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Phase 1c > ECGs > Flashcards

ECGs Flashcards

1
Q

ECG square dimension (time)

A

small square: 1mm, 0.04 sec
big square: 5mm, 0.20 sec

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2
Q

what does the p wave represent

A

atrial depolarisation, conduction from SAN throughout atria

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3
Q

PR interval represents

A

time for electrical activity to go from atria to ventricles through the AVN

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4
Q

what does QRS complex represent

A

ventricular depolarisation

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5
Q

what does ST segment represent

A

time taken after depolarisation finishes for repolarisation to begin

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6
Q

what does t wave represent

A

ventricular repolarisation

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7
Q

what does qt interval represent

A

time for ventricles to depolarise then repolarise

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8
Q

what does rr interval represent

A

time between two QRS complexes, time for one complete heart cycle

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9
Q

normal pulse

A

60-100 bpm

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10
Q

what is sinus rhythm

A

p wave starting each qrs complex

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11
Q

how to calculate rate if regular

A

1500/number of small squares
300/number of large squares

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12
Q

which leads are used to assess cardiac axis

A

I, II, aVF

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13
Q

how to assess cardiac axis

A

if II is +ve and I is +ve then cardiac axis normal
if II is -ve and I is +ve then left axis deviation
If II is +ve and I is -ve then right axis deviation
if aVF is -ve and I is -ve then there is extreme axis deviation

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14
Q

is axis deviation always pathological

A

no. LAD seen in short fat ppl and RAD in tall thin ppl

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15
Q

how should p waves look

A

+ve in leads I, II
inverted in aVR
biphasic in V1

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16
Q

how can p waves be abnormal

A

absent
sawtooth
p pulmonale (right atrial enlargement)
p mitrale (left atrial enlargement)
p wave inversion

17
Q

what does a wide QRS indicate

A

ventricles not correctly depolarised

18
Q

how does calcium affect qt interval

A

hypercalcaemia shortens it
hypocalcaemia prolongs it

19
Q

atrial fibrillation ECG

A

irregularly irregular rhythm
absent p waves
narrow QRS

20
Q

rule of thumb for if activity is from atria or ventricles

A

if the activity is starting at or above AVN then narrow QRS
broad QRS implies ventricular origin or aberrant conduction

21
Q

atrial flutter ECG

A

regularly irregular rhythm
absent p waves with sawtooth baseline
narrow QRS

22
Q

Supraventricular tachycardias ECG

A

any tachyarrythmia above bundle of His
retrograde p waves (after QRS)
p wave could be in T waves or look like double t waves

23
Q

1st degree heart block ECG

A

prolonged PR interval
can be seen in healthy ppl

24
Q

Mobitz type 1 heart block ECG

A

also 2nd degree heart block type 1 or Wenckeback phenomenom
usually benign

starts with shorter PR interval
gets longer each cycle
eventually p wave without QRS
then cycle begins again

represents increased delay at AVN

25
Q

Mobitz type 2 heart block ECG

A

aka 2nd degree heart block type 2
PR interval constant when QRS present
some p waves not followed by QRS

represents damage to conduction tissue below AVN - always pathological
could be broad or narrow QRS

26
Q

3rd degree heart block ECG

A

complete cessation of AV conduction
p waves and qrs independent

can be broad or narrow qrs

patient usually bradycardic

27
Q

Wolff-Parkinson-White ECG

A

accessory pathway from atria to ventricles typically connecting left atria to left ventricle

short pr interval

broad QRS with slurring of start

28
Q

ventricular fibrillation ECG

A

incompatible with life
rapid, broad, irregular, chaotic ventricular depolarisation
no discernible waves

29
Q

monomorphic VT ECG

A

most common VT
fast HR
broad, consistent ventricular complexes
loss of other features
sometimes occasional normal cycles

30
Q

left bundle branch block ECG

A

damage to left bundle branch, usually pathological
broad QRS
deep S wave in V1
notched R wave in V6
can also see notched top in other lateral leads

new LBBB consistent with STEMI

31
Q

right bundle branch block ECG

A

damage to right bundle branch usually pathological
broad QRS
RSR in V1 and adjacent leads
wide slurred S wave in V6
ST depression and t wave inversion v1-3

32
Q

Torsades de Pointes (TdP)

A

type of polymorphic VT
broad QRS
changing amplitude beat to beat
twisting appearance

33
Q

NSTEMI ECG

A

subendocardial ischaemia (sub-total occlusion)

widespread ST depression
T wave inversion

34
Q

pericarditis ECG

A

widespread concave ST elevation (often saddle shaped)
widespread PR depression
may be tachycardic

35
Q

hyperkalaemia ECG

A

potassium >5.5
tented T waves

36
Q

hypokalaemia ECG

A

potassium <3.5
ST depression
T wave inversion and U waves

Phase 1c (13 decks)

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