormal T waves look like?

Answer 39

``` Symmetrical Tall Peaked Biphasic Inverted ```

Question 40

What is the QT interval?

Answer 40

Start of Q wave until end of T wave

Question 41

What does the QT interval represent?

Answer 41

Time for ventricular depolarisation and repolarisation

Question 42

What is the relationship between QT interval and heart rate?

Answer 42

Inversely proportional

Question 43

What is an atrial septal defect?

Answer 43

Connection between 2 atria

Question 44

Explain the pathophysiology of an atrial septal defect

Answer 44

Slightly higher pressure in LA than RA Blood shunts left --> right Increased flow in right heart and lungs

Question 45

Does atrial septal defect cause cyanosis?

Answer 45

No

Question 46

What is a ventricular septal defect?

Answer 46

Connection between 2 ventricles

Question 47

Explain the pathophysiology of ventricular septal defect

Answer 47

High pressure LV, low pressure RV | Blood shunts left--> right

Question 48

Doest ventricular septal defect cause cyanosis?

Answer 48

No

Question 49

What is a coarctation of the aorta?

Answer 49

Narrowing of the aorta at the sight of insertion of the ductus arteriosus

Question 50

Does it cause cyanosis?

Answer 50

No

Question 51

What is a congenital abnormality of the aortic valve?

Answer 51

Bicuspid aortic valve

Question 52

What are the abnormalities in Tetralogy of Fallot?

Answer 52

1. Pulmonary infundibular stenosis 2. Overriding aorta 3. Ventricular septal defect 4. Right ventricular hypertrophy

Question 53

Explain the pathophysiology of Fallot's tetralogy

Answer 53

Stenosis of the RV outflow tract leads to the RV being at higher pressure than LV Blood shunts Right --> left (via VSD)

Question 54

Does Fallot's tetralogy cause cyanosis?

Answer 54

Yes

Question 55

What is a patent ductus arteriosus?

Answer 55

Connection between aorta and pulmonary arteries

Question 56

What is a patent foramen ovale?

Answer 56

Connection between left and right atria

Question 57

What are the clinical signs of ASD?

Answer 57

Pulmonary flow murmur | Big pulmonary arteries and heart

Question 58

What are the clinical signs of VSD?

Answer 58

Large - breathless, poor feeding, big heart, tachycardia | Small - v. loud systolic murmur

Question 59

What are the clinical signs of Coarctation of the aorta?

Answer 59

Severe - collapse with heart failure | Mild - hypertension (particuarly right arm)

Question 60

What are the clincial signs of patent ductus arteriosus?

Answer 60

Large - breathless, poor feeding | Small - asymptomatic

Question 61

What are the clincial signs of patent foramen ovale?

Answer 61

No symptoms - normal health if no other abnormalities

Question 62

What are th clincial signs of Fallot's tetralogy?

Answer 62

BLUE - cyanosis

Question 63

Which structural defects cause cyanosis?

Answer 63

Fallot's tetralogy