ECG, IHD, cardio exam, HTN Flashcards Preview

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Flashcards in ECG, IHD, cardio exam, HTN Deck (45):
1

which lead is used as rhythm strip usually

II

2

what is sinus arrhythmia

a normal variation where heart rate changes with respiration

3

what is a premature atrial complex

an atrial ectopic.
an early beat generated in the atria with a normal QRS

4

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

5

how does atrial fibrillation appear on ecg?

absence of p waves
irregularly irregular rhythm

6

how does atrial flutter appear on ECG?

saw tooth appearance of p waves.
too many p waves.

7

normal p wave length

<120ms (3 small squares)

8

what does the PR interval indicate

AV conduction time

9

what is first degree AV block

gradually increasing PR interval and eventually a non conducted P wave

10

normal QRS length

100ms

11

what causes right axis deviation

right ventricular hypertrophy

12

lateral ECG leads

V5 V6

13

inferioir ECG leads

2, 3, aVF

14

high lateral ECG leads

1, aVL

15

pronounced Q wave is indicative of

prior infarct

16

how long does ST elevation last in STEMI

only 48 hours

17

horizontal ST depression indicates

significant myocardial

18

3 types of ST depression

downgoing
horizontal
upgoing (might be ok)

19

atrial fibrillation on ECG

no p waves
irregularly irregular

20

what is torsades de pointes

QT lengthening can lead to this abnormal ecg that can cause vtachycardia and sudden death

21

how is hypokalaemia reflected on ECG

dampened t waves

22

definition of acute myocardial infarction. 3 features it includes

symptoms (chest pain, SOB etc)
change in ECG
elevation of cardiac markers

23

in AMI, is primary percutaenous intervention or fibrinolysis preferred?

primary percutaneous intervention (clot retrieval)

24

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)
ACEI
statin

25

what do you need to clarify about when a patient says they have "palpitations"

fast beats? missed beats? irregular? forceful?

26

possible diagnoses of "palpitations"

sinus tachycardia
atrial fibrillatoin
supraventricular tachycardia
ventricular tachycardia

27

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

28

2 mechanisms of tachycardia

single group of cells firing rapidly (the nodes)
or
re-entry

29

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

30

what is atrial flutter

re-entry tachycardia within the atria leading to sawtooth ecg

31

what are premature ventricular complexes

ectopic depolarisation within the ventricle that bypasses the his-purkinje system to cause slow depolarisation within ventricles
usually benign

32

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

33

first degree AV block

PR interval > .2 seconds

34

second degree AV block
types 1 and 2

1 = gradually increasing PR interval until a p isnt conducted
2 = intermittently blocked p waves

35

third degree av block

dissociation of atrial and ventricular activity

36

diagnosing hypertension

BP > 140/90 on 2 separate measurements

37

what level does Hb have to be for conjunctival pallor

less than 80

38

what causes cyanosis

deoxy Hb (as opposed to anemia)

39

what does JVP tell us

the filling pressure of the right side of the heart

40

how to tell if it is JVP vs carotid

cant feel it pulsing
double wave
hepatojugular reflux
inhalation changes
occlude it
varies with position

41

what is kussmauls sign

JVP rising with inspiration
indicative of constrictive pericarditis

42

what does S3 indicate?

turbulence during early ventricle filling
voume overload (aortic or mitral regurge)
dilated cardiomyopathy

43

what does S4 indicate?
when is it?

before S1.
indicates turbulence duering atrial contractoin in stiff ventricle (HTN, aortic stenosis, Hypertrophic cardiomyopathy)

44

aortic stenosis murmur?

crescendo-decrescendo

45

mitral regurgitation murmur ?

pansystolic