Deciphering the diagnosis of ecg. Description and interpretation of ECG for different conditions of the heart

Recently, medical studies have shown that heart disease has become more common throughout the world, and their number is only increasing every year. Studies have shown that a large percentage of heart disease is associated with an unhealthy lifestyle, such as drinking alcohol, smoking, frequent stressful situations also negatively affect health, and infectious pathologies cannot be ruled out. Timely diagnosis is necessary to establish the correct diagnosis and identify the causes of the disease.

To date, the electrocardiogram (ECG) is considered the most reliable and proven diagnostic method. Thanks to this diagnostic method and its decoding, even minor pathological changes in the work of the heart can be detected. How an ECG is done, what an ECG shows, how to decipher a cardiogram, what indications for its conduction, this and many other things need to be sorted out.

Features of the electrocardiogram in patients

The heart plays the role of an electrical generator in our body. Body tissues also have excellent electrical conductivity, which makes it possible to use electrodes and monitor the work of the heart. This diagnosis is called an electrocardiogram. Cardiogram of the heart is a diagnostic research method that reflects the functioning of the heart muscle in a normal setting. It is a graphic image, in the form of a curve, which is fixed on paper and a display. This work is performed using an apparatus - an electrocardiograph. ECG is the most accessible and safe heart diagnostics, suitable for both adults and children. Moreover, ECG is allowed to be performed during pregnancy, since this procedure is completely safe for the pregnant woman and the unborn child. Doctors recommend examining the heart after 40 years once a year, and at an older age and people with heart disease every 3-4 months. You can take an ECG in almost any clinic where the necessary equipment is available.

Thanks to the electrocardiogram and its interpretation, it is possible to determine the following indicators in patients:

• the state of the structure that causes contraction of the heart muscle;
• heart rate and heart rate;
• to examine the action of the pathways of the heart;
• assess the coronary blood supply to the heart muscle, see cicatricial changes;
• diagnose heart disease.

In addition to the electrocardiogram, there are several additional methods:, ECG with stress, transesophageal ECG. These additional methods will allow timely diagnosis of pathological disorders in the human heart.

The main indications for an electrocardiogram

An electrocardiogram is prescribed for the following indications:

• heart disease, including changes in rhythm and conduction;
• pathological disorders of the vascular system;
• control in the treatment of cardiac diseases, as well as after surgery;
• examination of patients with high blood sugar levels, thyroid diseases, etc.;
• routine examination in adolescents, children and older people.

There are no contraindications to ECG, the procedure will be difficult only in patients with an injured chest. Patients with acute myocardial infarction, coronary heart disease and other severe pathological changes are prohibited from stress ECG.

Preparation for the study and its conduct

No matter how much they say that the electrocardiogram does not require special preparation, but this is not at all the case. The ECG technique must comply with all rules and regulations. In order to obtain reliable results, before scheduled registration is carried out, patients must follow a few simple rules:

• Avoid stressful situations and strong experiences.
• Avoid strenuous exercise and hard work.
• When carrying out the procedure in the morning, it is best not to have breakfast or limit yourself to a very slight snack.
• Adults should also refrain from drinking alcohol and it is advisable not to smoke before the examination.
• You also need to remember that you need to limit the consumption of liquids, strong tea and coffee.
• On the day of the procedure, it is undesirable to use creams, gels and other cosmetics, as this may adversely affect the contact of the skin with the electrodes.

Before the procedure, it is necessary to remove outer clothing so that the chest is open, it is also supposed to expose the shins. The electrode attachment points are wiped with alcohol and gel is applied, then the cuffs and suction cups are fixed on the chest, ankles and arms. An electrocardiogram is recorded in a horizontal position. The procedure lasts about 10 minutes, after 10-15 minutes you can get a transcript with the results of the examination.

Deciphering the electrocardiogram

In order to understand the conclusion of the ECG and understand its decoding, you should understand what elements it consists of. The electrocardiogram consists of teeth, intervals and segments.

Waves are the convex and concave lines on the ECG display. There are several types of teeth that are responsible for a particular section of the heart.

1. P waves are atrial contractions.
2. Teeth Q R S - reflect the state of contraction of the ventricles.
3. T wave - shows their relaxation.
4. The U wave is rarely displayed and is not permanent.

In order to finally understand where the teeth are negative and where are positive, you should look at their direction. If they are facing down, then they are negative, when they are facing up, they are positive.

The segments are a segment of a straight line that connects the teeth.

An interval is a specific section of teeth and a segment.

In the conclusion of the electrocardiogram, the standards are determined and all changes in the work of the organ are recorded. Deciphering the cardiogram evaluates the following indicators:

• Heartbeat. The normal result in a healthy person is the heart rate of 60-80 beats per minute, the rhythm should be sinus. If there are deviations, both high and low standards, then this condition most often indicates the presence of violations.
• The interval calculation displays the duration of the contraction of systoles. The value of the intervals is calculated using a special formula. When there is a prolongation of the interval, there may be suspicions of myocarditis, coronary artery disease, the development of rheumatism. With a shortened interval, hypercalcemia is diagnosed.
• The position of the electric axis (EOS). The electrical axis (EOS) characterizes the position of the heart, the norm of the axis is 30-70 degrees. EOS is calculated from the isoline and along the height of the teeth. If the axes lead to the right, then changes in the function of the right ventricle are possible, when the EOS leads to the left, then most often this indicates right ventricular hypertrophy. In a normal ECG, the R wave is higher than the S wave.
• ST segment. This segment displays the recovery time of the depolarization of the heart muscle. When the ST segment in a person is located in the midline, then this is the norm. If the ST rise is above the isoline, then ischemia is most often diagnosed. With a slight rise in ST, tachycardia may develop. With angina pectoris, ST segment elevation can be observed only during an attack. Experts say that when evaluating this segment, not only its rise is important, but also its duration.
• Study of the QRS complex. If in decoding its width does not exceed 120 ms, then this state is normal.
• Equally important in deciphering the ECG is given to the action of the QT interval. The QT interval indicator is largely due to the age and gender of the patient, for example, in babies, it is much less. The QT interval is the time from the beginning of the QRT complex to the end of the wave. Normally, its value is 0.35-0.44 s. Its lengthenings are considered frequent violations. If the lengthening of the QT interval is violated, then this is one of the causes of serious ventricular disorders.
• Thus, the ECG norm in a person at the conclusion of specialists should correspond to the following indicators: Q and S teeth are negative, P, T, R are positive, from 60 to 80 beats per minute. The rise of the R wave is greater than the S, the QRS complex does not exceed 120 ms. When the value of the ECG has at least some changes, then often this indicates the beginning of the development of the pathological process. If the changes are significant and the cardiogram is poor, then an immediate appeal to the doctors is necessary.

