What are the three main components of an ECG waveform?
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Mastering this deck enables healthcare professionals to interpret ECGs accurately, facilitating early diagnosis of cardiac abnormalities such as arrhythmias and ischemia, ultimately improving patient management and outcomes.
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| 1 | What are the three main components of an ECG waveform? |
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Understand ECG principles, waveforms, intervals, and their significance in diagnosing arrhythmias, ischemia, and other cardiac conditions.
The P wave, QRS complex, and T wave are the three main components, representing atrial depolarization, ventricular depolarization, and ventricular repolarization, respectively. |
| Think of the P as 'Atrial', QRS as 'Ventricular', T as 'Recovery'. |
| 2 | What does the PR interval represent, and what is its normal duration? | The PR interval represents the time from atrial depolarization to ventricular depolarization, including conduction through the AV node. Normal duration is 120-200 milliseconds (0.12-0.20 seconds). | Think of PR as the 'pause' between atrial and ventricular activity. |
| 3 | How is the QT interval measured, and why is it clinically important? | The QT interval is measured from the start of the QRS complex to the end of the T wave. It reflects ventricular depolarization and repolarization. Prolonged QT can predispose to arrhythmias like Torsades de Pointes. | Remember QT as 'Q-T to T wave, the ventricular recovery time.' |
| 4 | What is the significance of ST segment elevation on an ECG? | ST segment elevation indicates acute myocardial injury or infarction, typically seen in ST-elevation myocardial infarction (STEMI). | Think 'ST-elevation' as 'injury' or 'acute ischemia'. |
| 5 | What ECG change is characteristic of hyperkalemia? | Tall, peaked T waves are characteristic of hyperkalemia, often accompanied by widened QRS complexes as severity increases. | Remember 'T' for 'Tall T waves' in hyperkalemia. |
| 6 | How does atrial fibrillation typically appear on an ECG? | Atrial fibrillation shows an irregularly irregular rhythm with absent discernible P waves and irregular R-R intervals. | Think 'Irregular P's' and 'No P waves' for AF. |
| 7 | What is the significance of a prolonged QRS complex (>120 ms)? | A prolonged QRS indicates delayed ventricular conduction, often due to bundle branch blocks or ventricular rhythms. | QRS prolongation suggests 'conduction delay'. |
| 8 | Which ECG pattern is indicative of ischemia or injury in the anterior wall of the heart? | ST segment elevation in the precordial leads (V1-V4) suggests anterior wall myocardial infarction. | Think 'V1-V4' as 'anterior' leads. |
| 9 | What is the typical ECG finding in a patient with a pericarditis? | Diffuse widespread ST segment elevation and PR segment depression are characteristic of pericarditis. | Look for 'widespread ST elevation' across multiple leads. |
| 10 | Define sinus rhythm and its typical rate range. | Sinus rhythm originates from the sinoatrial node with a regular rate between 60-100 beats per minute. | Think 'sinus' as the natural pacemaker of the heart. |
| 11 | What does a 'delta wave' on an ECG indicate? | A delta wave signifies pre-excitation of the ventricles via an accessory pathway, seen in Wolff-Parkinson-White syndrome. | Remember 'delta' as 'early activation'. |
| 12 | How can you differentiate between atrial flutter and atrial fibrillation on an ECG? | Atrial flutter shows sawtooth flutter waves, usually at a rate of 250-350 bpm, with regular atrial activity; AF shows irregularly irregular rhythm with absent P waves. | Flutter = 'sawtooth'; fibrillation = 'irregular irregular'. |
| 13 | What is the clinical significance of a short PR interval (<120 ms)? | A short PR interval suggests pre-excitation syndromes like Wolff-Parkinson-White, due to early ventricualr activation via an accessory pathway. | Think 'short' as 'early' conduction. |
| 14 | What characteristic ECG feature defines a first-degree AV block? | Prolongation of the PR interval beyond 200 ms with a regular rhythm and all P waves followed by QRS complexes. | First-degree = 'lengthened PR'. |
| 15 | What arrhythmia is characterized by a regular, narrow QRS complex tachycardia at 150-250 bpm with retrograde P waves often hidden? | Supraventricular tachycardia (SVT), often reentrant in origin. | Think 'rapid, narrow, regular'—common in young adults. |
| 16 | What is the typical ECG finding in ventricular tachycardia? | Wide QRS complexes (>120 ms) at a rate of 100-250 bpm, usually with a regular rhythm and no preceding P waves. | Ventricular tachycardia = 'wide QRS'. |
| 17 | How does the ECG change in digitalis toxicity? | Down-sloping ST depression with scooped appearance (sometimes called 'Salvador Dali's mustache') and arrhythmias. | Think 'digitalis' causes 'scooped' ST segments. |
| 18 | What does a peaked T wave indicate in terms of serum potassium levels? | Peaked T waves are an early sign of hyperkalemia, indicating elevated serum potassium. | T wave peaks = 'hyperkalemia'. |
| 19 | What ECG findings suggest a right bundle branch block (RBBB)? | Wide QRS (>120 ms) with an rsR' pattern in V1 and a wide S wave in V6. | RBBB creates 'M-shaped' R' in V1. |
| 20 | What is the typical ECG pattern in left bundle branch block (LBBB)? | Wide QRS (>120 ms) with broad, notched, or slurred R waves in leads V5 and V6, and absent Q waves in lateral leads. | LBBB causes 'widened, slurred' QRS complexes. |
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