ECG Made Easy Part 2 ECG Quiz
ECG made easyPart 2 – ECG Quiz Presented by: Dr Randall Hendriks, Interventional Cardiologist – Western Australia1
? Axis1. Left2. Right3. Indeterminate
? Axis1. Left2. Right3. Indeterminate
? Axis1. Left2. Right3. IndeterminatePage 4
? Axis1. Left2. Right3. IndeterminatePage 5
? Axis1. Left2. Right3. IndeterminatePage 6
? Axis1. Left2. Right3. IndeterminateStandard limb lead reversal!Page 7
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 8
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 9
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 10
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 11
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 12
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 13
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 14
Tachycardia1.2.3.4.5.Atrial fibrillationAtrial flutterSVTSinus tachycardiaJunctionalPage 15
Tachycardia1.2.3.4.5.Atrial flutterAtrial fibrillationSVTSinus tachycardiaJunctionalPage 16
Tachycardia1.2.3.4.5.Atrial flutterAtrial fibrillationSVTSinus tachycardiaJunctionalPage 17
Bradycardia1. Sinus bradycardia2. First degree AV block3. Mobitz Type I(Wenckebach)4. Mobitz Type 25. Complete heart blockPage 18
Bradycardia1. Sinus bradycardia2. First degree AV block3. Mobitz Type I(Wenckebach)4. Mobitz Type 25. Complete heart blockPage 19
ST elevation e 20
ST elevation e 21
ST elevation e 22
ST elevation e 23
ST elevation e 24
ST elevation e 25
ST elevation – 30 year old Thai man with syncope1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 26
ST elevation – 30 year old Thai man with syncope 1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 27
ST elevation – young adult patient with pleuritic chest pain1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 28
ST elevation – young adult patient with pleuritic chest pain1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 29
Palpitations1. VT2. SVT with aberrancyPage 30
ST elevation – young adult patient with pleuritic chest pain1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 31
ST elevation – young adult patient with pleuritic chest pain1.2.3.4.5.Anterior MINormal repolarisationLV aneurysmPericarditisBrugada syndromePage 32
Palpitations1. Absence of RS?2. No – next questionPage 33
Palpitations1. R/S interval 100msec?2. Yes - VTPage 34
Can’t miss-life threatening ECGs35
Bradycardia and hypotensive in EDPage 36
Bradycardia and hypotensive in EDComplete heart blockPage 37
Wolff-Parkinson-White syndrome
Palpitations: 20 year old female with presyncopePage 40
Palpitations: 20 year old female with presyncopePre-excited AFPage 41
HypokalaemiaPage 42
Broad complex tachycardia – diagnosis?Page 43
Broad complex tachycardia – diagnosis?Torsades de Pointes – QT prolongationPage 44
Hypokalaemia Decreased extracellular K – hyperexcitability: re-entrantarrhythmias Increase amplitude and width of P wave Prolonged PR interval T flattening / inversion ST depression Prominent U waves Apparent long QT (QTU fusion) SVEs, VPBs SVT (AF, atrial flutter, atrial tachy) VT, VF and Torsades de PointesPage 45
HyperkalaemiaPage 46
Hyperkalaemia Increased extracellular K – reduces myocardial excitability Repolarisation changes:Peaked T waves Atrial paralysis:P wave widens and flattensPR prolongationP wave disappears Conduction abnormality and bradycardia:QRS prolongs / bizarreHigh grade AV block, junctional and ventricular escape rhythmsSinus brady or slow AFSine wave (pre terminal) Cardiac arrest:AsystoleVFPEA with bizarre wide QRSPage 47
HyperkalaemiaPage 48
Digoxin toxicity – PAT with block and VPBsPage 49
Bidirectional VT – digoxin toxicityPage 50
Digoxin toxicity Increased automaticity / decreased AV conduction:SVT with slow ventricular responsePVC’s, sinus brady, AFAny type of AV blockRegularised AF (AF with CHB)VT (polymorphic or bidirectional)Page 51
Intracranial haemorrhagePage 52
Intracranial haemorrhage Widespread giant T inversionQT prolongationBradycardia (Cushing reflex – brain stem herniation)ST elevation or depressionIncreased U wave amplitudeST, junctional, VPBs, AF(? Hypothalamic stimulation / autonomic dysregulation)Page 53
Massive pulmonary embolismPage 54