Features of the electrocardiogram in children

An ECG is very often performed not only in adults, but also in children, since changes in the work of the heart can be observed from a very young age. The technique of the procedure is no different, but the decoding of the ECG has its own characteristics and is much more complicated, since this is due to the age-related characteristics of the child's body. In this regard, there is a special table according to which the ECG is deciphered in babies. A normal electrocardiogram in children should reflect the following indicators:

• Heart rate up to 3 years is normal 110 beats per minute, from 3 to 5 - 100, in adolescence - 60-90;
• QRS index - from 0.6 to 0.1s;
• The standard for the P wave is not higher than 0.1 s;
• The Q-T interval should not exceed 0.4 s;
• P-Q - normally should correspond to 0.2 s;
• Electrical axes (EOS) must be unchanged;
• The rhythm is sinus.

ECG during pregnancy

During pregnancy, the female body works differently, including the increase in the load on the heart, so various changes in the work of the heart are possible, especially in the early stages. In this regard, an ECG during pregnancy is a mandatory procedure that women can undergo at any time without fear for the health of the unborn child. With an electrocardiogram in pregnant women, single extrasystoles and a slight one are allowed, a change in the position of the heart is also possible, that is, the axis (EOS) is 70-90 degrees. If any other changes are found in the conclusion of the ECG during pregnancy and there is a bad ECG, then an additional examination and, if necessary, hospitalization are mandatory.

To date, making an ECG has become much easier, it can be done even at home by calling an ambulance. However, it must be remembered that the electrocardiogram and its interpretation should be carried out only by specialists in this field.

The method of electrocardiography is a simple and painless method of non-invasive diagnostics of the work of internal organs, which does not bring discomfort and does not directly affect the body. However, it is also an extremely informative examination, which is what has made it so popular for a long time. Only, unlike ultrasound studies, a cardiogram does not emit any waves, but only reads information, therefore, in order to find out what the ECG actually shows, it is necessary to turn to the principle of operation of the device itself. The electrocardiograph has a system of sensors that are attached to certain places on the patient's body and record the information received from there. All these highly sensitive mechanisms are able to capture the signals of electrical impulses produced by the work of the heart, and transform them into a curve, each tooth of which has its own special meaning. Thanks to this, doctors have the opportunity to quickly and easily identify various possible pathologies and abnormalities in the work of the heart and cardiovascular system, and even find out which diseases led to this. The simplicity and accessibility of this procedure allows it to be carried out quite often as a preventive diagnosis, and also as the very first and quick examination, which is performed if heart disease is suspected.

Despite the fact that this examination procedure has been used for diagnosing cardiovascular diseases for many years, it remains relevant to the present, due to its accessibility to patients and its effectiveness. The results obtained during the examination are an accurate reflection of the process occurring inside the human myocardium.

What does a heart cardiogram show?

The cardiogram reflects the rhythm of the heart and its impulses that are produced during work, and also captures the pulse, conductivity and the time it takes for the body to fill with blood. All this makes it possible to draw up a fairly complete clinical picture of the electrical activity of the myocardium and the general condition of the heart. All information transmitted from the sensors is recorded on the tape and compared with the results that should be normal for a person. If pathologies are present, they will necessarily be reflected on the cardiogram in the form of deviations of the main teeth of the curve. By what kind of teeth they are and how exactly they differ from the norm, the doctor can make a conclusion about the diagnosis of the patient, since each pathology is characterized by a certain set of deviations.

Thus, the electrocardiogram allows you to determine how fast the ventricles of the heart fill, identify myocardial problems and notice heart rhythm disturbances and the frequency of its contractions. The method makes it possible to learn about the state of muscle tissue due to the fact that the injured myocardium transmits impulses differently than healthy muscles. These changes are able to detect highly sensitive sensors on the patient's skin.

Often, in addition to the presence of pathology, the doctor can determine the type of damage and its location on the heart. A qualified cardiologist is able to identify deviations from the norm by the angles of inclination of the cardiogram teeth, without confusing them with normal variants, and make a diagnosis.

It would not be superfluous to take the results of previous electrocardiographic studies with you to an appointment with a cardiologist so that the doctor can determine the dynamics of the state of the heart and cardiovascular system, as well as track changes in rhythm, calculate whether the heart rate has increased, and whether any pathologies have appeared. All this will help to timely diagnose the development of diseases that can cause diseases such as myocardial infarction and will help to start treatment in a timely manner.

Diseases of the cardiovascular system, which can be determined by ECG

• Arrhythmia. Arrhythmia is characterized by a violation in the formation of an impulse and its progress through the muscle layer. At the same time, rhythm failure is often noted, the time intervals between R - R increase when the rhythm changes, and slight fluctuations in P - Q and Q - T become noticeable;
• Angina. This disease leads to pain in the heart. the cardiogram in this pathology shows a change in the amplitude of the T wave and depression of the S-T segment, which can be seen in certain parts of the curve;
• Tachycardia. With this pathology, there is a significant increase in contractions of the heart muscle. On the ECG, tachycardia is determined by a decrease in the intervals between segments, an increase in the rhythm, as well as a shift in the RS-T part by a small distance;
• Bradycardia. This disease is characterized by a reduced frequency of myocardial contractions. The ECG picture with such a pathology differs from the norm only by a decrease in rhythm, an increasing interval between segments and a slight change in the amplitude of the teeth;
• Hypertrophy of the heart. This pathology is determined by an overload of the ventricles or atria and manifests itself on the cardiogram in the form of an increased amplitude of the R wave, impaired tissue conductivity, as well as an increase in time intervals for an enlarged myocardial area and a change in the electrical position of the heart itself;
• Aneurysm. The aneurysm is manifested by finding a QS wave at the high R site and an elevated RS–T segment at the Q site;
• Extrasystole. With this disease, a rhythm disturbance appears, the ECG shows a large pause after extrasystoles, QRS deformation, altered extrasystoles and the absence of a P (e) wave;
• Pulmonary embolism. Such a pathology is characterized by oxygen deficiency of muscle tissue, hypertension of the vessels of the pulmonary circulation and an increase in the right heart, overload of the right ventricle and supraventricular tachyarrhythmias;
• Myocardial infarction. Infarction can be identified by the absence of the R wave, the rise of the S-T segment and the negative T-wave. During the acute stage on electrocardiography, the S-T segment is located above the isoline, and the T wave is not differentiated. The subacute stage is characterized by the descent of the S-T region and the appearance of a negative T. At the stage of infarction scarring, the ECG shows that the S-T segment is isoelectric, T is negative, and the Q wave is clearly visible.

Diseases that are difficult to diagnose using an ECG

In most cases, the ECG does not allow diagnosing diseases such as malignant and benign neoplasms in the region of the heart, defective vascular conditions and congenital heart defects, as well as disturbances in blood dynamics. At the same time, in most cases, due to their location, tumors in different parts of the heart affect the functioning of the muscle and cause disturbances in intracardiac dynamics, which are diagnosed with ECG as valvular defects of the organ. Therefore, in the case when a cardiologist reveals such disorders during the diagnosis process as hypertrophy of the heart, uneven or irregular rhythm, as well as heart failure, he can additionally prescribe echocardiography after the ECG, which will help determine whether there are neoplasms in the heart or the patient has another disease .

