WHAT DIS ECG BIZ

Question 1

Irregularly irregular

Answer 1

AF, atrial flutter

Question 2

Regularly Irregular

Answer 2

2nd degrees heart block

Question 3

Left Axis deviation

Answer 3

Left ventricular hypertrophy, LBBB

Question 4

Right Axis deviation

Answer 4

Right Ventricular hypertrophy, RBBB, PE

Question 5

P mitrale

Answer 5

MS, left atrial enlargement

Question 6

P Pulmonale

Answer 6

PE, right atrial enlargement

Question 7

Fixed increased PR (>0.2s/5 small squares)

Answer 7

1st degree AV HB. Also narrow QRS.

–> inferior wall MI, hyperkal, beta blockers/CCBs

Question 8

Fixed interval increase but dropped QRS

Answer 8

Mobitx T1 2nd degree AV HB
–> inferior wall MI, RhF, beta blockers/CCBs
Narrow QRS

Question 9

Slowly increased PR irregularly then drop

Answer 9

Mobitz T2 2nd degree AV HB
Broad QRS
—> RhD, BBs

Question 10

Delta slope

Answer 10

WPW/AVRT

Question 11

Broad QRS (>0.12s/3squares)

Answer 11

Ventricular tachy, BBB, WPW S

Question 12

Tall complex

Answer 12

Left ventricular hypertrophy

Question 13

Pathological Q wave

Answer 13

Old infarct. (a bit of a deeper Q)

Question 14

QT syndrome

Answer 14

(Prolonged QT, >0.44s)
1. Congenital 
2. Hypomagnesemia 
3. Hypokalaemia 
4. Drug 
(MI, myocarditis) 
Increases risk of torsades de pointes

Question 15

ST elevation

Answer 15

MI, pericarditis (saddle shaped), variant angina

Question 16

ST depression

Answer 16

AVRT, Hypokal, posterior MI

Question 17

T wave inversion

Answer 17

R ventricular strain, previous MI, BBB, PE

Question 18

Tall T waves

Answer 18

Hyperkal,

Hyperacute STEMI

Question 19

Biphasic T wave

Answer 19

Ischaemia

Question 20

Flattened T waves

Answer 20

Ischaemia

Question 21

U waves

Answer 21

(small deflections after t waves)

Electrolyte imbalance

Question 22

LBBB - ECG, causes

Answer 22

2 deep S waves in V1, 2 tall R waves in V6
LAD
–> AS, IHD, hypertension, ant MI, Dilated cardiomyopathy

Question 23

RBBB - ECG, causes

Answer 23

2 tall R waves in V1, 2 deep S waves in V6

–> Cor pulmonale, PE (IDH, RhF)

Question 24

P and QRS asynchonised

Answer 24

3rd degree heart block
A cannon wave in JVP
Due to ant/inf MI, CHD, myocarditis, BBs

Question 25

AF

Answer 25

Irregularly irregular, no p waves | IHD, PE, thyrotox, caridomyopathy

Question 26

Atrial Flutter

Answer 26

300bpm no t wave, saaw tooth patten CAUSES: Coronary heart disease, cardiomyopathy, inflammation, blood pressure. EFFECTS: Stroke, dyspnoea, dizziness, angina pectoris, palpitations

Question 27

Ventricular fibrillation

Answer 27

o Chaotic irregular deflections of varying amplitude o No identifiable p waves, QRSs or T waves o Rate 150-500bpm o Amplitude decreases with duration o Coronay heart disease, cardiomyopathy, echo

Question 28

Ventricular flutter

Answer 28

o Monomorphic sine wave o >200bpm o ECG identical when turned upside down

Question 29

AVNRT

Answer 29

 140-180bpm tachycardia  QRS is narrow (unless pre-existing BBB)  ST depression  P waves may be buried in the QRS complex (it starts at the same time)

Question 30

AVRT

Answer 30

 200-300bpm  Can be orthodromic (signal travels down via AV node) or antidromic (signal travels up via AV node)  P waves may not be buried, but can be. May be retrograde  Narrow QRS complexes (<120ms; unless pre-existing BBB)  T wave inversion common  ST segment depression

Question 31

Wolf Parkinson White Syndrome

Answer 31

* Irregular rhythm, axis stable * PR interval shorter  Delta wave * Broad QRS (>120ms) * Leads to AVRT

Question 32

Torades de Pointes

Answer 32

 A type of polymorphic ventricular tachycardia when there is QT prolongation  QRS “twists” around the isoelectric line.  >220bpm  VF

Question 33

ST elevation: | V1-V4

Answer 33

Left Anterior Descending Anterior MI Also axis deviation Pathological Q may be seen

Question 34

ST eelvation I, V5, V6

Answer 34

Left Circumflex, Lateral MI Also axis deviation Pathological Q may be seen

Question 35

ST elevation | I, V1-V6

Answer 35

Left main Stem Antriolatral MI Also axis deviation Pathological Q may be seen

Question 36

ST elevation | II, III, avF

Answer 36

Right Coronary Artery Inferior MI Also axis deviation Pathological Q may be seen

Question 37

ST depression | V1-V4

Answer 37

Posterior Decending artery Posterior MI Also axis deviation Pathological Q may be seen

Question 38

Pericarditis

Answer 38

 Widespread ST elevation on all ECG leads. Saddle shaped.  PR depression on limb leads (except aVR, elevation)  Sinus tachycardia is common (pain or pericardial effusion)  After days/months, it is replaced by T Wave inversion

Question 39

vasospastic angina

Answer 39

ST elevation

Question 40

PE

Answer 40

o Sinus tachycardia & atria tachyarrhythmia o Complete/incomplete RBBB o ST elevation or depression o Right ventricular strain (T wave inversion on V1-4, and inferior leads II, III, a) o RAD o P Pulmonale – Peaked p wave in Lead II o S1Q3T3 (Deep S wave in I, Q wave in III and inverted T in III)

Question 41

Hypokal

Answer 41

``` o Increased amplitude o PR prolongation o T wave flattening and inversion o ST Depression o Prominent U waves o (long QT interval) ``` Tx: potassium

Question 42

Hyperkal

Answer 42

``` o Peaked T waves (K>5.5) o Prolonged PR segment o Loss/flattening of P waves (K>6.5) o Weird QRS complexes (broad and bradycardia) (K>7.5) o Sine wave if extreme ``` Tx: 10% 10ml calcium gluconate to stabilise the myocardium, then dextrose to prevent hypoglycaemia, and insulin to help the cells take up potassium (salbutamol may also be used instead of insulin)

Question 43

J waves

Answer 43

Hypothermia

Question 44

Causes of ventricular tachy? (2)

Answer 44

Hypomagnesium, and hypokal