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Cardiology

ECG

QuestionAnswer
Hypokalaemia (3.5 - 5 mmol/L normal range) ECG changes ECG features of hypokalaemia U waves small or absent T waves (occasionally inversion) prolong PR interval ST depression long QT "In Hypokalaemia, U have no Pot and no T, but a long PR and a long QT"
Delta waves are seen in what? Wolf PArkinsons White syndrome
What waves are seen in Hypothermia? J waves
What are the drugs that may cause Prolonged QT ingterval? Amiodarone, Sotalol, class 1a Antiarrhythmic drugs Tricyclic antidepressants, Fluoxetine Chloroquine Terfenadine Erythromycin
Congenital causes of Prolonged QT Jervell-Lange-Nielsen syndrome (includes deafness and is due to an abnormal potassium channel) Romano-Ward syndrome (no deafness)
Physiological causes of prolonged QT (incuding electrolyte abnormalities) electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia acute myocardial infarction myocarditis hypothermia subarachnoid haemorrhage
RBBB ECG features One of the most common ways to remember the difference between LBBB and RBBB is WiLLiaM MaRRoW in LBBB there is a 'W' in V1 and a 'M' in V6 in RBBB there is a 'M' in V1 and a 'W' in V6 The following features can be seen on this ECG: broad QRS > 120 ms rSR' pattern in V1-3 ('M' shaped QRS complex) wide, slurred S wave in the lateral leads (aVL, V5-6)
RBBB causes right ventricular hypertrophy chronically increased right ventricular pressure - e.g. cor pulmonale pulmonary embolism myocardial infarction atrial septal defect cardiomyopathy or myocarditis
Atrial flutter ECG appearance sawtooth atrial rate is often around 300/min the ventricular or heart rate is dependent on the degree of AV block. For example if there is 2:1 block the ventricular rate will be 150/min flutter waves may be visible - carotid sinus massage or adenosine
ECG territories and blood supply: Anteroseptal V1-V4 Left anterior descending
ECG territories and blood supply: Inferior II, III, aVF Right coronary
ECG territories and blood supply: Anterlateral V4-6, I, aVL Left anterior descending or left circumflex
ECG territories and blood supply: Lateral I, aVL +/- V5-6 Left circumflex
ECG territories and blood supply: Posterior Tall R waves V1-2 Usually left circumflex, also right coronary
ECG changes for thrombolysis or percutaneous intervention: ST elevation of > 2mm (2 small squares) in 2 or more consecutive anterior leads (V1-V6) OR ST elevation of greater than 1mm (1 small square) in greater than 2 consecutive inferior leads (II, III, avF, avL) OR New Left bundle branch block
CAuses of LBBB ischaemic heart disease hypertension aortic stenosis cardiomyopathy rare: idiopathic fibrosis, digoxin toxicity, hyperkalaemia
Acute MI ECG characteristics Hyperacute T waves are often the first sign of MI but often only persists for a few minutes. ST elevation may then develop.
Acute MI characteristics continued T waves typically become inverted within the first 24 hours. The inversion of the T waves can last for days to months. Pathological Q waves: several hours to days. This change usually persists indefinitely.
Created by: Vernificus
 

 



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