ECG

Question 1

COPD ECG Changes

Answer 1

1. R axis deviation
2. ‘P pulmonale’ – tall, peaked P wave in leads II, III and aVF

Question 2

Pulmonary Embolism

Answer 2

1. Sinus tachycardia – most common
2. R axis deviation
3. RBBB
4. “S1Q3T3” pattern (rare – usually MASSIVE PE)

Question 3

Hyperkalaemia

Answer 3

Causes – renal failure, diuretics

ECG Changes –

1. Pwave flattening
2. QRS complex broadens
3. Tall, peaked Twaves
4. ST segment ‘disappears’
5. VT/VF

Question 4

Hypokalaemia

Answer 4

Causes – vomiting, diarrhoea, some diuretics

ECG Changes –

1. Tall, peaked Pwaves
2. ST segment depression
3. T wave flattening
4. Prominent U wave
5. Prolonged QT interval
6. Ventricular dysrhythmias – VT/VF

Question 5

Hypercalcaemia

Answer 5

Causes:

• Renal failure, malignancy, adrenal insufficiency, thyrotoxicosis

ECG Changes:

• Shortened QT interval

Question 6

Hypocalcaemia

Answer 6

Causes:

• Some diuretics, chronic steatorrhoea, osteomalacia, pregnancy

ECG Changes:

• Flattened ST segments / T waves
• Prolonged QT interval