Ecg Review

Front 1

ECG nml axis describe lead I & aVF

Back 1

Both +

Front 2

LAD describe leads I & aVF

Back 2

I = + aVF (-)

Front 3

RAD describe I & aVF

Back 3

I (neg) aVF (+)

Front 4

Extreme axis describe I & aVF

Back 4

both negative

Front 5

LAD is associated with what disorder?

Back 5

Left anterior hemiblock seen in CAD

Front 6

RAD is seen when?

Back 6

often nml finding in children and young adults
Left posterior hemiblock
RVH, pulm HTN

Front 7

How do you determine HR on an ECG

Back 7

1500/# of little squares
300/# of big squares

Front 8

What is the nml P-R interval? What does a long PR inerval mean? What does a short P-R mean?

Back 8

3-5 small squares should be no longer than 1 big square.
1 degree block
short could be WPW

Front 9

What are the causes of a widened QRS?

Back 9

BBB, PVC, TCA toxicity, WPW

Hint 9

4

Front 10

What is the nml duration of a QRS?

Back 10

1/2 big square
<100 ms

Front 11

What is the nml QT interval? How do you correct for time?

Back 11

QTc = 340-430 ms
QTc= QT/sq rt(RR in sec)
Rule of thumb QT should be 40% of RR

Front 12

What do the squares on the ECG mean in terms of time?

Back 12

Big square = 0.2 sec or 200 ms
small square = 40 ms

Front 13

What arrthymia develops from a prolonged QT inerval?

Back 13

Torsades de pointes

Front 14

What are the more common causes of prolonged QT interval?

Back 14

TCA overdose
Hypo Ca, Mg, K
quinidine, procanamide, amiodarone, starvation, CNS injury, liquid protein diet

Hint 14

10

Front 15

What can non-sedating antihistamines do to an ECG?

Back 15

Prolong the QT interval exacerbated by erthromycin, ketakonozole, hepatic dysfunction.

Front 16

35 yo Female with allergies resently prescribed Hismanal who was noted to have an abnml ECG. What was the cause? She has an infection what should you not prescribe?

Back 16

QT prolongation exacerbated by erthromycin

Front 17

What shortens the QT

Back 17

hypercalcemia and digitalis

Hint 17

2

Front 18

Describe the nml p wave

Back 18

< 2 mm high
< 120 mm (3 sm squares wide)
+ in lead II and - aVR also look in V1

Front 19

Describe the p wave in right atrial enlargement? Left atrial enlargement

Back 19

RAE = peaked p
LAE = widened p wave neg V1

Front 20

Peaked T waves are associated with what?

Back 20

Hyperkalemia
Hyperacute MI
intracerebral hemorrahge
V1 V2 evloving post MI

Hint 20

think about symetry of t wave

Front 21

Focal flipped T waves?

Unknown question

Back 21

V1-V2 RBBB, LVH
I aVL V6 LBBB

Front 22

Prominent U waves indicate what

Back 22

Increased tendency to Toorsades de pointes, hypokalemia, bradycardia, digitalis, amiodarone

Front 23

Diffuse flipped T waves?

Back 23

Pericarditis
diffuse ischemia
metabolic abnml
Intracerebral hemmorhage

Hint 23

4

Front 24

What is the sig of negative U waves

Back 24

U waves in a different direction from T wave always significant casues are ischemia, HTN Aortic valve dz, RVH

Front 25

What are the 3 main causes of ST elevation?

Back 25

Acute MI
Prinzmetal angina
Pericarditis or myocarditis

Hint 25

3

Front 26

Describe 4 rules to determine axis on an ECG?

Back 26

1. I & aVF both + = nml
2. I(+) aVF(-) = LAD
3. I(-) aVF(-) = extreme axis
4. I(-) aVF(+) = RAD

Front 27

In what leads are ischemic changes seen in a septal MI?

Back 27

V1-V2

Front 28

In what leads are ischemic changes seen in a anteroseptal MI?

Back 28

V1-V4

Front 29

In what leads are ischemic changes seen in a anerior MI?

Back 29

V3-V4

Front 30

In what leads are ischemic changes seen in a lateral MI?

Back 30

I aVL V6

Front 31

In what leads are ischemic changes seen in a posterior MI?

Back 31

Tall R waves in V1-V2

Front 32

In what leads are ischemic changes seen in a inferior MI?

Back 32

II, III, aVF

Front 33

What does ST depression indicate?

Back 33

1. subendocarial ischemia
2. V1-V2 = posterior MI
3. Dig tox
4. LVH
5. Hypokalemia
6. LV strain (ST depression with flipped T Waves)

Front 34

What are the criteria for LVH?

Back 34

Flipped T waves in V1-V2
S in V1 + R in V5 35 mm
R peak time > 50ms watch out for WPW!
May also have strain pattern ST depression + flipped T waves
RV5>25-35

Front 35

Describe the specificity and sensitivity of voltage criteria for LVH & RVH

Back 35

Specificty is fairly good (low FP) Sensitivity is horrible (lots of FN)

Front 36

What are the ECG criteria for RVH

Back 36

RAD
ST depression + fipped T wave V1
Large R wave V1

Front 37

Criteria for LBBB

Back 37

QRS 120-180ms 3-4.5 sqs
RR' V6 SS' V1
T wave flipped

Front 38

Criteria for RBBB

Back 38

QRS >120 ms 3sqs
RSR' in V1

Front 39

When interpreting an ECG, right ventricular hypertrophy (RVH) can mimic which of the following conditions?


A. LBBB
B. AV block
C. True posterior MI
D. LAFB
E. LPFB

Back 39

The prominent anterior forces seen in RVH are also seen in a number of other conditions including a true posterior MI. Thus, RVH is sometimes referred to as a pseudoinfarct.
RBBB and WPW could also result in prominent anterior forces but they may be distinguished in other ways. (rSR' morphology in V1, delta waves, and short PR.)

Front 40

What are the ECG criteria for RVH?

Back 40

Right axis deviation ( I negative AVF +)
R wave > S wave in V1 & S wave > R wave in V6

Front 41

What are the ECG criteria for LVH?

Back 41

R in V5,6 + S in V1,2 >35
R in AVL >13 mm
Repolarization abnml

Front 42

List the 7 potential causes of arrhythimas?

Back 42

HIS DEBS (Acronym)
Hypoxia
Ischemia & Irritability
Sympathetic stimulation
Drugs
Electrolyte disturbances
Bradycardia
Stretch such as in CHF LAE

Front 43

What are the 4 most important questions in determining the origin of an arrhythmia?

Back 43

1. Are nml P waves present?
2. QRS duration < 0.12 sec?
3. Relationship between P & QRS?
4. Regular or Irregular?