The problem with the ECG is that the initial stages of some diseases, as well as certain types of pathologies, are poorly visible on the cardiogram. This is due to the fact that the time of the procedure is not enough to make a full examination and examine the patient's heart in various situations. As a solution to this problem based on electrocardiography, there is a diagnostic method in which the patient must walk with a device that measures heart health for a day or even more.

Congenital heart defects include a whole group of diseases that lead to pathologies in the work of the myocardium. However, during echocardiography, such heart defects are usually identified as signs of specific syndromes, such as hypoxia or heart failure, due to which it is difficult to identify the underlying cause of the disease.

Also, a great difficulty for diagnosis using an ECG is the fact that some pathologies have similar disorders and deviations, which are noted by the cardiogram. In this case, it is necessary to consult an experienced cardiologist, who, based on the results obtained, will be able to give a more accurate diagnosis or refer him for an additional examination.

Another problem of electrocardiography is that in most cases the procedure occurs when the patient is at rest, while for ordinary life the absence of physical activity and psycho-emotional arousal is absolutely atypical for most people. Thus, in some cases, with an ECG without additional voltage, an inaccurate clinical picture is obtained, which can affect the final results of the diagnosis, since in most cases symptoms and pathologies do not appear in a calm state. That is why, for maximum efficiency of the study, the electrocardiography procedure can take place with minor patient loads or immediately after them. This provides more accurate information about the state of the heart and the presence of possible pathologies.

Definition of myocardial infarction using a cardiogram

Myocardial infarction is divided into several stages. The first is an acute period in which part of the muscle tissue dies, while the excitation vector disappears on the cardiogram at this stage of the disease in those parts of the heart where myocardial damage occurred. Also on the ECG it becomes clear that there is no R wave and Q appears, which normally should not be in the leads. At the same time, the location of the S-T region also changes and the appearance of the T wave is diagnosed. After the acute stage, a subacute period begins, at which the T and R teeth gradually begin to return to normal. At the scarring stage, the heart gradually adapts to tissue damage and continues its work, on the cardiogram, the scar remaining after a heart attack is clearly visible.

Determination of ischemia using ECG

Ischemic heart disease is characterized by reduced blood supply to the myocardium and other tissues of the heart, resulting in a lack of oxygen and gradual muscle damage and atrophy. Too long oxygen deficiency, often characteristic of the advanced stage of ischemia, can subsequently lead to the formation of myocardial infarction.

An ECG is not the best method for detecting ischemia, since this procedure is performed at rest, in which it is quite difficult to diagnose the location of the affected area. Also, there are certain areas on the heart that are not available for examination by electrocardiography and are not tested, therefore, if a pathological process occurs in them, this will not be noticeable on the ECG, or the data obtained may subsequently be interpreted by the doctor incorrectly.

On the ECG, coronary heart disease is manifested, first of all, by disturbances in the amplitude and shape of the T wave. This is due to reduced impulse conduction.

What can an electrocardiogram tell?

An electrocardiogram (ECG) is a record of the electrical activity of heart muscle cells at rest. Professional ECG analysis allows you to assess the functional state of the heart and identify most cardiac pathologies. But this study does not show some of them. In such cases, additional studies are prescribed. So, latent pathology can be detected when taking a cardiogram against the background of a stress test. Holter monitoring is even more informative - taking a round-the-clock cardiogram, as well as echocardiography.

When is an ECG ordered?

The cardiologist issues a referral if the patient has the following primary complaints:

• pain in the heart, back, chest, abdomen, neck;
• swelling in the legs;
• dyspnea;
• fainting;
• interruptions in the work of the heart.

Regular removal of a cardiogram is considered mandatory for such diagnosed diseases:

• previous heart attack or stroke;
• hypertension;
• diabetes;
• rheumatism.

Without fail, an ECG is carried out in preparation for operations, pregnancy monitoring, during a medical examination of pilots, drivers, and sailors. The result of the cardiogram is often required when applying for a voucher for sanatorium treatment and issuing permits for active sports activities. For preventive purposes, even in the absence of complaints, it is recommended to take an ECG every year for everyone, especially people over 40 years old. Often this helps to diagnose asymptomatic heart disease.

The heart works tirelessly throughout life. Take care of this amazing organ without waiting for its complaints!

What does the ECG show

Visually, the cardiogram shows a combination of teeth and recessions. The teeth are sequentially designated by the letters P, Q, R, S, T. Analyzing the height, width, depth of these teeth and the duration of the intervals between them, the cardiologist gets an idea about the state of different parts of the heart muscle. So, the first P wave contains information about the work of the atria. The next 3 teeth represent the process of excitation of the ventricles. After the T wave, there is a period of relaxation of the heart.

The cardiogram allows you to determine:

• heart rate (HR);
• heart rate;
• various types of arrhythmias;
• various types of conduction blocks;
• myocardial infarction;
• ischemic and cardiodystrophic changes;
• Wolf-Parkinson-White syndrome (WPW);
• ventricular hypertrophy;
• the position of the electrical axis of the heart (EOS).

Diagnostic value of ECG parameters

The heart of an adult human normally contracts from 60 to 90 times per minute. At a lower value, bradycardia is determined, and at a higher value, tachycardia, which is not necessarily a pathology. So, significant bradycardia is characteristic of trained athletes, especially runners and skiers, and transient tachycardia is quite normal with mental experiences.

Heartbeat

A normal heart rhythm is called regular sinus, that is, generated in the sinus node of the heart. Non-sinus generation is pathological, and irregularity indicates one of the types of arrhythmia.

During the ECG, the patient is asked to hold their breath in order to identify a possible pathological non-respiratory arrhythmia. A serious problem is atrial fibrillation (atrial fibrillation). With it, the generation of cardiac impulses occurs not in the sinus node, but in the cells of the atria. As a result, the atria and ventricles contract randomly. This contributes to thrombosis and creates a real threat of heart attack and stroke. To prevent them, lifelong antiarrhythmic and antithrombotic therapy is prescribed.

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Arrhythmia also includes extrasystole. An extrasystole is an abnormal contraction of the heart muscle under the influence of an excess electrical impulse that does not originate from the sinus node. There are atrial, ventricular and atrioventricular extrasystoles. What types of extrasystoles require intervention? Single functional extrasystoles (usually atrial) often occur with a healthy heart against the background of stress or excessive physical exertion. Potentially dangerous include group and frequent ventricular extrasystoles.

blockades

Atrioventricular (A-V) blockade is a violation of the conduction of electrical impulses from the atria to the ventricles. As a result, they contract out of sync. A-V block usually requires treatment and, in severe cases, a pacemaker.

Impaired conduction within the myocardium is called bundle branch block. It can be localized on the left or right leg or on both together and be partial or complete. With this pathology, conservative treatment is indicated.

Sinoatrial blockade is a conduction defect from the sinus node to the myocardium. This type of blockade occurs with other heart diseases or with an overdose of drugs. Requires conservative treatment.

myocardial infarction

Sometimes an ECG reveals a myocardial infarction - necrosis of a section of the heart muscle due to a cessation of its blood circulation. The cause may be large atherosclerotic plaques or a sharp vasospasm. The type of infarction is distinguished by the degree of damage - small-focal (not Q-infarction) and extensive (transmural, Q-infarction) types, as well as localization. Detection of signs of a heart attack suggests urgent hospitalization of the patient.

