ECG Findings

Question 1

What is the normal PR interval?

Answer 1

Normal PR interval is 120-200ms.

Question 2

What is normal QRS?

Answer 2

Normal QRS interval is 120m/s.

Question 3

What is the normal heart rate?

Answer 3

Generally, normal rate of the heart is 220 subtracted by a person’s age.

Question 4

What is low atrial rhythm?

Answer 4

Low atrial rhythm is inversion of p wave before QRS complex which indicates origin of heart beat other than SA.

Question 5

What does t wave inversion mean?

Answer 5

Inverted or biphasic T wave indicates ischaemia.

Question 6

What does tall QRS complex mean?

Answer 6

Tall QRS complex is LVH.

Question 7

What does P wave enlargement mean?

Answer 7

P wave enlargement is R atrial enlargement.

Question 8

What ECG is on left anterior fascicular block?

Answer 8

Left anterior fascicular block causes left axis deviation as posterior fascicle compensates.

Question 9

What ECG is on left posterior fascicular block?

Answer 9

Left posterior fascicular block results in right axis deviation on ECG.

Question 10

What ECG findings for both fascicles?

Answer 10

When both fascicles are blocked, it is left axis deviation.

Question 11

What degree is right and left axis deviation?

Answer 11

Right axis deviation is between 90-180 degrees. Left axis deviation is between -30 to -90 degrees.

Question 12

What is extreme axis deviation?

Answer 12

Extreme axis deviation is between -90 and 180 due to extreme hyperkalemia, misplaced electrodes, extreme COPD or ventricular pacing in apex.

Question 13

How does RBBB appear on ECG?

Answer 13

Right bundle branch block is best seen in V1 and avF. It is from heart diseases.

Question 14

How does LBBB appear on ECG?

Answer 14

Left bundle branch block is best seen in Lead 1, avL and V6. It arises from heart failure, hyperkalemia, digoxin toxicity or MI.

Question 15

What is sinus pause?

Answer 15

Sinus pause is 3 second pause in heart.

Question 16

What is Bifasicular block?

Answer 16

Bifasicular block is when there is an issue with 2 out of 3 fascicles.

Question 17

What is Trifasicular block?

Answer 17

Trifasicular block is when there is issue with the AV node causing conduction delay in all 3 fascicles.

Question 18

What is first degree block?

Answer 18

1st degree AV block has prolonged PR interval.

Question 19

What is Mobitz 1 block?

Answer 19

Mobitz I block is progressive lengthening of PR interval before dropped P wave.

Question 20

What is Mobitz 2 block?

Answer 20

Mobitz II block is random drop of P wave which is associated with risk of complete heart block so requires pacemaker.

Question 21

What does 2nd degree block with syncope indicate?

Answer 21

If 2nd degree AV block is associated with presyncope or syncope, this can indicate a pacemaker.

Question 22

What is type 3 block?

Answer 22

Type 3 heart block has no association of P and QRS complex.

Question 23

What is AV block?

Answer 23

AV block can occur because of infiltrative disorders like amyloidosis, muscular dystrophy or myocarditis/endocarditis.

Question 24

What is junctional beat?

Answer 24

Junctional beat is regular rhythm but no P waves OR a retrograde P wave.

Question 25

What does inverted P waves mean?

Answer 25

Inverted P waves is a low atrial rhythm.

Question 26

What is atrial flutter?

Answer 26

Atrial flutter is caused by re-entrant signs and results in a 2:1 block.

Question 27

What is notched T wave?

Answer 27

Notched T wave is Right atrial hypertrophy.

Question 28

What is multifocal atrial tachycardia?

Answer 28

Multifocal atrial tachycardia is associated with the elderly with heart disease due to atrial enlargement.

Question 29

What are the risk factors of multifocal atrial tachycardia?

Answer 29

Risk factors for multifocal atrial tachycardia are high levels of calcium, hypokalemia and hypomagnesaemia and hypoxia.

Question 30

What is the ECG features of ventricular tachycardia?

Answer 30

When all QRS complexes are wide and identical with abnormal morphology of Left bundle branch or right bundle branch morphology on every lead, it is ventricular tachycardia.

Question 31

What is compensatory pause?

Answer 31

Compensatory pause in ventricular tachycardia is when ectopic beat occurs following a prolonged sinus pause.

Question 32

What is coupling?

Answer 32

Coupling is two ectopic beats in a row during ventricular tachycardia.

Question 33

What is salvos?

Answer 33

Salvos is 5-6 ectopic beats in a row.

Question 34

What is bigeminy?

Answer 34

Bigeminy is ectopic beat every other beat.

Question 35

What is trigeminy?

Answer 35

Trigeminy is every 3rd beat being an ectopic.

Question 36

What is Torsades de pointes?

Answer 36

Torsades de pointes occurs due to triggered activity in early or late depolarisation.

Question 37

What is the treatment of Torsades de pointes?

Answer 37

Treatment of Torsades de pointes is with IV magnesium and potassium supplement.

Question 38

How does torsades present on ECG?

Answer 38

Torsades will have an alternating pattern of long QT and twisting around itself.

Question 39

What is sinus bradycardia?

Answer 39

Sinus bradycardia can be differentiated from syncope because sinus bradycardia will have sudden collapse without prior buildup.

Question 40

What is sinus arrest?

Answer 40

Sinus arrest is prolonged failure of impulse generation and junctional escape rhythm.

Question 41

What is tachybrady syndrome?

Answer 41

Tachybrady syndrome is prior to sinus pause, there will be atrial fibrillation or atrial flutter.

Question 42

What is pericarditis?

Answer 42

Pericarditis causes PR depression on avR and ST elevation everywhere.

Question 43

What is premature atrial contraction?

Answer 43

Premature atrial contraction is common in patients with heart disease and worsened by caffeine and alcohol.

Question 44

What are the ECG features of digoxin?

Answer 44

* down-sloping ST depression ('reverse tick', 'scooped out') * flattened/inverted T waves * short QT interval * arrhythmias e.g. AV block, bradycardia

Question 45

What are the ECG features of hypokalaemia?

Answer 45

* U waves on V2 or V3 * small or absent T waves (occasionally inversion) * prolong PR interval * ST depression * long QT

Question 46

What are the ECG changes in hypothermia?

Answer 46

* bradycardia * 'J' wave (Osborne waves) - small hump at the end of the QRS complex * first degree heart block * long QT interval * atrial and ventricular arrhythmias

Question 47

What is Wellen's syndrome?

Answer 47

ECG pattern that is typically caused by high-grade stenosis in the left anterior descending coronary artery.