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Medicine MD3001 cardiovascular system > Interpretation of ECG > Flashcards

Interpretation of ECG Flashcards

1
Q

how is a regular rate on an ECG calculated?

A

300/number of big squares per R-R interval

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2
Q

what is a normal rate?

A

60-100 bpm

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3
Q

what is a sinus rhythm?

A
  • normal P waves
  • normal QRS complexes
  • one P wave per QRS complex
  • regular rhythm
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4
Q

how is atrial fibrillation seen on an ECG trace?

A
  • no discernable P waves

- irregular QRS complexes

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5
Q

how is arterial flutter seen on an ECG trace?

A
  • p waves seen at a rate of 300 per minute

- p waves have a saw toothed appearance

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6
Q

what is Junctional tachycardia? how is junctional tachycardia seen on ECG?

A
  • impulses arriving from AV node

- normal QRS complexes yet absent P waves

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7
Q

what is ventricular tachycardia?

A
  • after 2 sinus beats rate increases to 150 bpm

- QRS complexes become broad and T waves are difficult to identify

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8
Q

what is a P wave? What is its normal form on an ECG?

A
  • time for atrial depolarisation

- less than 0.25 mv should be upright in 2,3 and aVF

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9
Q

what is P-mitrale?

A
  • bifid P wave

- L atrial hypertrophy

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10
Q

what is P pulmonale?

A
  • peaked P wave greater than 0.25 mv

- R atrial hypertrophy

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11
Q

what is the PR interval? what is the normal range?

A
  • time between atrial and ventricular depolarisation

- 0.12 s-0.2 s

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12
Q

what does an abnormal length PR interval mean?

A

prolonged interval implies delayed AV conduction hence a 1st degree heart block

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13
Q

what is QRS complex? what is the normal range?

A
  • time for ventricular depolarisation

- normally is less than or equal to 0.12s

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14
Q

what is normal Q wave?

A

less than 0.04s and less than 2mm in depth

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15
Q

what is an abnormal QRS complex? What is it indicative of?

A
  • greater than 0.12s

- ventricular conduction defects- left or right Bundle Branch Block

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16
Q

what does it mean if the voltage of the QRS complex is less than 5mv?

A
  • hypothyroidism
  • COAD
  • Myocarditis
  • precarditis and pericardial effusion
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17
Q

how is L ventricular hypertrophy seen on an ECG?

A

R wave in V5 greater than 25mv

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18
Q

how is R ventricular hypertrophy seen on ECG trace?

A

dominant R wave in V1 or deep S wave in V6

19
Q

what features define a significant Q wave?

A
  • interval greater than 0.04s

- depth greater than 2mv

20
Q

what does an abnormal Q wave in lead 3 indicate?

A

Pulmonary embolism

21
Q

what is QT interval?

A
  • measured from start of Q to end of T

- ventricular depolarisation then repolarisation

22
Q

how is corrected QT calculated?

A

QTc= QT/ square route of RR interval

23
Q

what is normal range for the QT interval?

A

0.38-0.42 s

24
Q

why is the corrected QT interval used?

A

any change in heart rate alters QT interval and the heart rate is not constant

25
what can cause prolonged QT interval?
-acute myocardial ischaemia -myocarditis -bradycardia -head injury -hypothermia -urea and electrolyte imbalance congenital -drugs
26
what is the the ST segment?
time from end of ventricular depolarisation to start of ventricular repolarisation
27
what is a normal ST segment?
isoelectric
28
what does ST elevation indicate? what defines ST elevation?
- 1mm in 2 adjacent limb leads | - infarction
29
what does depression of ST segment indicate?
ischaemia
30
what are T waves representative of?
ventricular repolarisation
31
where are T waves most likely to be inverted?
aVR and V1
32
where is it abnormal for T waves to be inverted? What is this indicative of?
- lead 1 or 2 and V4-V6 | - ischaemia or infarction
33
what effects does digoxin have on T waves?
- T wave inversion | - St segment slopping depression
34
what 3 changes happen to ECG trace in Acute MI?
- T wave peaking followed by T wave depression - ST segment elevation - appearance of new Q waves
35
how is an anterior infract identified on an ECG?
- sinus rhythm - Q waves in leads V2-V4 - inverted T waves leads V4-V6
36
how is an anterolateral infarct seen in an ECG?
- sinus rhythm - Q waves in leads 1, 2 aVL - raised ST segments V2-V6
37
how is an inferior infract seen on an ECG?
- sinus rhythm - Q waves leads 3 and aVF - depressed ST segment in aVL and V6
38
how is a posterior infarct identified from an ECG?
V1- ST segment depression and tall R wave
39
How can a pulmonary embolism be identified from an ECG?
- large S wave in lead 1 - deep Q wave in lead 3 - inverted T wave in lead 3
40
what are the features of hyperkalaemia on an ECG?
- Tall, tented T wave | - widened QRS
41
what are the ECG features of hypokalaemia?
- small T wave | - prominant U wave
42
what is the features on an ECG of hypercalcaemia?
short QT interval
43
what are the 2 features on an ECG identifying hypocalcaemia?
- long QT interval | - small T waves

Medicine MD3001 cardiovascular system (44 decks)

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