The detection of scars on the cardiogram indicates a past myocardial infarction, possibly painless and unnoticed by the patient.

Ischemic and dystrophic changes

Ischemia of the heart is called oxygen starvation of its various parts due to insufficient blood supply. The detection of such a pathology requires the appointment of anti-ischemic drugs.

Dystrophic refers to metabolic disorders in the myocardium that are not associated with circulatory disorders.

Wolff-Parkinson-White syndrome

This is a congenital disease, consisting in the existence of abnormal conduction pathways in the myocardium. If this pathology causes arrhythmic attacks, then treatment is necessary, and in severe cases, surgical intervention.

Hypertrophy of the ventricles - an increase in size or thickening of the wall. Most often, hypertrophy is a consequence of heart defects, hypertension, and pulmonary diseases. The position of the EOS has no independent diagnostic value either. In particular, with hypertension, a horizontal position or deviation to the left is determined. The composition also matters. In thin people, as a rule, the position of the EOS is vertical.

Features of the ECG in children

For children under the age of one year, tachycardia up to 140 beats per minute, fluctuations in heart rate when taking an ECG, incomplete blockade of the right leg of the His bundle, vertical EOS are considered normal. At the age of 6 years, a heart rate of up to 128 beats per minute is acceptable. Respiratory arrhythmia is typical for the age of 6 to 15 years.

What does electrocardiography (ECG) show?

Conditions of myocardial infarction, angina pectoris, atherosclerosis, myocardiopathy, rheumatic heart disease, arrhythmias of various origins, hypertension - all these cardiac diseases occur in people over the age of forty.

Heart disease occurs due to the negative impact on the human body of certain hereditary factors, chronic overstrain (emotional or physical), physical trauma, stress or neurosis.

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Also, frequent causes of the development of a particular cardiovascular pathology can be: unhealthy lifestyle, poor nutrition, bad habits, sleep and wakefulness disturbances.

But today, we would like to talk about that. In today's publication, we propose to pay attention to the electrocardiography (ECG) procedure, with the help of which physicians are able to detect these pathologies in a timely manner.

What is this diagnostic technique? What does a cardiogram show to doctors? How informative and safe is the procedure in question?

Maybe, instead of a banal cardiogram (ECG), it is better to conduct an ultrasound examination (ultrasound) of the heart? Let's figure it out.

What deviations in the work of the body can be fixed?

First of all, it should be noted that the procedure of electrocardiography (ECG) is deservedly recognized as the main diagnostic technique for the timely detection of pathologies of the heart (the entire cardiovascular system). The procedure is widely used in modern cardiology practice.

The muscular structure of the human heart functions under the constant control of the so-called pacemaker, which originates in the heart itself. At the same time, its own pacemaker generates electrical impulses that are transmitted through the conduction system of the heart to its various departments.

Muscular structure of the heart

On any version of the cardiogram (ECG), it is precisely these electrical impulses that are recorded and recorded, which make it possible to judge the functioning of the organ.

In other words, we can say that the ECG captures and records the peculiar language of the heart muscle.

According to the resulting deviations of specific teeth on the cardiogram (recall, these are the P, Q, R, S and T teeth), doctors get the opportunity to judge what pathology underlies the unpleasant symptoms felt by the patient.

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With the help of various ECG options, doctors can recognize the following heart diseases:

Hypertrophy of various parts of the heart muscle.

The problem can occur with violations of the hemodynamics of the vascular bed, which provokes an overload of various cardiac departments. Even a classic ECG allows you to fix several basic signs of cardiac hypertrophy.

These can be: signs of an increase in the behavior of impulses, changes in the amplitude of various teeth, signs of ischemia of the subendocardial cardiac sections, deviation of the electrical cardiac axis.

Angina pectoris, ischemic heart disease.

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This disease, we recall, causes a lot of trouble for a person, since it is manifested by attacks of anginal pain that can last from insignificant seconds to half an hour.

Signs of this disease on the ECG can be recorded: as changes in the QRS complexes, as a state of depression of the S-T segment, changes in the T wave.

Arrhythmias of various types.

Such pathologies of the heart muscle are incredibly diverse, they are characterized by numerous changes in the rhythm of heart contractions. On electrocardiography, such disorders are manifested: by the frequency of changes in the R-R intervals, by fluctuations in the P-Q and Q-T indicators.

In addition, with the help of electrocardiography, it is often possible to fix: signs of the presence of a heart aneurysm, the development of extrasystole, the occurrence of an inflammatory process in the myocardium (myocarditis, endocarditis), the development of acute conditions of myocardial infarction or heart failure.

Do the results of different ECG methods differ?

It is no secret to anyone that electrocardiography in different situations can be carried out in different ways, or rather, doctors can use different methods of ECG research.

It is quite clear that the data of various variants of an electrocardiographic study may differ somewhat.

The most common electrocardiographic studies can be considered:

Intraesophageal electrocardiography procedure.

The technique consists in placing an active electrode in the lumen of the esophagus.

This procedure allows more accurate assessment of atrial electrical activity, as well as the functioning of the atrioventricular node.

The technique is of greatest value for fixing certain heart blocks.

Vectorcardiography procedure. This technique allows you to register changes in the electrical vector of the functioning of the heart muscle.

Information can be presented in the form of a special projection of three-dimensional figures on the plane of assignments.

Electrocardiographic tests with a load.

This procedure may also be called bicycle ergometry. It is most expedient to conduct such a study to detect coronary heart disease.

This is due to the fact that angina attacks usually occur precisely at the moment of physical stress of the patient, and at rest the cardiogram can remain within the normal range.

Holter monitoring procedure.

The procedure is commonly referred to as 24-hour Holter electrocardiography monitoring.

The essence of the technique lies in the fact that the sensors fixed on the human body record the performance of the heart muscle during the day or even more.

It is most advisable to carry out such a procedure when the unpleasant symptoms of heart disease are transient.

What diseases can be diagnosed during the study?

It should be said that various options for electrocardiography of the heart can be used not only as a primary diagnosis, which makes it possible to fix the initial stages of a cardiac disease.

Often, various types of electrocardiographic studies can be carried out in order to monitor and control an already existing cardiac pathology.

So such studies can be prescribed to patients with the following pathologies:

• patients with previous myocardial infarction;
• people suffering from various forms of cardiac ischemia;
• patients with infectious diseases of the heart muscle - pericarditis, endocarditis;
• patients suffering from cardiosclerosis;
• people with hypertension or hypotension;
• patients with vegetovascular dystonia, etc.

And, of course, this study of the heart often allows you to answer questions - why do patients experience this or that unpleasant symptomatology - shortness of breath, chest pain, heart rhythm disturbances.

