4.1 Medicine Cardiovascular Paediatric Ecg

Front 1

Which is incorrect regarding the Paediatric ECG?
A. ECG recording is essentially the same as Adults.
B. Syncope is an indication for ECG in the Paediatric age group.
C. A leftward axis is normal in Toddlers.
D. There is Right ventricular dominance in neonates and infants.

Back 1

C. A "normal" or "rightward"axis is considered normal
neonate : +60 - 190 degrees
2 months : +5 - 100 degrees

Front 2

In regards to the Paediatric ECG and P waves, which of the following is correct?
A. Right atrial hypertrophy = wide P waves
B. Left atrial hypertrophy = tall P waves
C. The normal P wave amplitude is < 5 mm
D. The normal P wave duration is < 0.09 sec, and is best evaluated in leads II and V1.

Back 2

D.

A = RAH : Tall P waves
B = LAH : wide P waves
C = Normal amplitude < 3 mm

Front 3

In regards to the PR interval on the Paediatric ECG, which of the following is incorrect?
A. Shortened PR interval can be suggestive of pre-excitation e.g.. WPW
B. The normal PR interval is < 100 msec
C. The PR interval is shorter in Children until age 16
D. Prolonged PR interval doe not occur in Children.

Back 3

D. It can
1. Drugs
2. Congenital heart disease
3. Metabolic : hyperkalaemia

Front 4

Which of the following is incorrect regarding the Paediatric ECG?
A. Q waves can be present in multiple leads in neonates and infants.
B. Right Bundle Branch Block (RBBB) is uncommon.
C. The QRS duration is typically shorter due to less muscle mass.
D. A Dominant R wave in V1 can be normal

Back 4

B. RBBB is common, as is a Partial RBBB pattern.

Front 5

Which of the following is correct regarding the Paediatric ECG?
A. T waves inversion occurs in all leads until age 16.
B. A QT interval > 430 msec is considered prolonged in older Children.
C. Hypocalcaemia can produce a prolonged QT ECG pattern, whilst hypercalcaemia produces a shortened QT.
D. A QT interval up to 500 msec is normal in < 6 month age group.

Back 5

C.

A : T inversion isolated to V1-V2 by age 10
"Juvenile" pattern may persist into Adolescence in V1V2
B : QT interval > 450 msec = prolonged in older Children
D. < 490 msec can be normal in age < 6 months.

Front 6

What are the indications for an ECG in the Paediatric age group? (4)

Back 6

1. Syncope
2. Arrhythmias (tachy / brady)
3. Drug ingestion
4. Congenital heart defects

Front 7

What is the normal Axis in Age > 2 months in Paediatric ECG's?
A. +60 - 190 degrees
B. +5 - 100 degrees
C. +30 - 110 degrees
D. + 65 to 160 degrees

Back 7

B. >2months = +5 to 100 degrees

< 1 week = +60 to 190 degrees
1-3 weeks = +65 to 160 degrees
1-2 months = +30 to 110 degrees