ECGs to interpret Flashcards
What does this ECG show?
Atrial Fibrillation
Irregular without P-waves
What does this ECG show?
Atrial flutter
Regular with saw-tooth baseline
(fluttering P-waves)
2:1, 3:1 or 4:1 block
What does this ECG Show?
Atrial tachycardia
Regular with abnormal P waves
What does this ECG show?
AV nodal re-entry (junctional) Tachycardia (AVRNT)
Regular with no P waves
What does this ECG show?
Ventricular Fibrillation
No discernible P waves/QRS complexes
(random wavy line)
NO PULSE!
What does this ECG show?
Ventricular Tachycardia
Broad complex tachycardia is VT until proven otherwise
(Organised wavy line)
What does this ECG show?
Atrial ectopic
Narrow QRS +/- preceding ectopic P wave
(resets the P wave cycle)
What does this ECG show?
Ventricular ectopic
Abnormal broad QRS at abnormal time
- It doesn’t affect the SA node so next P wave occurs at predicted time
What does this ECG Show?
Ventricular bigeminy
A.K.A. regular ventricular ectopics
- Abnormal premature ventricular complexes
What does this ECG show?
Wolff-Parkinson-White (WPW) syndrome
Slurred upstroke into the QRS complex (delta wave)
Short PR interval
QRS complexes maybe slightly broad
Dominant R wave in V1 (because the accessory pathway is left-sided)
What does this ECG show?
Brugada syndrome
(cardiac sodium channelopathy)
RBBB with ST elevation V1-3
[RBBB = QRS in V1 has M pattern and in V6 is W = MaRRoW]
What does this ECG show?
Infarction
ST elevation (first change)
T wave inversion
Pathological Q waves - Signify full thickness MI and develop 8-12 hours after ST elevation if myocardium is not reperfused
What are the STEMI criteria?
STEMI criteria
ST elevation in >2 small squares in 2 adjacent chest leads [v1-v6]
ST elevation >1 small square in 2 adjacent limb leads
[three bipolar limb leads (I, II, and III), the unipolar limb leads (AVR, AVL, and AVF)]
OR
New LBBB
What does this ECG show?
Ischaemia:
ST depression
New T-wave inversion
What does this ECG show?
Posterior (wall of LV) infarction
Dominant R wave in V1/2 (like right ventricular hypertrophy but without other changes)
ST depression
NB: Q waves can only be seen by placing limb leads on pts back
How can you tell previous infarcts?
Previous infarcts
T-wave inversion (last weeks-months) and pathological Q waves (permanent)
What does this ECG show?
Left ventricular hypertrophy
R-wave >5 big squares in V5/6,
T wave inversion in lateral leads (I, aVL, V5-6)
What does this ECG show?
Right ventricular hypertrophy
Dominant R wave in V1
T wave inversion in right chest leads (V1-3)
Right axis deviation
What does this ECG show?
Hypertrophic cardiomyopathy
Left ventricular hypertrophy signs
[R-wave >5 big squares in V5/6,
T wave inversion in lateral leads (I, aVL, V5-6)]
Dramatic T wave inversion in lateral leads (maximal in V4 rather than in V6)