Data indicating the need for additional tests

Unfortunately, it should be understood that the electrocardiogram cannot be considered the only true criterion for establishing one or another cardiological diagnosis.

To establish a truly correct diagnosis, doctors always use several diagnostic criteria: they must conduct a visual examination of the patient, palpation, auscultation, percussion, take an anamnesis and conduct electrocardiography.

Provided that the data of cardiography are confirmed by specific (corresponding to the alleged pathology) symptoms in the patient, the data obtained during the examination, the diagnosis is made quickly enough.

But, if a cardiologist observes some discrepancy between the patient's complaints and electrocardiography indicators, additional studies may be prescribed to the patient.

Additional studies (ultrasound, echocardiography, MRI, CT or others) may also be necessary if the electrocardiogram remains normal, and the patient makes some complaints about the intense manifestations of a problem of unclear or doubtful origin.

Ultrasound and electrocardiogram: differences in results

The technique of studying the heart muscle using ultrasound (ultrasound) has long been used in cardiology. Ultrasound diagnostics of the heart muscle, unlike an electrocardiographic study, allows you to notice not only some deviations in the functioning of the organ.

Ultrasound of the heart muscle is considered an informative, non-invasive and completely safe procedure that allows you to assess the structure, size, deformations and other characteristics of the heart muscle.

In this case, ultrasound of the heart muscle can be prescribed in the following cases:

• if the patient has unclear symptoms - chest pain, shortness of breath, fatigue;
• with periodic jumps in blood pressure;
• in the presence of signs of a cardiological disease that is not fixed on the cardiogram;
• Ultrasound is also prescribed to patients after myocardial infarction, to assess the damage to muscle structures, to monitor the progress of the pathology.

When conducting ultrasound, doctors get the opportunity to determine the morphology of the heart muscle, assess the size of the entire organ, notice the volume of the heart cavities, understand what is the thickness of the walls, what condition the heart valves are in.

Ultrasound also allows you to notice the presence of organ aneurysms, blood clots in the heart, assess the size of tissue scars, etc. on the tissues.

We can say that ultrasound, in some cases, is more informative than an electrocardiogram.

Summing up, we note that both considered research methods are necessary in modern cardiology practice. It is more correct to decide which study is better to choose together with a qualified cardiologist.

Otherwise, the use of the diagnostic procedure may be inappropriate!

How to check the heart? ECG of the heart: decoding. What does the ECG of the heart show?

Electrocardiography (ECG) is a method by which the study of the cardiovascular muscle is carried out as a result of recording the indicators of electrical cardiac impulses emitted by the heart and fixing the pulse. The obtained indicators are recorded on paper in the form of a curve called a cardiogram, and the apparatus with which this is done is called an electrocardiograph.

An electrocardiogram is required in case of pain, weakness, or heart rhythm disturbances. ECG is effectively used as the main method, if necessary, a planned examination of the work of the heart. With it, you can determine the degree of intracardiac conduction and even diagnose a heart attack. In addition, it is the electrocardiogram that helps in the initial stages to diagnose mental illness and nervous disorders.

It is noteworthy that for electrocardiography, the patient does not need to come with special training, because the procedure can be performed both in a sitting position or lying down. Since special electrodes are attached to the patient's chest, if it becomes necessary to conduct an ECG of the child's heart, it is required that one of the parents is always nearby throughout the procedure. The average cost of the examination does not exceed 1000 rubles.

The need for examination

In the event that you are concerned about discomfort in the chest, jaw, shoulders and in the area between the shoulder blades, you should immediately undergo an ECG. It will not be superfluous to check the condition of your heart even if:

You suffer from diseases of the cardiovascular system;

You are about to go to a sanatorium;

Expose your body to physical activity every day;

In preparation for any operation;

Your age has exceeded 40 years - in this case, it is necessary to examine the heart at least once a year, even in the absence of complaints;

During pregnancy - at least 2 times;

When passing a medical commission - for employment;

There were blood relatives in your family with heart problems.

It is noteworthy that in order to obtain more accurate results, an ECG of the heart can be performed not only when a person is at rest, but also with an active lifestyle. In this case, your performance in the period from one day to a week is recorded on a special carrier - "Holter monitoring", when worn on a belt over your shoulder or on your belt. With the help of this device, all daily changes in the patient's condition are monitored, which is subjected to various stresses and loads throughout the day and night, which cannot be recorded in a standard study.

How to prepare for an EKG?

Despite the fact that special preparation of the patient during this study is not required, in order to obtain more accurate indicators, men need to shave their chest, and girls need to remove metal jewelry, socks, stockings, tights.

Please note that the doctor will lubricate the skin with a special liquid, on top of which electrodes are attached, most of which will be located on the chest, wrists and ankles and on the side of the heart. The ECG captures not only heart fluctuations, but also the pulse, therefore, in order to obtain the most accurate results, it is important that the body is at rest during the procedure.

Before going to the clinic, select clothes in such a way that, at the request of the doctor, you can easily remove not only outerwear, but also bare your feet.

ECG of the heart - the norm in children

Normal indicators of children's ECG differ significantly from the norm of adults, having, moreover, a number of specific features that are unique for each age period. The most pronounced differences are observed in newborn children. After 12 years, a child's normal ECG approaches that of an adult.

For children, profuse heart contractions are characteristic, decreasing as the child grows older. In children, there is also a pronounced instability of heart rate indicators, acceptable fluctuations are up to 20% in the results of each of the subsequent studies.

Conclusion on the result of the ECG study

A specialist in the field of cardiology should form a conclusion on the results of the study. The study of the results obtained is a complex and painstaking process that requires not only the availability of special knowledge, but also its repeated application in practice. A highly qualified doctor should not only know the basic physiological processes that often occur in the heart, but also the variants of a normal cardiogram. In addition, he will determine all kinds of changes in the work of the heart.

Be sure to take into account the influence of various medications that the patient takes, and other external factors on the formation of teeth and intervals on the ECG of the heart. Decryption includes several successive stages. At the initial stage, the age and gender of the patient are assessed, because each age group has its own diagnostic features.

After that, it is determined how the teeth obtained on the cardiogram correspond to normal values. To do this, the rhythm of beats and the position of the heart in the chest are assessed, and the results obtained are compared with the indications that were obtained during previous studies of the same patient, dynamic changes in the indicators are ascertained.

Equipment check

After a cardiac ECG, deciphering the results should begin with an examination of the recording technique for possible deviations from the norm.

The standard check includes:

• The first image on the ECG should be about 10 mm.
• Investigation for interference.
• Determining the speed of paper movement - in most cases, it is indicated along the edges of the sheet with the result of the study.

ECG interpretation - waveform analysis

The course of repolarization is the period during which the cell membrane, having overcome excitation, returns to its normal state. When the impulse moves through the heart, there is a short-term change in the structure of the membrane at the molecular level, as a result of which ions pass through it without hindrance. During repolarization, ions return in the opposite direction to restore the membrane charge, after which the cell will be ready for further electrical activity.

• P - shows how the atria function.
• QRS - shows ventricular systole.
• ST segment and T wave - reflect the processes of repolarization of the ventricular myocardium.

