Interpretation Flashcards
(26 cards)
Inverted Narrow P wave
Skinny because both atria depolarise simultaneously instead of right then left
Impulse moves from inner heart outwards
SUPRAVENTRICULAR TACHYCARDIA
M shaped P wave
Enlarged left atrium
Wide P wave
Atrial enlargement or slow conduction
When is it useful to examine elevation or depression of the PR segment
In acute pericarditis
Initial wide upstroke of QRS complex
Initial depolarisation takes longer than usual or it’s slower due to:
Accessory pathway or Wolff Parkinson White pattern- slow conduction due to Accessory pathway via delta wave
Left ventricular hypertrophy
In a bundle branch block is the QRS normal or delayed
Normal
Are Q waves normal in V1 and V2
NO
Where is it normal to find a Q wave
aVR
Right ventricular hypertrophy
Q waves in V1 and V2
Where are small narrow Q waves seen
V6 and Lead I
Large QRS
Left ventricular hypertrophy
Very wide QRS
Ventricular tachycardia
Wide and large QRS plus tachycardia
BBB
RV hypertrophy
Voltage more than 7mm
Size of pathological Q wave
More than 40ms 1 small block wide
Posterior infarction
Usually never occurs in iso and usually with inferior infarction
R waves in V1 and 2 become dominant
ST segment depression and T wave evolves to become upright
Mirror image of pathological Q wave
Tall R wave or dominant R wave in V1
Right BBB
Right ventricular hypertrophy
Posterior infarction
WPW
Duchennes Muscular Dystrophy
Left ventricular pacing
Small QRS/ low amplitude QRS
Something between heart and skin electrodes such as
Fat
Fluid: pericardial effusion
Air: obstructive airways disease and pneumothorax
Or
Cardiomyopathy (end stage thin globally dilated LV with pericardial effusion)
Do echo
ST segment elevation
Myocardial ischaemia Acute pericarditis (saddle back, also look for PR segment elevation or depression) Depolarisation abnormalities Electrolyte abnormalities Bundle branch block
Myocardial ischaemia
NEED TO OBSERVE A FEW ECGs
T waves initially become taller and larger but later become inverted and symmetrical
ST segment elevation
Pathological Q waves
ST elevation in aVR
Very proximal left anterior descending artery
Peaked or deep T waves
Hyperkalaemia
Myocardial ischaemia usually anterior and inferior leads
Post resus
Cardiomyopathy
Hyperkalaemia ECG changes
Peaked T waves
Absent P wave or flat
QRS widening
ST segment changes up or down
T wave alterans
Tachycardia
Pericardial effusion
Chronic HD
Long QT syndrome
