The key thing- ECGs are useless without a good HISTORY
- TAKE A HISTORY!!
- Make sure you don't thrombolyse someone with pericarditis
Regular rhythm - R-R constant
- P waves before each QRS
- P-R constant
Atrial flutter types P wave abnormalities - Should be 3 x 2.5 squares
- P pulmonale
- P mitrale
- From mitral stenosis
- Can flip into AF and therefore won't be seen!
Medications - Most common cause of 1st degree block
- Most common cause of long QT
Aortic stenosis - Bulky ventricles, long systole => Ischaemia
- Gradually decreasing exercise tolerance
Locations + vessels - LAD
- Septal - V1, V2
- Anterior - V3, V4
- Circumflex
- Right
Pericarditis - Diffuse saddle-shaped ST elevation
- Pattern does not sensibly correspond to arteries
- PR depression
- Pain relieved by leaning forwards
- History of viral illness
- They'll tamponade if you thrombolyse them!
Notes - V4R sometimes useful for right heart stuff
- Physiological sinus arrhythmia from deep breathing
- WPW is not dangerous in itself - only when palpitations occur for some other reason
- As they all get transmitted
- New-onset BBB is a criteria for MI
- Look at the vessels affected and see if it can possibly be an MI, or is it more likely pericarditis
- Pathological Q is >2 mm
- Posterior MI => Big R waves in V1, V2 due to unopposed vector
- QT should be approximately less than 2 large squares
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