ECG Flashcards

(46 cards)

1
Q

What do leads refer to in an ECG

A

the view of the heart

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2
Q

Define cardiac vectors

A

reflect the magnitude and direction of electrical events in the heart, measured by electrocardiography

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3
Q

What does an isoelectric line suggest

A

Mo net change in voltage i.e. the vectors are perpendicular to the lead

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4
Q

What denotes the duration of an event in an ECG

A

width of deflection

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5
Q

What are upward deflections toward in an ECG

A

Cathode (+)

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6
Q

What are downward deflections toward in an ECG

A

Anode (-)

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7
Q

What does steepness of a line denote in an ECG

A

velocity of action potential

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8
Q

What occurs at P in an ECG

A

atrial depolarisation and contraction

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9
Q

What occurs through QRS in an ECG

A

ventricular depolarisation and contraction (+atrial depolarisation)

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10
Q

What occurs at T in an ECG

A

Ventricular repolarisation and relaxation

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11
Q

What occurs at Q in an ECG

A

Septal depolarisation in the bundle branches

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12
Q

What occurs at R in an ECG

A

Ventricular depolarisation in the Purkinje fibres

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13
Q

What occurs at S in an ECG

A

Late ventricular depolarisation in the Purkinje fibres

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14
Q

Which electrodes does lead I read from

A

right arm to left arm

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15
Q

Which electrodes does lead II read from

A

Left leg to right arm

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16
Q

Which electrodes does lead III read from

A

left arm to left leg

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17
Q

What is used to enhance conduction on the limb electrodes

A

Conductive gel

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18
Q

What planes are the leads visual representations of

A

Coronal and horizontal plane

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19
Q

Which leads have a fixed anode

A

Lead I, II, III

20
Q

Which leads have a viral anode

A

aVR, aVL, aVF, V1-V6

21
Q

Which lead is usually isoelectric

A

avL as it is viewed from bottom right to top left

22
Q

Where are the chest leads placed

A
V1 - right 4th intercostal
V2 - left 4th intercostal
V3 - halfway V2 V4
V4 - 5th intercostal space mid-clavicular line
V5 - V4 at the Anterior axillary line
V6 - V4 at the mid-axillary line
23
Q

Which lead is commonly used

24
Q

What does each big square represent in most ECGs

25
What may ECGs interpretation vary for the same person
Interpretation can be subjective and dependent on skill, experience and knowledge
26
What can an ECG help to recognise
Conduction abnormalities Structural abnormalities Perfusion abnormalities
27
What is the order of approach to evaluation of ECG
1. Rate and rhythm (R-R) 2. P-wave and PR interval 3. QRS duration 4. QRS axis 5. ST segment (height) 6. QT interval T wave
28
What must be taken into account before reading an ECG
Is it the correct one? review the signal and quality of the leads Verify voltage and paper speed Review patient background
29
Describe the ECG for sinus rhythm
P wave followed by QRS | Rate is regular (even R-R) and normal (~80bpm)
30
Describe the ECG for sinus bradycardia
P wave followed by QRS Rate is regular (Even R-R) and slow (~56bpm) May be healthy, on medication, or vagal stimulated
31
Describe the ECG for sinus tachycardia
P wave followed by QRS Rate is regular (even R-R) and fast (~110bpm) Often a physiological response
32
Describe the ECG for sinus arrhythmia
P wave followed by a QRS wave Rate is irregular (variable R-R) and normal (65-100 bpm) R-R interval varies with breathing
33
Describe the ECG for atrial fibrillation
Oscillating baseline Rhythm irregular and slow rate Turbulent flow increases clot risk Atria contract asynchronously
34
Describe the ECG for atrial flutter
Regular saw-tooth pattern in II, III , aVF | Atrial to ventricular beats at 2:1 ratio or greater
35
Describe the ECG for First degree heart block
Prolonged PR segment (slow AV conduction) | Regular rhythm and 1:! ratio of P waves to QRS
36
Describe the ECG for second degree heart block (Mobitz I)
Gradual prolongation of the PR interval until a beat is skipped Most P followed by QRS Regularly irregular Disease in AV node
37
Describe the ECG for second degree heart block (Mobitz II)
Regular P waves, only some followed by QRS No P-R prolongation Regularly irregular
38
Describe the ECG for third degree heartblock
Regular P waves, QRS regular, no relationship | P waves can be hidden by bigger vectors
39
Describe the ECG for ventricular tachycardia
Rate is regular and fast P waves hidden High risk of deterioration into fibrillation/ cardiac arrest
40
Describe the ECG for ventricular fibrillation
Irregular and fast (>250bpm) Cardiac arrest Unable to generate output - no filling
41
Describe the ECG for ST elevation
P waves visible and followed by QRS Rhythm is regular and rate is normal (85bpm) ST segment elevated >2mm above isoelectric line Caused by infarction
42
Describe the ECG for ST depression
P waves are visible and followed by QRS Rhythm is regular and normal ST segment is depressed >2mm below the isoelectric line Caused by ischaemia
43
What is the time represented by each small square
0.04s (100ms)
44
What are the clinical features and management for atrial fibrillation
Dizziness and confusion Chest pain, palpitations and dyspnoea Anti-arrythmia medication or beta blockers Anticoagulants?
45
What is someone with left axis deviation likely to have
``` Left ventricular hypertrophy Left bundle branch block (LBBB) Hyperkalemia Inferior myocardial infarction Conditions that elevate the diaphragm such as pregnancy, ascites, abdominal tumors, and also in patients with COPD ```
46
What is someone with right axis deviation likely to have
Right bundle branch block Right ventricular hypertrophy Lateral wall myocardial infarction