Flashcards in ECG, IHD, cardio exam, HTN Deck (45):
which lead is used as rhythm strip usually
what is sinus arrhythmia
a normal variation where heart rate changes with respiration
what is a premature atrial complex
an atrial ectopic.
an early beat generated in the atria with a normal QRS
what is a premature ventricular complex? how would it look on ECG?
a ventricular ectopic beat. broad QRS in absence of P wave.
a ventricular extra beat
how does atrial fibrillation appear on ecg?
absence of p waves
irregularly irregular rhythm
how does atrial flutter appear on ECG?
saw tooth appearance of p waves.
too many p waves.
normal p wave length
<120ms (3 small squares)
what does the PR interval indicate
AV conduction time
what is first degree AV block
gradually increasing PR interval and eventually a non conducted P wave
normal QRS length
what causes right axis deviation
right ventricular hypertrophy
lateral ECG leads
inferioir ECG leads
2, 3, aVF
high lateral ECG leads
pronounced Q wave is indicative of
how long does ST elevation last in STEMI
only 48 hours
horizontal ST depression indicates
3 types of ST depression
upgoing (might be ok)
atrial fibrillation on ECG
no p waves
what is torsades de pointes
QT lengthening can lead to this abnormal ecg that can cause vtachycardia and sudden death
how is hypokalaemia reflected on ECG
dampened t waves
definition of acute myocardial infarction. 3 features it includes
symptoms (chest pain, SOB etc)
change in ECG
elevation of cardiac markers
in AMI, is primary percutaenous intervention or fibrinolysis preferred?
primary percutaneous intervention (clot retrieval)
4 medications you will be put on after an AMI
beta blockers (reduce recurrency, reduce angine, reduce arrhythmias)
aspirin (antiplatelet therapy important for future prevention)
what do you need to clarify about when a patient says they have "palpitations"
fast beats? missed beats? irregular? forceful?
possible diagnoses of "palpitations"
investigations to be completed for palpitations
ECG is needed most importantly but can be difficult. may need implantable monitor.
also echocardiogram for underlying strucutral disease of the heart
maybe UEC to determine if there is electrolyte imbalance
2 mechanisms of tachycardia
single group of cells firing rapidly (the nodes)
mechanism of re-entry
2 electrical paths around an area of scar, one path becomes unable to conduct and then the other path can go around the scar, go up the other path, and may get past the block and then create a circular electrical circuit
what is atrial flutter
re-entry tachycardia within the atria leading to sawtooth ecg
what are premature ventricular complexes
ectopic depolarisation within the ventricle that bypasses the his-purkinje system to cause slow depolarisation within ventricles
treatment for atrial fibrillation
often want to control the rate instead of the rhythm
beta blockers, digoxin
and then want to control stroke risk vs bleeding risk (aspirin? warfarin?)
and if nothing works then may need catheter ablation of pulmonary veins
first degree AV block
PR interval > .2 seconds
second degree AV block
types 1 and 2
1 = gradually increasing PR interval until a p isnt conducted
2 = intermittently blocked p waves
third degree av block
dissociation of atrial and ventricular activity
BP > 140/90 on 2 separate measurements
what level does Hb have to be for conjunctival pallor
less than 80
what causes cyanosis
deoxy Hb (as opposed to anemia)
what does JVP tell us
the filling pressure of the right side of the heart
how to tell if it is JVP vs carotid
cant feel it pulsing
varies with position
what is kussmauls sign
JVP rising with inspiration
indicative of constrictive pericarditis
what does S3 indicate?
turbulence during early ventricle filling
voume overload (aortic or mitral regurge)
what does S4 indicate?
when is it?
indicates turbulence duering atrial contractoin in stiff ventricle (HTN, aortic stenosis, Hypertrophic cardiomyopathy)
aortic stenosis murmur?