CurrentlyAtLevel
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I can’t even start.
Upon looking at the MS
All I could comprehend were marking points 1,2,4 and 5.
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The pictures might not be clear so here are links:
https://pmt.physicsandmathstutor.com...%20A-level.pdf
Q4c
https://pmt.physicsandmathstutor.com...%20A-level.pdf
Last edited by CurrentlyAtLevel; 6 months ago
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macpatgh-Sheldon
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(I have an unfair advantage of having seen cardiac patients and therefore a large number of ECGs - I shall try to put myself in the shoes of an A level student)

3. If you look at the intervals (on x axis = horizontally) between the beats , this interval is steady on the ECG on left [normal], but is shorter between the 1st normal beat and the ectopic beat on ECG on right [abnormal], yeah? So the ectopic beat is premature i.e. it has come too early.
6. ECG on right [abnormal]: For the interval between the 2nd [= ectopic] beat and the 3rd beat [normal one] the gap is much longer, so this tells you that "a beat has been missed" [to put it simply], with me?
7. (v unfair Q for A level): the pulmonary artery pressure trace on right (abnormal) shows no peak at the time of the ectopic beat [looking directly vertically below the abnormal ECG above it], so this tells you that there was effectively no blood pumped out by the heart in timing with the ectopic beat [however, it is actually not ideal to measure pulmonary artery pressure here but aortic pressure, but I suppose at A level, these items cannot be fully correct [the examiners are extremely unlikely to be doctors]].
8. (look up refractory period in your books).
9. (difficult to predict this wording i.e. difficult to read examiner's mind here)
10. (as in 8).

EXTRA INFO: Yes, this is a very difficult Q for A level.
1. An ectopic beat has a different waveform from normal beats (you can see that the shape of "E" is very different from that of the other QRS complexes.
2. "E" has no P wave before it, yeah? Do you remember what generates the P wave? …………………………
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