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ECGs and Conduction syndromes (*WPW Syndrome = Wolf-Parkinson White…
ECGs and Conduction syndromes
*WPW Syndrome = Wolf-Parkinson White Syndrome
WPW Case examples
Clinical Case
Clinical Case
Notes
:
note that
Notes
:
WPW syndrome key is that there is electrical conduction excaping from the atrium into the ventricles and bypassing the AV node
you see a P wave, but then a sharp up curve with no Q downstroke from the septal conduction, because it goes through the WPW hole and straight into the ventricles
WPW ECG Triad
short wide and no Q
1 = Short PR interval
2 = wide qRs complex
3 = missing Q and upstroke WPW hole = delta wave
*AV Block
AV --> bundle branches during PR interval
all AV blocks have changes in PR intervals, dropped beats or independent P waves and qRs
3rd Degree = complete AV Block
Atrial and ventricles beat independent of each other
P waves and qRs are completely independent
3rd degree AV Blcok = "Separate TICKS on ECG"
Clinical Cases
Clinical Case
Notes
:
note that
Clinical Case
3rd degree AV Blcok = "Separate TICKS on ECG"
separate
= Atrium and ventricles are completely independent of each other
--> P waves and qRs are separate
separate TICKS
= AV 3rd degree block caused by LIME disease
Lyme Disease Carditis
different types of AV block come from a Lyme disease infection
initial present with NON-itchy bullseye rash from Tick
--> out in the forest
Clinical Cases
Clinical Case
Notes
:
note that
Clinical Case
Atrial Fibrillation and Flutter
A fib has triad including irreg irreg
Atrial flutter has regular rhythm, but "sawtooth waves"
Atrial Fibrillation
A Fib triad
--> irregularly irregular heart rhythm (with no P waves)
--> palpitations
--> tachycardia
Atrial Flutter
saw tooth edges on ECG
reenry circuit within atrium along venotricuspid isthmus
--> reason why there are normal ventricle qRs and saw tooth continuous P waves from the right atrium
Case examples
Clinical Case
Notes
:
note that
Clinical Case
*Torsades de Pointes
Ventricular tachycardia that looks like sine wave
*Tachycardias
Ventricular
supraventricular
Ventricular Tachycardias
stay within the ventricles, NO reentery through Bundle of Kent, etc.
Causes of Ventricular tachycardia
Prolongued QT interval
--> can be congenital LQTS
*LQTS = long QT syndrome
can be congenital LQTS
caused by electrolyte imbalance
--> hypo K+ and hypomagnesium
drug-induced
Clinical Cases
Clinical Case
Notes
:
note that
Clinical Case
Clinical Case
Clinical Case
Notes
:
note that
Torsades de pointes = TdP
Drug-induced LQTS
"MiQQy T triple big MAAAC"
"MiQQy T triple big MAAAC"
MiQQy T = QT interval prolonged
M = Macrolides and Fluroquinolones
A = Antiemetics
A = Antipsychotics and Antidepressants (TCA's)
C = Class1A / 3 anti ARs (K+ channels phase 3)
"QuinT -essential episode of Everybody Loves RAYMOND..."
QT Raymond- Ward Syndrome = KCH
Congenital LQTS
many genetic mutations
type 1 and 2 = K+ channel blockage
--> block depol from K+ and prolongue QT
can result in V tach
ECG *Physiology
BASICS
Notes
:
PR interval
--> normal < 200 msec
qRs complex
--> normal < 120 msec
ECG and Muscle *Contractions
-
Speed of Conduction
"Park AT Venture AVenue"
fastest to slowest
SA node fastest
--> all others speed up from slowest AV --> fastest Perkinje fibres
