ECG Interpretation Flashcards Preview

Cardiorespiratory Physiotherapy > ECG Interpretation > Flashcards

Flashcards in ECG Interpretation Deck (12)
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1
Q

Normal Interpretation

A

Rate - count no. of squares between R, divide 300 by that number = heart rate
Rhythm - is there equal spaces between the QRS complexes?
P wave - consistent shape? do they precede a QRS complex? <0.12 secs
PR Interval - 0.12-0.2 secs
QRS complex - normal shape, 1:1 with p wave, <0.12 secs
ST segment - consistent with isoelectric line?
Interpretation?

2
Q

ST Depression

A
Indicative of myocardial ischaemia
Appearance - 
ST line horizontal
downwards sloping 
upwards sloping from downwards position 

Causes -

  • myocardial ischaemia
  • ventricular hypertrophy
  • right and left bundle branch block
  • digoxin toxicity

Course of Action

  • monitor pulse and BP, stay with teh patient
  • stop treatment
  • report to medical stagg
  • consider emergency response
3
Q

ST Elevation

A
Indicative of myocardial infarction 
Early Acute MI 
- no Q waves
- ST elevation sloping upwards
- tall, widened T waves 

Established MI

  • prominent Q waves
  • elevated ST segments
  • inverted T wave

ST line may be horizontal, convex or coved

Causes - 
- MI 
myocardial ischaemia 
myocardial injury 
myocardial infection 
coronary vasospasm 
pericarditis 

Course of Action

  • stop treatment
  • seek medical assistance
  • prep emergency equipment
  • monitor the patient
  • prep for CPR
4
Q

Sinus Tachycardia

A
  • increased rate in atrial contraction originating from the
    SA node
  • 100bpm +
  • normal shapes and ratios just increased rate
  • not pathological if during increased activity
  • source for concern if at rest
5
Q

Atrial Fibrillation (tachycardia)

A

a disorganised electrical signal from abnormal ectopic foci in the atria

Appearance -

  • bag of worms
  • no distinct p waves
  • irregular RR interval

Causes - any disease process that changes the structure of atrial tissue

Course of Action - 
Chronic 
- look at current symptoms, changes in BP, pulse or pallor
- is the rate controlled?
- would they be able to tolerate functional rehab?
Acute
- if new onset - cease intervention 
- refer on medical assessment
6
Q

Atrial Flutter (tachycardia)

A

flutter occurs when automaticity foci fire when they shouldn’t
rate is normally 250bpm
due to AV node refractory period, AV depolarisation doesn’t occur with each flutter

Appearance

  • multiple, saw tooth p waves
  • occasional QR complex
  • regular RR interval
Course of Action - 
Chronic 
- look at current symptoms, changes in BP, pulse or pallor
- is the rate controlled?
- would they be able to tolerate functional rehab?
Acute
- if new onset - cease intervention 
- refer on medical assessment
7
Q

Premature Atrial Contraction

A
premature beat arising from the atria 
Appearance - 
- abnormal p wave 
- followed by a normal QRS complex 
- occurs in pairs, groups or threes 
Course of Action - 
Chronic 
- look at current symptoms, changes in BP, pulse or pallor
- is the rate controlled?
- would they be able to tolerate functional rehab?
Acute
- if new onset - cease intervention 
- refer on medical assessment
8
Q

Premature Ventricular Contraction

A

premature discharge of an ectopic focus in the ventricles

Appearance

  • can occur as a single beat, every second beat or in pairs
  • abnormal QRS complex
  • no preceding p wave

Causes -

  • anxiety
  • excessive caffeine/alcohol
  • drugs
  • congestive heart failure
  • myocardial infarction
  • valvular heart disease

Not life threatening
Issue if have other heart condition or if occurs very frequently

9
Q

Ventricular Fibrillation

A

chaotic electrical discharge from multiple foci in the ventricles
- lose cardiac output - ventricles aren’t working properly

Appearance -

  • extremely disorganised
  • no rate
  • no wave or QRS complex
  • series of random peaks, no regular shape or rate

Causes -

  • may be spontaneous
  • electrolyte disturbance
  • reperfusion of the myocardium after thrombolysis
  • mechanical stimulation
  • myocardial infarction

Course of Action

  • medical emergency
  • stop treatment
  • seek medical assistance
  • need to commence CPR
10
Q

Ventricular Tachycardia

A

originates from a ventricular ectopic focus
- between 140-250bpm

Appearance

  • regular QRS complexes, wide, abnormal shape, just look like wide peaks
  • no p wave

Causes -

  • digoxin toxicity
  • electrolyte disturbances
  • myocardial infarction
  • cardiomyopathy
  • congestive heart failure
  • medications

Course of Action

  • medical emergency
  • stop treatment
  • seek medical assistance
  • need to commence CPR
11
Q

Pulseless Electrical Activity

A

form of cardiac arrest
no pulse but still have electrical impulse
severe cardiac/circulatory dysfunction means that despite electrical impulse there is no contraction of the heart
can’t use defib

12
Q

Asystole

A

absence of all electrical activity
- flat line

Causes - 
ischaemia 
degeneration of the conducting system 
electrocution 
can't use defib