Normal ECG results

If the heart rhythms on the ECG are correct, then the sinus node, whose standard indicators for an adult are from 60 to 100 beats per minute, is in a normal state. The heart rate, the so-called R-R interval, can be determined by measuring the distance between adjacent R waves on the received cardiogram.

In addition, the doctor determines in which direction the electrical axis of the heart is directed, which shows the position of the resulting electromotive force vector (angle alpha, measured in degrees). The normal axis corresponds to the value of the alpha angle and ranges from 40 to 70 degrees.

Violation of the heart

Heart rhythm disturbance (arrhythmia) is diagnosed if the heart contracts faster than 100 beats per minute or does not reach 60. ECG will show such malfunctions in the heart when:

• non-sinus rhythm.
• Violation of the automatism of the sinus node.

On the basis of conduction and rhythm disturbances in the heart, the ECG, according to the deviations found, can be divided into three main categories:

1. blockades;
2. ventricular asystole;
3. ventricular preexcitation syndromes.

However, it must be borne in mind that even in the presence of these disorders, the signs of diseases can be extremely diverse, as a result of which it is difficult to detect them during a conventional cardiogram.

Hypertrophy of the heart

Myocardial hypertrophy is a reaction of the body, which is trying to adapt to the increased stress on the body. Most often it manifests itself as a result of a significant increase in the mass of the heart, together with the thickness of its walls. All changes in this disease are due to increased electrical activity of the heart chamber, slowing down the propagation of an electrical signal in its wall.

Knowing what the ECG of the heart shows, you can even determine the signs of hypertrophy in each atrium and ventricle.

Heart attack prevention

In some cases, using an ECG, you can evaluate how the blood supply to the heart muscle is going. which is especially important in the diagnosis of myocardial infarction, as a result of which there is an acute violation of blood flow in the coronary vessels, accompanied by necrosis of parts of the heart muscles and the formation of changes in these areas in the form of scars.

Knowing what the ECG of the heart shows, you can independently monitor changes in its condition. In addition, it will allow timely detection of possible complications, thereby reducing the risk of developing heart disease.

Determination of the electrical axis of the heart

The study of the ECG of the axis of the heart is one of the most important points in the conduct of electrocardiography. Certain deviations can be observed as a result of the presence of ventricular hypertrophy. The side to which the axis deviates indicates a disease of the cardiac ventricle located on the same side.

The following options are available (all readings are in degrees):

• Norm - indicators of assignment are.
• According to the horizontal position of the heart, the leads are from 00 to 300.
• According to the vertical position of the heart, the leads are from 700 to 900.
• If the axis deviates to the right, the abduction will be from 900 to 1800.
• If the axis deviates to the left, the lead will be from 00 to minus 900.

Children's cardiac axis:

• Newborns - deviation to the right from 90 to 180 °.
• 1 year - the axis becomes vertical, deviating from the future norm by 75–90 °.
• 2 years - in most children, the axis is still vertical, and in 1/3 - the deviation is 30-70 °.
• From 3 to 12 years - the axis gradually assumes a normal position.

Newly born children show large differences in the electrical axis compared to normal results in adults or adolescents, the axis of which is slightly shifted to the right.

Conclusion

Remember that the result of deciphering the ECG is not a ready-made diagnosis and cannot serve as a kind of guide to prescribing treatment. In fact, this is just a description of the performance of the heart.

The study may show:

• normal functioning of the heart;
• certain deviations;
• cardiac pathologies;
• hereditary anomalies;
• the effect of drugs.

Keep in mind that, despite the fact that you can independently decipher the results, after the heart is examined, the ECG must be viewed by a qualified cardiologist who will not only diagnose you, but also, if necessary, help with the choice of treatment.

Heart ECG results and normal values

An ECG of the heart is a study that is based on electrical impulses that occur when an organ contracts. The ECG device is compact and inexpensive, which makes it possible to equip resuscitation ambulance teams with it. It allows you to quickly diagnose myocardial infarction and take adequate measures to save human life. There are other pathologies that this study shows.

An electrocardiogram is a method for studying the functionality of the cardiovascular system. It is based on the registration of impulses arising in the heart, and their recording in the form of teeth on a special paper tape. With the help of an ECG, various diseases of the cardiovascular system can be recognized.

The human heart produces a small amount of electrical current. It is formed due to the cyclic movement of ions in the cells and the intercellular fluid of the myocardium. From a change in the magnitude of the fluctuation of the charge difference, the magnitude of the electric current in the circuit changes. The electrocardiograph is able to register the potential differences in the electric field of the heart and record them. The interpretation of the results is carried out by a doctor of functional diagnostics, a therapist or a cardiologist.

If it is impossible to fully assess the condition of the heart muscle on the ECG, additional types of studies are used:

• ECG with exercise - the study is carried out on an exercise bike, is intended to determine the work of the heart during exercise. Allows you to identify pathologies that do not manifest themselves at rest.
• Drug test - the study is carried out under the influence of a drug that is taken before the start of the procedure.
• Holter monitoring - a device is connected to the patient, which records the electrical activity of the heart during the day.

An ECG is carried out in a clinic or in a hospital in the ECG diagnostic room. Special preparation is not required: the last meal should be a few hours before the procedure, you should stop smoking, drinking coffee and alcohol before the procedure.

Before starting the study, a person is advised to sit quietly for a minute. The patient undresses to the waist, exposes the lower leg and forearms, and lies down on the couch. The doctor applies a special gel to the chest, wrists and ankles, where he then attaches the electrodes - one clothespin on the arms and legs, and six suction cups on the chest in the projection of the heart.

After turning on the device, the reading of electrical impulses begins. The result is visible on the computer screen and is displayed on the thermal film in the form of a graphic curve. The study takes 5-10 minutes and does not cause discomfort. At the end, the cardiologist evaluates the cardiogram and reports the result to the patient.

Deciphering the ECG consists in measuring the size, length of the teeth and recessions, assessing their shape and direction. These teeth are designated by capital Latin letters P, Q, R, S and T.

The evaluation of the results is carried out according to several parameters:

• Determination of heart rate indicators. The distance between the R teeth must be the same.
• Heart rate. The indicator should not exceed 90 beats per minute. Normally, the patient should be in sinus rhythm.
• Q-prong depth dimension. Must not exceed 0.25% of R and 30ms width.
• Latitude of oscillation "R" of the hill. Should be within 0.5 - 2.5 mV. The activation time of excitation over the zone of the right cardiac chamber is 30 ms, the left - 50 ms.
• Max tooth length. Normally, it does not exceed 2.5 mV.
• Oscillation amplitude R. OMS may vary.
• A measure of the width of the ventricular excitation complex. Normally it is 100 ms.

During pregnancy, an ECG is recommended. This study is the only method for diagnosing the functionality of the heart muscle of the expectant mother. Many people notice a manifestation of shortness of breath and palpitations, although such problems have not arisen before. ECG is absolutely safe for the unborn fetus.