Massive pulmonary embolism Sinus tachycardia Complete or incomplete RBBB RV strainT inversion V1-4, II,III,aVF Right axis deviation Dominant R V1 P pulmonale SI, QIII, TIII in 20% only Clockwise rotation Atrial arrhythmias Non specific ST/T changesPage 55
Pacemaker malfunctionPage 56
70 year old, chest pain and diaphoresisPage 57
70 year old, chest pain and diaphoresisExtensive anterior MI (‘tombstoning” pattern)Page 58
Ischaemic sounding chest painPage 59
Ischaemic sounding chest painWellens’ Syndrome – proximal LAD stenosisPage 60
LMCA occlusionPage 61
LMCA occlusion Widespread ST depression (leads I, II, V4 – 6) ST elevation aVR 1mm ST elevation aVR V1 Can also see in:prox LAD occlusionsevere triple vessel diseasediffuse subendocardial ischaemia (ie. post resuscitation) aVR records electrical activity right upper portion of heart,including RVOT and basal IV septumPage 62
De Winter’s T waveAnterior STEMI equivalentST depression and peaked T waves inprecordial leadsSeen in 2% acute LAD occlusionsYounger / male / hypercholesterolaemiaCode STEMIPage 64
Middle aged female presents with dyspnoea, prior mastectomy for breastcancer.Page 65
Middle aged female presents with dyspnoea, prior mastectomy for breastcancer.QRS alternans – pericardial effusionPage 66
Ventricular flutterPage 67
Ventricular flutter Continuous monomorphic sine wave No identifiable P, QRS or T wave Rate 200 Extreme form of VT Rapid degeneration into VFPage68
HypothermiaBradyarrhythmias (any)Osborn waves ( J waves positive deflection at J point)Prolonged PR, QRS and QTShivering artefactVPBsCardiac arrest due to VT, VF orasystolePage 69
HypothyroidismBradycardiaLow QRS voltageWidespread T wave inversionQT prolongationFirst degree AV blockIVCDsMyxoedematous deposits in myocardiumDecreased SNS activityLess thyroxine – decreased inotropy /chronotropyPage 70
The End71
ECG made easy Part 2 –ECG Quiz 1 Presented by: Dr Randall
a 12-lead ECG Recording a high-quality ECG is essential to ensure that interpretation of the ECG is correct. Errors that can occur in ECG recording include poor electrode contact and incorrect electrode positioning, which can lead to misinterpretation of the ECG and misdiagnosis. This guide to performing a standard 12-lead ECG recording
Electrocardiography (ECG) Handout Thanks to everyone who has looked at the EmergencyPedia page since we started in April 2013. Since the start we've been keen to include a FOAM ECG page to share our ECG collection and ideas. We have started by presenting an ECG checklist, OSCE station and more than 20 original ECG cases on this page (see below).
the ECG wave simultaneously. Jyoti Gupta et al. (2015), proposed use of MATLAB to process the ECG signals acquired from an online ECG database. MATLAB was used for processing the ECG signals. Dijkstra's Algorithm was used to send the processed ECG data from a wireless node to a remote location using a shortest path.
User Manual for Easy ECG Monitor 3 10. Data interface: for connecting Mini USB data cable. 1.2 Name and Model Name: Easy ECG Monitor Model: Prince-180B 1.3 Structure Prince-180B Easy ECG Monitor consists of main board, panels and electrodes. 1.4 Features 1. Small in size, light in weight and easy to carry. 2. One-key measurement, easy to .
ECG made easy 1 Presented by: Dr Randall Hendriks, Interventional Cardiologist –Western Australia. Reading an ECG The ECG does not have to be intimidating Establish a consistent ap
Beginning 12 Lead ECG Workshop Virginia Hass, DNP, FNP-C, PA-C . 12-Lead ECG- Limb Lead Placement WHITE TO THE RIGHT, SMOKE OVER FIRE! GREEN IS GROUND. 12-Lead ECG: Chest Lead Placement. 12-Lead ECG: Chest Lead Placement The electrodes for the chest leads MUST go in the standard pos
Diagnostic ECG Three steps to performing a basic ECG investigation - Get a good clean tracing - Make rapid reliable measurements - Interpretation based on the trace and clinical observation. Getting a good clean ECG Trace . Microsoft PowerPoint - PRACTICAL ECG.ppt Author:
Boris Fausto, vem cobrir parte desta lacuna do período do Estado Novo. O autor traz contribuições valiosas para o entendimento do modo de pensar e de como as pessoas comuns sobreviviam no interior de uma cidade de São Paulo em transformação. O autor se relaciona com a micro-história ao considerar aspectos determinantes daquela metodologia, tais como a redução da observação do .
