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Changes in ECG

Pathological Changes in ECG

Depressed QRS Heart failure, ischemia, pericardial effusion, obesity, COPD
Elevated QRS Hypertrophy of myocardium
Q wave Previous MI
ST segment elevation Acute MI
Atrial Fibrillation (A. Fib) Irregular atrial rhythm, no rate, P waves are abnormal or not identifiable "F" waves absent, quivers noted, ventricular rhythm varies CO is usually maintained Common causes: HTN, CHF, CAD, rheumatic heart disease, cor pulmonale, pericarditis
Supraventricular Tachycardia Rate varies 160-250 bpm, regular rhythm Common causes: mitral valve prolapse, cor pulmonale, digitalis toxicity, rheumatic heart disease
Ventricular Fibrillation (V.fib) No regular rate or rhythm, emergency, require immediate medical attention Erratic activity without QRS wave No effective CO; clinical death in 4-6 minutes Common causes: post MI, long term or severe heart disease, hypercalcemia, hypo and hyper kalemia
Premature Atrial Contractions (PAC) P wave is premature with abnormal configuration Rate is normal Indicative of ischemia or valve pathology Common causes: caffeine intake, emotional stress, smoking, CAD, CHF, infection, electrolyte imbalance.
Ventricular Tachycardia (VT) Rate > 100 bpm, rhythm usually regular No P wave or it appears after QRS complex with retrograde conduction; Wide bizarre QRS waves Requires immediate medical attention Common causes: post MI, rheumatic heart disease, CAD, cardiomyopathy Compromised
Premature Ventricular Contractions (PVC) Rate is normal (60-100 bpm) P wave absent, ST segment distorted, QRS complex occurs early Common causes: caffeine intake, emotional stress, smoking, CAD, MI, cardiomyopathy, digitalis toxicity.
Complex heart block (3rd degree AV block) Regular rhythm Requires immediate medical intervention (pacemaker) Common causes: CAD, infection, electrolyte imbalance, anteroseptal MI, impairment with AV conduction system.
Multifocal Ventricular Tachycardia Rate > 150 bpm, irregular rhythm No P waves, QRS complex is wide, require immediate medical attention Common causes: hypokalemia, hypomagnesemia, hypothermia, drug-induced through antiarrhythmic medications.
Asystole No rhythm Absence of P waves, QRS, and T wave Can have abrupt onset and requires immediate medical attention Common causes: failure of all pacemakers to initiate, conduction system failure, acute MI, ventricular rupture.
Ischemia Inverted T wave
ST depression May indicate ischemia if downsloping 2-3 mm
ST elevation Shows new infarct, injury, or pericarditis
Created by: cdesai