The physiological state of the heart changes during pregnancy, which leads to such changes in ECG parameters:

• Heart rate. Heart rate up to 100 beats per minute is allowed. The reason for this is an increase in blood volume in the body and a decrease in vascular tone.
• Change in the electrical axis of the heart. The enlarging uterus presses on the diaphragm, and the heart has to take a horizontal position towards the end of pregnancy. After childbirth, it will return to its original place.
• Respiratory arrhythmia. It is characterized by a short inhalation and a long exhalation. It is considered normal in pregnant women.

Many of these changes may be related to pregnancy and will not bother the patient after delivery. But doctors recommend playing it safe and being examined to eliminate the risk of developing cardiovascular pathology.

In the last months of pregnancy, a fetal cardiotocogram (CTG) is performed in order to identify possible pathologies in the development of the baby. The woman takes the most comfortable position: half-sitting or lying on her left side. A sensor is placed on the mother's stomach in the region of maximum audibility of the baby's heart rate. The procedure takes minutes depending on the activity of the fetus. Sometimes the fetal heart rate is recorded until the baby moves 2 times. The norm of heart contractions is beats / min.

An electrocardiogram helps to detect various pathologies of the heart: acute heart attack, aneurysm, and the presence of scars.

The disease is characterized by the death of areas of living tissue in the heart due to lack of blood supply. There is an extensive myocardial infarction and a microinfarction. The main reason is the blockage of blood vessels by atherosclerotic plaques.

A person may suspect the first signs of an incipient heart attack in a few days. It begins with pain in the region of the heart, radiating to the neck or left arm. Such pain is relieved by taking medications. By contacting a doctor at this stage, you can reduce the risk of developing a heart attack.

You need to pay attention to the main symptoms:

• sharp, burning pain in the region of the heart;
• irradiation of pain to the left side: chest, arm or under the shoulder blade;
• manifestation of a panic attack with an acute fear of death.

The arrival of doctors to the patient within an hour and a half will save his life.

Precursor of heart attack and stroke. It is difficult to diagnose, since these deviations are also manifested in other heart diseases. Attacks of pain in the sternum or left arm that last from a few seconds to 20 minutes.

Increased pain occurs when lifting weights, when going out into the cold. The skin turns pale, the pulse becomes uneven. After taking the medicine, the condition is normalized.

Rapid heart rate at rest, at which the pulse reaches beats / min. The disease manifests itself at any age.

Frequent contraction of the heart muscle leads to a decrease in blood output and oxygen starvation of the body. If left untreated, tachycardia will lead to malfunctioning of the heart and an increase in its size. Tachycardia is manifested by a feeling of increased heart rate, an attack of panic anxiety, shortness of breath.

Sinus tachycardia. It is diagnosed when the pulse exceeds 90 beats / min. It happens physiological (after exercise, drinking coffee, energy drinks). It is not a disease, the pulse returns to normal on its own. And pathological, which occurs at rest, with infections, dehydration, toxicosis.

Rhythm deviations on the ECG

It is a violation of the heart rhythm. The patient's pulse quickens when inhaling and slows down when exhaling. Arrhythmia may be accompanied by suffocation, dizziness, fainting.

sinus arrhythmia. Normally occurs in children and adolescents. The heart beats at different intervals.

The result of deciphering the ECG is not a diagnosis, but only gives an idea of ​​​​the work of the heart muscle. Timely electrocardiogram can prevent the development of serious diseases. Highly informative study is safe and suitable for children, pregnant women and adults.

And some secrets.

Have you ever suffered from HEART PAIN? Judging by the fact that you are reading this article, the victory was not on your side. And of course you are still looking for a good way to get your heart working.

Then read what Elena Malysheva says in her program about natural methods of treating the heart and cleaning blood vessels.

Electrocardiography (ECG): fundamentals of theory, removal, analysis, detection of pathologies

Applied for practical purposes in the 70s of the 19th century by the Englishman A. Waller, an apparatus that records the electrical activity of the heart continues to faithfully serve humanity to this day. Of course, for almost 150 years it has undergone numerous changes and improvements, but the principle of its work, based on records of electrical impulses propagating in the heart muscle, remained the same.

Now almost every ambulance team is equipped with a portable, lightweight and mobile electrocardiograph, which allows you to quickly take an ECG, not lose precious minutes, diagnose and promptly deliver the patient to the hospital. For large-focal myocardial infarction, and other diseases that require emergency measures, minutes count, so an urgent electrocardiogram saves more than one life every day.

Deciphering the ECG for the doctor of the cardiology team is a common thing, and if it indicates the presence of an acute cardiovascular pathology, then the team immediately, turning on the siren, goes to the hospital, where, bypassing the emergency room, they will take the patient to the intensive care unit for urgent care. The diagnosis with the help of an ECG has already been made and no time has been lost.

Patients want to know...

Yes, patients want to know what the incomprehensible teeth on the tape left by the recorder mean, therefore, before going to the doctor, patients want to decipher the ECG themselves. However, everything is not so simple, and in order to understand the “tricky” record, you need to know what a human “motor” is.

The heart of mammals, which includes humans, consists of 4 chambers: two atria, endowed with auxiliary functions and having relatively thin walls, and two ventricles, which carry the main load. The left and right parts of the heart also differ from each other. Providing blood to the pulmonary circulation is less difficult for the right ventricle than pushing blood into the systemic circulation with the left. Therefore, the left ventricle is more developed, but also suffers more. However, regardless of the difference, both parts of the heart should work evenly and harmoniously.

The heart is heterogeneous in its structure and electrical activity, since contractile elements (myocardium) and irreducible elements (nerves, blood vessels, valves, fatty tissue) differ in varying degrees of electrical response.

Usually patients, especially older ones, are worried: are there any signs of myocardial infarction on the ECG, which is quite understandable. However, for this you need to learn more about the heart and the cardiogram. And we will try to provide this opportunity by talking about waves, intervals and leads and, of course, about some common heart diseases.

Ability of the heart

For the first time, we learn about the specific functions of the heart from school textbooks, so we imagine that the heart has:

1. automatism, due to the spontaneous generation of impulses, which then cause its excitation;
2. excitability or the ability of the heart to activate under the influence of exciting impulses;
3. or the “ability” of the heart to ensure the conduction of impulses from their place of origin to contractile structures;
4. Contractility, that is, the ability of the heart muscle to carry out contractions and relaxation under the control of impulses;
5. tonicity, in which the heart in diastole does not lose its shape and provides continuous cyclic activity.

In general, the heart muscle in a calm state (static polarization) is electrically neutral, and biocurrents(electrical processes) in it are formed under the influence of exciting impulses.

Biocurrents in the heart can be recorded

Electrical processes in the heart are due to the movement of sodium ions (Na +), which are initially located outside the myocardial cell, inside it and the movement of potassium ions (K +), rushing from the inside of the cell to the outside. This movement creates conditions for changes in transmembrane potentials during the entire cardiac cycle and repeated depolarizations(excitation, then contraction) and repolarizations(transition to the original state). All myocardial cells have electrical activity, but slow spontaneous depolarization is characteristic only of the cells of the conduction system, which is why they are capable of automatism.

