ECG 2- Abnormalities

Question 1

ECG: ST elevation.

Answer 1

MI

Question 2

ECG: Wavy baseline, no p waves, narrow QRS complexes.

Answer 2

Atrial fibrillation

Question 3

What do pathological Q waves indicate?

Answer 3

Necrotic tissue

Question 4

What is the difference between ST elevation and ST depression

Answer 4

Elevation: injury
Depression: ischaemia

Question 5

What would be seen with hyperkalaemia?

Answer 5

A bit raised: High T wave. Prolonged PR interval. ST depression
Raised higher: P wave absent, atrial standstill
Very high, ventricular fibrillation

Question 6

What would you see in atrial fib?

Answer 6

ECG: Wavy baseline, no p waves, narrow QRS complexes.

Question 7

ECG: Normal apart from pathological Q wave

Answer 7

Has had MI in the past

Question 8

ECG: Abnormal chaotic baseline. No QRS

Answer 8

Ventricvular fibrillation

Question 9

Give 7 questions you would ask when viewing an ecg

Answer 9

Heart rate?
Regular or irregular
Broad or narrow QRS (Broad would suggest impulse is orginating in the ventricle)
P waves present?
What are the P waves like?
Relationship of P waves to QRS? (Heart block)
ST segment

Question 10

ECG: High T wave. ST depression.

Answer 10

Hyperkalaemia

Question 11

ECG: Prolonged PR interval. Otherwise normal

Answer 11

First degree heart block

Question 12

ECG: ST depression

Answer 12

Ischaemia

Question 13

When will you see ST elevation?

Answer 13

When the muscle injury extends the full thickness from endo to epicardium

Question 14

Describe third degree heart block

Answer 14

AV node nnot conducting the atrial signal through to the ventricles. Ventricular escape rhythm takes over

Question 15

What would be seen in hypokalaemia?

Answer 15

Low T wave
The presence of a U wave after the T wave
If very low, some ST depression

Question 16

What is first degree heart block?

Answer 16

Prolonged PR interval due to slow conduction of AV to His bundle

Question 17

Danger of mobitx type 2?

Answer 17

Likely to progress to third degree heart block

Question 18

Two causes of heart block?

Answer 18

MI

Degenerative disease

Question 19

define ventricular tachycardia

Answer 19

run of 3 or more ectopic beats

Question 20

What two factors make a Q wave pathological?

Answer 20

> 1 square wide

>2 squares deep (Small)

Question 21

Describe what you would do if you get a patient in VF

Answer 21

CPR

Defibrillation

Question 22

ECG: Low T wave. A wave present after the T wave

Answer 22

Kypokalaemia

Question 23

Describe the ecg of third degree heart block

Answer 23

ECG: P waves not associated with QRS complex. Heart rate slow (30-40). wide QRS complex

Question 24

Describe what you will see over time with STEMI

Answer 24

Acute: ST elevation
Hours: ST elevation, decreased R wave, Beginning of a Q wave
Days: The above. Inverted T wave.
Weeks: Pathological Q wave. Rest normalises

Question 25

How is a ventricular ectopic beat different to the escape rhythm?

Answer 25

Escape rhythm regular | Ventricular ectopic beat random and just find opportunistic moment

Question 26

What is atrial fibrillation?

Answer 26

Multiple foci with chaotic impulses

Question 27

ECG: Progressively lengthening PR interval. Sudden QRS complex dropped. resets.

Answer 27

Second degree heart block, mobitz type 1 (WEnchebach)

Question 28

ECG: Every couple of QRS complexes, one is missed. Otherwise normal

Answer 28

Second degree heart block, mobitz type 2

Question 29

ECG: P waves not associated with QRS complex. Heart rate slow (30-40). wide QRS complex

Answer 29

third degree heart block

Question 30

Describe the ecg of a ventricular ectopic beat

Answer 30

ECG: Random, wide QRS complex. Otherwise normal. Proceeded by normal sinus rhythm

Question 31

What would you see with Second degree heart block, mobitz type 1 (WEnchebach)

Answer 31

ECG: Progressively lengthening PR interval. Sudden QRS complex dropped. resets.

Question 32

ECG: Random, wide QRS complex. Otherwise normal. Proceeded by normal sinus rhythm

Answer 32

Ventricular ectopic beat