Basic ecg quiz pdf

Figure 1. A 70 years-old male was admitted to the ER emergency room due to chest pain and discomfort in his left arm. These symptoms debuted a few hours earlier. Physical examination did not reveal anything unusual. The ECG shows a heart rate of 69 beats per minute. The PR interval is ms normal. The QRS duration is 84 ms normal. The QTc corrected QT interval is ms normal and the electrical axis is 30 degrees normal.

Note that the ECG paper speed is 50 mm per second and the leads are presented using the Cabrera format , which is the recommended format. As always, you start by viewing lead II, where you note a positive P-wave. Because the heart rate is 69 per minute, and the P-wave is positive in lead II, you conclude that the rhythm is sinus rhythm, which is correct. You also note that the most positive QRS amplitude is noted in lead —aVR, which is consistent with an electrical axis of 30 degrees lead —aVR is located at 30 degrees in the coordinate system.

Finally you also note that the QRS complex is positive in lead I and lead II, which means that the electrical axis is normal. But the question is, why does this patient experience chest pain? Why does this year old male experience palpitations intermittently?

This year old lady has an abnormal ECG. Two days earlier she experienced chest discomfort and shortness of breath. Define the abnormalitites on the ECG. A year old male is admitted to the emegency room ER due to palpitations and chest discomfort. What is the correct diagnosis?

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Your answers are highlighted below. Question 1. Which of the following best describes the ECG leads shown below? Question 2. What view of the heart do leads V3 and V4 represent? Question 3. Which of the following is the most likely diagnosis? Question 3 Explanation:. Second-degree heart block Mobitz type 1 is a disease of the atrioventricular node.

Question 4. Question 5. Which artery is most likely to be affected in the context of ST elevation being present in leads V3 and V4? Question 5 Explanation:. Leads V3 and V4 represent the anterior portion of the heart.

ST elevation in these leads would be suggestive of anterior myocardial infarction. The anterior portion of the heart is supplied primarily by the left anterior descending artery. Question 6. What is the duration of a normal PR-interval?

Question 6 Explanation:. In healthy individuals, the PR-interval is between 0. A PR interval longer than 0. A short PR-interval may suggest the presence of an accessory pathway between the atria and ventricles e. WPW syndrome. Question 7. Question 8. Question 8 Explanation:. ST-elevation in only these leads would be suggestive of an inferior myocardial infarction. Question 9. What is the most common cause of left axis deviation? Question 9 Explanation:. Left axis deviation is rarely the result of left ventricular hypertrophy and more often due to defects in the conduction system of the heart.

Question What is the normal duration of a QRS complex? Question 10 Explanation:. In most healthy individuals, you would expect QRS complexes to be around 0. If a QRS complex lasts longer it is described as a "wide QRS" and indicates inefficient conduction ventricular conduction e.

An ECG reveals an absence of P-waves and an irregular rhythm. Question 11 Explanation:. In atrial fibrillation, the atria no longer conduct electricity from the sinoatrial node in an orderly fashion.

As a result, P-waves are lost. As a result of disordered atrial activity, only occasional waves of depolarisation pass through to the atrioventricular node and cause ventricular activation. This causes the typical irregular rhythm. If there were 3 large squares in an R-R interval what would the heart rate be?

Question 12 Explanation:.