Excitation propagated through conducting system, sequentially covers the departments of the heart. Starting in the sinoatrial (sinus) node (the wall of the right atrium), which has maximum automatism, the impulse passes through the atrial muscles, the atrioventricular node, the bundle of His with its legs and goes to the ventricles, while exciting the sections of the conduction system even before the manifestation of its own automatism .

The excitation that occurs on the outer surface of the myocardium leaves this part electronegative in relation to the areas that the excitation has not touched. However, due to the fact that the tissues of the body have electrical conductivity, biocurrents are projected onto the surface of the body and can be registered and recorded on a moving tape in the form of a curve - an electrocardiogram. The ECG consists of teeth that are repeated after each heartbeat, and through them shows those violations that are in the human heart.

How is an EKG taken?

Many people can probably answer this question. Making an ECG, if necessary, is also not difficult - there is an electrocardiograph in every clinic. EKG technique? It only seems at first glance that she is so familiar to everyone, but meanwhile, only health workers who have received special training in taking an electrocardiogram know her. But it is hardly worthwhile for us to go into details, since no one will allow us to do such work without preparation anyway.

Patients need to know how to properly prepare: that is, it is advisable not to overeat, do not smoke, do not consume alcoholic beverages and drugs, do not get involved in heavy physical labor and do not drink coffee before the procedure, otherwise you can deceive the ECG. It will certainly be provided, if not something else.

So, a completely calm patient undresses to the waist, releases his legs and lies down on the couch, and the nurse will lubricate the necessary places (leads) with a special solution, apply electrodes, from which wires of different colors go to the device, and take a cardiogram.

The doctor will then decipher it, but if you are interested, you can try to figure out your teeth and intervals on your own.

Teeth, leads, intervals

Perhaps this section will not be of interest to everyone, then it can be skipped, but for those who are trying to figure out their ECG on their own, it may be useful.

The teeth in the ECG are indicated using Latin letters: P, Q, R, S, T, U, where each of them reflects the state of different parts of the heart:

• P - atrial depolarization;
• QRS complex - depolarization of the ventricles;
• T - repolarization of the ventricles;
• A small U wave may indicate repolarization of the distal ventricular conduction system.

To record an ECG, as a rule, 12 leads are used:

• 3 standard - I, II, III;
• 3 reinforced unipolar limb leads (according to Goldberger);
• 6 reinforced unipolar chest (according to Wilson).

In some cases (arrhythmias, abnormal location of the heart), it becomes necessary to use additional unipolar chest and bipolar leads and according to Nebu (D, A, I).

When deciphering the results of the ECG, the duration of the intervals between its components is measured. This calculation is necessary to assess the frequency of the rhythm, where the shape and size of the teeth in different leads will be an indicator of the nature of the rhythm, the electrical phenomena occurring in the heart and (to some extent) the electrical activity of individual sections of the myocardium, that is, the electrocardiogram shows how our heart works in that or other period.

Video: lesson on ECG waves, segments and intervals

ECG analysis

A more rigorous interpretation of the ECG is carried out by analyzing and calculating the area of ​​\u200b\u200bthe teeth using special leads (vector theory), however, in practice, they generally manage with such an indicator as electrical axis direction, which is the total QRS vector. It is clear that each chest is arranged in its own way and the heart does not have such a strict location, the weight ratio of the ventricles and the conductivity inside them are also different for everyone, therefore, when decoding, the horizontal or vertical direction of this vector is indicated.

Doctors analyze the ECG in sequential order, determining the norm and violations:

1. Assess the heart rate and measure the heart rate (with a normal ECG - sinus rhythm, heart rate - from 60 to 80 beats per minute);
2. Intervals (QT, normal - 390-450 ms) are calculated, characterizing the duration of the contraction phase (systole) using a special formula (more often I use the Bazett formula). If this interval is lengthened, then the doctor has the right to suspect,. And hypercalcemia, on the contrary, leads to a shortening of the QT interval. The pulse conductivity reflected by the intervals is calculated using a computer program, which significantly increases the reliability of the results;
3. they begin to count from the isoline along the height of the teeth (normally R is always higher than S) and if S exceeds R, and the axis deviates to the right, then they think about violations of the right ventricle, if vice versa - to the left, and at the same time the height of S is greater than R in II and III leads - suspect left ventricular hypertrophy;
4. The QRS complex is studied, which is formed during the conduction of electrical impulses to the ventricular muscle and determines the activity of the latter (the norm is the absence of a pathological Q wave, the width of the complex is not more than 120 ms). If this interval is displaced, then they speak of blockades (complete and partial) of the legs of the His bundle or conduction disturbance. Moreover, incomplete blockade of the right leg of the His bundle is an electrocardiographic criterion for right ventricular hypertrophy, and incomplete blockade of the left leg of the His bundle may indicate left hypertrophy;
5. The ST segments are described, which reflect the period of recovery of the initial state of the heart muscle after its complete depolarization (normally located on the isoline) and the T wave, which characterizes the process of repolarization of both ventricles, which is directed upwards, is asymmetric, its amplitude is below the wave in duration, it is longer than the QRS complex.

Only a doctor does the work on decoding, however, some ambulance paramedics perfectly recognize a common pathology, which is very important in emergency cases. But first you still need to know the ECG norm.

This is how a cardiogram of a healthy person looks like, whose heart works rhythmically and correctly, but not everyone knows what this record means, which can change under various physiological conditions, such as pregnancy. In pregnant women, the heart occupies a different position in the chest, so the electrical axis shifts. In addition, depending on the period, the load on the heart is added. An ECG during pregnancy will reflect these changes.

The indicators of the cardiogram are also excellent in children, they will “grow” with the baby, therefore they will change according to age, only after 12 years the child’s electrocardiogram begins to approach the ECG of an adult.

Worst Diagnosis: Heart Attack

The most serious diagnosis on the ECG, of course, is, in the recognition of which the cardiogram plays the main role, because it is she (the first!) Finds the zones of necrosis, determines the localization and depth of the lesion, and can distinguish an acute infarction from the scars of the past.

The classic signs of myocardial infarction on the ECG are the registration of a deep Q wave (OS), segment elevationST, which deforms R, smoothing it, and the subsequent appearance of a negative pointed isosceles T wave. Such an elevation of the ST segment visually resembles a cat's back ("cat"). However, myocardial infarction is distinguished with and without a Q wave.

Video: signs of a heart attack on the ECG

When there's something wrong with the heart

Often in the conclusions of the ECG you can find the expression: "". As a rule, people whose heart has carried an additional load for a long time, for example, with obesity, have such a cardiogram. It is clear that the left ventricle in such situations is not easy. Then the electric axis deviates to the left, and S becomes greater than R.

hypertrophy of the left (left) and right (right) ventricles of the heart on the ECG

Video: cardiac hypertrophy on the ECG

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In questions about the interpretation of the ECG, be sure to indicate the gender, age, clinical data, diagnoses and complaints of the patient