Essential Revision Notes for MRCP Third Edition - PasTest

Essential Revision Notes for MRCPnormally isoelectric ST segment. In contrast toRBBB, LBBB is always pathological.• Causes of LBBB• Ischaemic heart disease (recent or oldMI)• Hypertension• LVH• Aortic valve disease• Cardiomyopathy• Myocarditis• Post-valve replacement• Right ventricular pacemaker• Tachycardia with aberrancy orconcealed conduction• Ventricular ectopy• Causes of RBBB• Normal in the young• Right ventricular strain (eg pulmonaryembolus)• ASD• Ischaemic heart disease• Myocarditis• Idiopathic• Tachycardia with aberrancy orconcealed conduction• Ventricular ectopy• Causes of ST elevation• Early repolarisation• Acute MI• Pericarditis (saddle-shaped)• Ventricular aneurysm• Coronary artery spasm• During angioplasty• Non-standard ECG acquisition settings(eg on monitor)• Other ST-T wave changes (not elevation)• Ischaemia: ST depression,T inversion andpeaking• Digoxin therapy: downslopingST depression• Hypertrophy: ST depression,T inversion• Post-tachycardia: ST depression,T inversion• Hyperventilation: ST depression,T inversion andpeaking• Oesophageal/upper abdominalirritation:ST depression,T inversion• Cardiac contusion: ST depression,T inversion• Mitral valve prolapse:T wave inversion• Acute cerebral event(eg subarachnoid haemorrhage):ST depression,T inversion• Electrolyte abnormalitiesQ waves can be permanent (reflecting myocardialnecrosis) or transient (suggesting failure of myocardialfunction, but not necrosis).• Permanent Q waves• Transmural infarction• LBBB• WPW syndrome• HCM• Idiopathic cardiomyopathy• Amyloid heart disease• Neoplastic infiltration• Friedreich’s ataxia• Dextrocardia• Sarcoidosis• Progressive muscular dystrophy• Myocarditis (may resolve)• Transient Q waves• Coronary spasm• Hypoxia• Hyperkalaemia• Cardiac contusion• Hypothermia8