Introduction to the ECG Flashcards Preview

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Flashcards in Introduction to the ECG Deck (15):
1

Where should ECG leads be placed?

- V1 in the 4th intercostal space on the patient’s right-hand side of the sternum and V6 in the midaxillary line with V2, 3, 4 and 5 in between

2

How should an ECG be read?

- Check date, time and patient

- Check paper speed (25mm/s) and gain (10mV/mm)

- Identify P/QRS/T

- Measure rate

- Check intervals (PR <1 large, QRS <3 small, QT < 11 small)

- Determine the axis (normal +ve in I and II)

- Check P/QRS/T morphology

3

What rhythm is this?

Q image thumb

- Sinus bradycardia

- Rate <60

- Regular, narrow QRS

- P waves present

- P:QRS is 1:1

4

What rhythm is this?

Q image thumb

- Junctional bradycardia

- QRS is narrow so must be using specialised conduction system

- No P waves so no atrial depolarisation

- Impulse must be coming from the AV node

- Rate <60bpm

- Regular narrow QRS

- No P waves present

5

What rhythm is this?

Q image thumb

- Second degree AV block (Mobitz type I)

- Failure of AV nodal conduction

- Slowest rate <60bpm

- Irregular, narrow QRS

- P:QRS not 1:1 (increasing PR interval then dropped beat)

6

What rhythm is this?

Q image thumb

- Second degree AV block (Mobitz type II)

- AV node working normally or completely fails

- Slowest rate <60bpm

- Irregular, narrow QRS

- P:QRS not 1:1 (constant PR interval with intermittent dropped beats)

7

What rhythm is this?

Q image thumb

- Complete AV block

- No signal so cells in heart develop their own signals

- Rate <60bpm

- Regular broad QRS

- No relation between P and QRS

8

What rhythm is this?

Q image thumb

- Atrial fibrillation

- Cells depolarising in a chaotic fashion as they have lost control at SA node

- Rate is fast and variable

- Irregular, narrow QRS

- No P waves

9

What rhythm is this?

Q image thumb

- Sinus tachycardia

- Rate >100bpm

- Regular, narrow QRS

- P waves present

- P:QRS is 1:1

10

What rhythm is this?

Q image thumb

- Supraventricular tachycardia

- Rate usually >150bpm

- Regular, narrow QRS

- P waves present?

- P:QRS is 1:1

11

What rhythm is this?

Q image thumb

- Ventricular tachycardia

- Rate >120bpm

- Regular broad QRS

- P waves variable

12

What condition is this?

Q image thumb

- Posterior STEMI

- Tall R wave, tall upright T wave in leads V1-3

13

What condition is this?

Q image thumb

- Anterior STEMI

- ST elevation in anterior leads V1-6 and aVL

- Reciprocal ST depression in the inferior leads

14

What condition is this?

Q image thumb

- Inferior STEMI

- ST elevation in inferior leads II, III and aVF

- Reciprocal ST depression in the anterior leads

15

What condition is this?

Q image thumb

- Lateral STEMI

- ST elevation in lateral leads I, aVL and V5-6

- Reciprocal ST depression in inferior leads III and aVF