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Data Interpretation > ECG > Flashcards

ECG Flashcards

(47 cards)

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1
Q

Inferior leads

A

Lead 2,3 and aVF

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2
Q

Lateral leads

A

1, aVL, aVR, V5-6

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3
Q

Septal leads

A

V1, V2

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4
Q

Anterior leads

A

V3-V4

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5
Q

Order of reading ECG

A
  1. Patient details
  2. Heart rate
  3. Heart rhythm
  4. Cardiac axis
  5. P waves
  6. PR interval
  7. QRS complex
  8. ST segment
  9. T waves
  10. U waves
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6
Q

Normal heart rate and how to measure

A

60 to 100bpm
300 / RR interval (big squares)
If irregular - no of complexes on rhythm strip (6 secs = 30 boxes) x 10

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7
Q

Assessing heart rhythm

A

Regularly regular
Irregularly irregular

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8
Q

Cardiac axis

A

Leaving - left axis deviation (leads 1+2)
Arriving - right axis deviation

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9
Q

P wave assessment

A

Present
Followed by QRS
Duration, direction, shape
Sawtooth =flutter
Chaotic = fibrillation

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10
Q

PR interval assessment

A

Prolonged = more than 200ms (1 large square)
Shortened = less than 120ms (3 small boxes)

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11
Q

Delta wave

A

Wolff-Parkinson syndrome if occurs with tachycardia
Slurred upstroke of R wave

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12
Q

QRS complex assessment

A
  1. Width - broad if >120ms (3 small squares)
  2. Height - tall if >5mm (1 large square) in limbs and >10mm (2 large squares) in chest
  3. Delta wave
  4. Pathological q wave- >25% of size of R wave />2mm in height (2 small squares) + > 40ms in width (1 small squares) in V1-V3
  5. R/S waves - S>R until V3/4
  6. J point (looks like ST elevation)
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13
Q

ST segment

A

Elevation - >1mm (1 small square) in 2+ contiguous limb leads or >2mm (2 small squares) in 2+ chest leads
Depression - > 0.5mm (half small square) in 2+ contiguous leads

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14
Q

T waves

A

Tall - >5mm (1 large square) in limbs and >10mm (2 large squares) in chest
Inverted - normal in V1 and 3
Biphasic
Flattened

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15
Q

U wave

A

Rare
>0.5 (half small square) deflection after t wave
In V2/3

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16
Q

First degree heart block

A

Fixed prolonged PR interval

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17
Q

Second degree heart block

A

Mobitz type 1/ Wenckebach phenomenon - progressive prolonging of PR interval followed by absence of QRS

Mobitz type 2- constant PR interval, absent QRS every 3 to 4 waves (3:1 or 4:1)

Acute MI / chronic heart disease

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18
Q

Third degree heart block

A

No relationship between p waves and QRS complexes - more p waves than QRS
Right axis deviation
Variable PR intervals

MI
Fibrosis
Consider pacemaker

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19
Q

Right bundle branch block

Study These Flashcards
A

Normal PR interval
Broad QRS (>120s)
Second R wave (slow depolarisation on RHS) (R1)
MaRroW
V1 - M shape - +ve R, -ve S, +ve R1
V6 - W shape - -ve R, +ve S, -ve R1
Wide slurred S wave in lateral leads

20
Q

Left bundle branch block

Study These Flashcards
A

Normal PR interval
Broad QRS
WilLiaM
Dominant S wave in V1
Broad monophonic R wave in lat leads
Absence of q waves in lat leads
Prolonged R wave in lateral leads

21
Q

Sinus rhythm

Study These Flashcards
A

One p wave per QRS
Constant PR interval

22
Q

Causes of BBB

Study These Flashcards
A

Aortic stenosis
MI

23
Q

Sinus tachycardia

Study These Flashcards
A

Exercise
Dear
Pain
Haemorrhage
Thyrotoxicosis

24
Q

Sinus bradycardia

Study These Flashcards
A

Athletic training
Fainting
Hypothermia
Myxoedema
Immediately after MI

25
Locations of rhythm abnormality
SAN AVN (nodal/junctional) Ventricular muscle
26
Supraventricular rhythms
Rhythm that originates outside of ventricles and spreads in normal manner Can be atrial or nodal Normal QRS
27
Atrial escape
SAN node does not start depolarisation Another part of atrium does Abnormal p wave Normal QRS Normal beats after abnormal one
28
Nodal escape
No p waves Normal QRS Bradycardic
29
Ventricular escape
Seen in complete heart block / one offs SAN and junctional escape fails No p wave Normal rhythm afterwards
30
Accelerated idioventricular rhythm
Ventricular rhythm but not bradycardic - normal rhythm Benign
31
Extrasystoles
Similar to escape rhythms But beat occurs earlier rather than later than expected
32
Junctional extrasystole
absent / misplaced p wave As depolarisation travels to atria and ventricle at same time Normal QRS
33
Atrial extrasystole
Normal beat but earlier than expected
34
Tachycardia
Either atrium or AVN depolarising too quickly Look at p wave to discover origin If intermittent = paroxysmal
35
Atrial tachycardia
p waves superimposed on the t waves of preceding beat QRS normal AVN limit is 200bpm - if atrial depolarisation faster - AV block But block has sinus rhythm (no tachycardia)
36
Atrial flutter
Rate > 250bpm Saw tooth p waves Associated with block
37
Nodal tachycardia
P waves very close to QRS or no p waves QRS normal Carotid sinus pressure - stimulate AVN and SAN - no effect on ventricular tachycardias
38
Ventricular tachycardia
Broad QRS Difficult to identify t waves No p waves Regular QRS similar to BBB If just had MI - VT
39
Atrial fibrillation
No p waves Irregularly irregular Tachycardia
40
Ventricular fibrillation
No discernable pattern Very likely to lose consciousness Urgent defibrillation
41
Wolff-Parkinson-White syndrome
Accessory pathway from atria to ventricles on LHS (bundle of kent) Pre-excitation of ventricles Risk of sudden death if paroxysmal tachycardia - loop of depolarisation / re-entry circuit R axis deviation Short PR and QRS Delta wave If tachycardic = no p waves
42
Pacemaker
Occasional p waves not related to QRS QRS preceeded by spike Broad QRS as depolarisation is ventricular in origin
43
Ectopic beats
Unexpected p waves (atrial) or QRS (ventricular)
44
Atrial ectopics
Abnormal or no p wave Normal QRS Benign
45
Ventricular ectopics
Widened QRS Irregularly irregular pulse Benign Predispose to VT
46
Hyperkalaemia
Peaked t wave Wide/flat p waves Bradycardia Conduction blocks QRS widening
47
Hypokalaemia
Tall p wave Prolonged PR interval ST depression T wave flattening/inversion U waves Long QT interval due to fusion of T and U waves

Data Interpretation (1 decks)

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