Non cardiac conditions and the ECG

Question 1

Cerebral haemorrhage ECG changes

Answer 1

Bradycardia
Massive deep T waves
Prolonged QT interval due to wide T waves

Question 2

Pulmonary embolism ECG changes

Answer 2

Sinus tachycardia
RVSP
S1,Q3,T3
complete or incomplete RBBB signs
Right axis deviation
T wave inversion in lead 3 V1 = highly specific for PE

Question 3

hypothermia ECG changes

Answer 3

bradyarrhythmia’s
Osbourne waves (small wave after QRS with fishhook appearance.
Prolonged PR, QRS and QT intervals
Shivering artefact
Ventricular ectopic

Question 4

Hyperkalaemia

Answer 4

Increased extracellular potassium levels causing reduced myocardial activity and depressing conduction and contraction. Serum potassium over 5.2mmol/L.

Question 5

Hyperkalaemia ECG changes

Answer 5

Tall, peaked T waves.
P wave flattening and PR elongation
Bradyarrhythmia’s
BBB
QRS widening and bizarre morphology

Question 6

Hypokalaemia ECG changes

Answer 6

T wave inversion
ST depression
U wave = sixth wave on ECG after T wave due to delayed de/repolarisation
prolonged PR interval
Prolonged T wave causing torsade’s de pointes if R wave occurs at same time as a T wave.

Question 7

PE

Answer 7

ECG changes due to pulmonary hypertension

Question 8

Cerebral haemorrhage

Answer 8

ECG changes due to increased pressure or damage to rhythmic centre of the brain.