ECGS Flashcards
(15 cards)
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Hyperkalemia - peaked T waves
P wave flattening,
PR prolongation (often hidden due to the widened QRS complex)
QRS widening with abnormal morphology
- Rate
Count the large squares between R waves → appears tachycardic (>100 bpm). - Rhythm
Regular or irregular? Appears mostly regular.
P waves? Not clearly visible before every QRS → suggests a non-sinus origin.
- Axis
Extreme right axis deviation (possible VT or hyperkalemia). - Intervals
PR Interval: Difficult to assess due to unclear P waves.
QRS Duration: Wide QRS complexes (>120 ms), suggesting ventricular origin or conduction delay (e.g., bundle branch block, hyperkalemia, or drug effect).
QT Interval: Hard to assess accurately but may be prolonged.
- Morphology
QRS: Very broad, bizarre, and tall, suggesting ventricular tachycardia (VT) or severe hyperkalemia.
T waves: Peaked in some leads, which can be a sign of hyperkalemia.
- ST Segments & T Waves
No clear ST-elevation or depression, but T-wave changes are abnormal (peaked or distorted).
ECG features of hyperkalemia
peaked T waves
P wave flattening,
PR prolongation (often hidden due to the widened QRS complex)
QRS widening with abnormal morphology
ECG features of VF
no identifiable P waves, QRS complexes/ T waves. Irregular deflections of varying amplitude rate of 150-500 and decreasing amplitude with duration
ECG features of VT
a ventricular tachycardia will show a rapid heart rate (above 100bpm), broad QRS complexes (above 160ms), AV dissociation (the P wave and QRS complexes occur at different rates), and right axis deviation (QRS is positive in lead aVR and negative in leads I and aVF)
ECG features in acute pericarditis
widespread ST elevation and PR depression in limb leads (leads I, II, III, aVL, and aVF) as well as in precordial leads V2-6. Reciprocal ST depression and PR elevation in lead aVR and V1 may also be seen. Sinus tachycardia is also a common ECG characteristic of acute pericarditis due to pericardial effusion.
https://upload.wikimedia.org/wikipedia/commons/thumb/f/f1/Ventricular_fibrillation.png/640px-Ventricular_fibrillation.png
ventricular fibrillation
https://thephysiologist.org/wp-content/uploads/2016/02/94-216-f.jpg?w=640
ventricular tachycardia
Normal ECG parameters
HR- 60-100
P wave - Upright in 1,2,aVF, inverted in aVR
PR interval - 3-5 small boxes
QRS - 2.5 small boxes
QT interval - 9-11 small boxes <0.45seconds
most common causes of hypokalaemia include:
sepsis
vomiting
diarrhea
DKA
Cushing’s syndrome
primary/secondary hyperaldosteronism
Poor nutrition
fasting/starvation
Renal tubular defects
ECG changes associated with hyperkalemia
1 = Increase in T wave amplitude, peaked T waves
2 = wave flattening and PR prolongation
3= bradyarrhythmias, widened QRS
4 = SInusoidal, torsades
Meds that may cause hyperkalemia
aldosterone antag
NSAID
Ciclosporin
potassium supplements
spiranolcatone
ACE/ARB
Digoxin
Mng hyperkalemia
ECG changes hypokalmeia
Mng hypokalemia
Tx of torsades
IV MgSO4
