ecg

Question 1

which leads is normal to have T wave inversion

Answer 1

lead III, VR, V1-2, and V3 in black people

Question 2

what does right/left atrial hypertrophy look like?

Answer 2

R - peaked tall P wave

L - notched, board P wave

Question 3

what if QRS complex widen?

Tall R wave in V1/ 6, what does it mean

Answer 3

QRS complex widen -> ventricular origin/ BBB

Tall r waves in lead V1 = RV hypertrophy
Tall r waves in lead V6 = LV hypertrophy

Question 4

why does clockwise rotation of V3 and V4 means, normally the R and S waves it equal in chest leads over the interventricular septum

Answer 4

chronic lung disease

Question 5

ST segment rise/ depress in?

Answer 5

rise - acute MI (>/= 2 consecutive leads), pericarditis (wide spread)

depressed - ischaemia, digoxin

Question 6

t waves peak in? falt and prolonged in?

Answer 6

peaked in hyperK

flat and prolonged in hypoK

Question 7

T wave inversion occurs in

Answer 7

normal in some leads (III, VR, V1-3)
ischaemia
infarction
L/R ventricular hypertrophy
inverted in V1-3 in PE
bbb

Question 8

U wave is normal or not?

Answer 8

can be normal/ hypoK

Question 9

first degree block

Answer 9

one p wave per qrs

pr interval > 200 ms

Question 10

second degree block

Answer 10

type I (mobitz I):

• gradual prolongation of PR interval precedes the failure of conduction of a P wave (wenckebach phenomenon)
• trigger usually reversible: increased vagal tone (follow sx), RCA medicated ischemia, not for temp or permanent pacing

type II (mobitz II):

• PR interval constant with abrupt failure of conduction of P wave
• increase risk of high grade/ 3rd degree AV block

Question 11

3rd degree heart blocks

Answer 11

no relationship between P and QRS wave

QRS can be wide or narrow (usally

Question 12

length of PR interval and QRS complex

Answer 12

PR interval 200ms (5 small square)
QRS complex: 120 ms (3 small squares)
QT interval 450ms

Question 13

RBBB

Answer 13

qrs complex duration > 120 ms
RSR pattern
usually dominant R in lead V1
inverted T wave in lead V1 and sometimes in lead V2-3
deep and wide S waves in lead V6

Question 14

LBBB

Answer 14

QRS complex duration > 120 ms
M pattern in lead V6 and sometimes Lead V4-5
no septal q waves
inverted t waves in lead I, VL, V5-6 and sometimes V4
LBBB can mask ecg signs of MI

Question 15

left anterior hemiblock (fascicular block)
right posterior fasicular block (hemiblock)
bifasciular block

Answer 15

LPFB:
Bifascicular block:

Question 16

how to report ecg

Answer 16

rhythm
conduction
PR interval (sinus)
cardiac axis
QRS complex
- duration, height of R and S waves, presence of Q waves
ST segments
T waves