ECG I
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This document discusses interventricular conduction delay and raised intracranial pressure as seen on electrocardiograms (ECGs). It defines interventricular conduction delay and lists various causes including fascicular blocks, bundle branch blocks, ventricular hypertrophy, dilatation, electrolyte abnormalities, toxins, pre-excitation, and arrhythmogenic cardiac conditions. It then discusses raised intracranial pressure and the associated ECG findings of widespread T-wave inversions, QT prolongation, and bradycardia as part of the Cushing reflex, indicating imminent brainstem herniation. Massive intracranial hemorrhages such as subarachnoid hemorrhage are the most common causes
ECG I
- 2. Interventricular conduction delay Burns E. Interventricular Conduction Delay (April 16, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/ivcd/ PowerPlugs Templates for PowerPoint Preview 2
- 3. Definition
- 4. Causes Fascicular and bundle-branch blocks Left anterior fascicular block Left posterior fascicular block Left bundle branch block Right bundle branch block Bifascicular block Trifascicular block Ventricular hypertrophy and dilatation Left ventricular hypertrophy Right ventricular hypertrophy Biventricular enlargement Dilated cardiomyopathy PowerPlugs Templates for PowerPoint Preview 4
- 5. Causes Electrolyte abnormalities Hyperkalaemia Toxins Sodium-channel blocker toxicity (TCA overdose): wide QRS + positive R’ wave in aVR. PowerPlugs Templates for PowerPoint Preview 5
- 6. Causes Pre-excitation Wolff- Parkinson- White syndrome: wide QRS + delta waves. Arrhythmogenic cardiac conditions Brugada syndrome: localised QRS widening in V1-V2 with RBBB morphology. Arrhythmogenic right ventricular dysplasia (AVRD): localised QRS widening in V1-V2 + epsilon waves + variable signs of right ventricular hypertrophy. PowerPlugs Templates for PowerPoint Preview 6
- 7. Non-specific interventricular conduction delay When other causes are excluded! PowerPlugs Templates for PowerPoint Preview 7
- 8. Intracranial haemorrhage Burns E. Raised Intracranial Pressure (August 29, 2017). Retrieved from https://lifeinthefastlane.com/ecg-library/raised-intracranial-pressure/ PowerPlugs Templates for PowerPoint Preview 8
- 9. Raised intracranial pressure triad Widespread giant T-wave inversions called CEREBRAL T WAVES. QT prolongation. Bradycardia as the consequence of the Cushing reflex-indicates imminent brainstem herniation. PowerPlugs Templates for PowerPoint Preview 9
- 10. Other ECG features •ST segment elevation or depression. •Increased U wave amplitude. •Other rhythm disturbances: sinus tachycardia, junctional rhythms, premature ventricular contractions, atrial fibrillation. PowerPlugs Templates for PowerPoint Preview 10
- 11. ECG changes due to raised ICP are most commonly seen with: massive intracranial haemorrhage such as subarachnoid haemorrhage and intraparenchymal haemorrhage (haemorrhagic stroke). PowerPlugs Templates for PowerPoint Preview 11
- 12. Subarachnoid haemorrhage PowerPlugs Templates for PowerPoint Preview 12 Cerebral T waves QT interval prolongation Bradycardia
- 13. References PowerPlugs Templates for PowerPoint Preview 13