ECG electrical axis of the heart is vertical. In what diseases are violations observed? Methods for determining the position of the EOS

EOS deviation to the right is recorded if it is in the range from +90 to +180 degrees.

Let's take a closer look at why this happens and what are the normal numbers.

When deciphering an electrocardiogram, one of the parameters is EOS - the electrical axis of the heart. This indicator indirectly reflects the position of this organ in the chest.

The atria and ventricles of the heart are controlled by impulses that propagate through the conduction system. When taking a cardiogram, electrical signals passing inside the heart muscle are recorded.

For ease of measurement, the heart is schematically represented as a three-dimensional coordinate axis.

In the total addition, the impulses form a directed electric vector. It is projected onto the frontal vertical plane. This is EOS. Usually the electrical axis coincides with the anatomical one.

What should be its normal position?

The anatomical structure of the heart is such that its left ventricle weighs more than the right one. Therefore, the electrical excitation in the left side of the organ is stronger.

Graphically, this is expressed in the fact that the axis is directed diagonally to the left and down. If you look at the projection of the vector, then the left side of the heart is in the area from +30 to +70 degrees. This is the normal value for an adult.

The position of the axis depends, among other things, on the individual characteristics of physiology.

The direction of the EOS is influenced by the following factors:

• impulse speed.
• The ability of the heart muscle to contract.
• Features of the structure of the spine, chest, internal organs that interact with the heart.

Given these factors, the normal value of the axis ranges from 0 to +90 degrees.

At healthy person EOS can be in one of the following positions:

• Normal - the angle of deviation from the coordinate axis is from +30 to +70 degrees.
• Intermediate - from +15 to +60.
• Vertical - between +70 and +90. This is typical for thin people with a narrow chest.
• Horizontal - from 0 to + 30 degrees. It occurs in people with a wide chest with low stature.

In newborns, EOS deviation to the right is often observed. By one or two years, it moves into an upright position. After the children reach the age of three, the axis usually assumes a normal position.

This is due to the growth of the heart, in particular, with an increase in the mass of the left ventricle.

Why would she move to the right?

A sharp deviation of the electric vector from its axis is sometimes caused by processes occurring inside the body (pregnancy, development of tumors, etc.).

However, most often this means the presence of disorders in the work of the heart muscle.

Axis shift can occur for the following pathological reasons:

• Ischemic disease. Blockage of the arteries that supply blood to the myocardium develops.
• Violation of blood flow in the branches of the pulmonary artery. It occurs as a result of vasoconstriction, which causes an increase in pressure in the right side of the heart.
• Myocardial infarction. Against the background of ischemic disease, tissue necrosis develops due to insufficient blood supply.
• The opening between the left atrium and the ventricle narrows (stenosis), which leads to significant tension in the right side of the organ and its subsequent hypertrophy.
• Blockage of the pulmonary artery (thrombosis).
• Arrhythmia is a violation of the heartbeat, accompanied by chaotic excitation of the atria.
• The occurrence of pulmonary pathology of the chronic type, in which the ventricle is also observed. In medicine, this disease is called "cor pulmonale".
• Abnormal development of the myocardium, in which there is a displacement of the organ to the right side. At the same time, the electric axis also deviates.

And also a shift of the axis to the right is observed due to long-term use of tricyclic antidepressants, resulting in severe intoxication of the body. This negatively affects the work of the heart.

When in newborns the EOS is deviated to the right side, this is considered the norm.

However, if the shift is associated with (violation of the passage of the electrical impulse through the bundles of heart cells), then an additional examination of the baby is carried out.

Cardiac pathologies are congenital or acquired during life, which develop as a result of previous serious illnesses or due to increased physical exertion.

For example, professional athletes are often diagnosed with an increase in the mass and volume of the left ventricle (hypertrophy).

Signs of bias on the ECG

The angle of the electrical axis and its direction are the main characteristics when deciphering the ECG.

The interpretation of the cardiogram is given by a cardiologist. To do this, he uses special schemes and tables designed to determine the displacement of the EOS.

The diagnostician examines the QRS teeth on the electrocardiogram. This is a set of notation showing and displaying the polarization of the ventricles.

QRS waves characterize their contraction or relaxation. R - tooth directed upwards (positive), Q, S - negative, or directed downwards. Q is before R and S is after it. By these signs, the cardiologist judges how the axis is shifting.

Deviation of the electrical axis of the heart to the right occurs if R is greater in the third lead than in the first. If the highest amplitude of R is in the second lead, the EOS corresponds to the normal position.

Additional diagnostic methods

If the patient has a tendency to shift the EOS to the right on the ECG, an additional examination is carried out in order to make an accurate diagnosis.

Basically, this indicator indicates an increase in the mass of the right side of the heart.

The following diagnostic methods are used:

• Chest X-ray. The pictures show an increase in the heart muscle, if any.
• . The method allows you to get a complete visual picture of the state of the myocardium.
• . Used in the presence of tachycardia in a patient.
• An electronic cardiogram with an additional load (for example,) - to determine coronary disease.
• Angiography - reveals abnormalities in the work of the coronary vessels.

Should I be concerned and what should I do?

By itself, the displacement of the electrical axis of the heart is not a disease, it only indicates the possible presence of pathologies. Cardiologists believe that one of the main reasons for the deviation of the cardiac axis to the right is hypertrophy of the heart muscle.

If a shift to the right side is detected, additional examinations should be immediately carried out. Based on their results, the doctor will prescribe treatment if any disorder is identified.

Usually, a sharp deviation of the EOS on the electrocardiogram does not signal a threat to life. Only a strong change in the vector angle (up to +900) can alert the doctor. With this indicator, cardiac arrest may occur. The patient is immediately transferred to the intensive care unit.

In order to avoid serious consequences, in the presence of EOS displacement, it is recommended to be examined by a cardiologist every year.

The location of the electrical axis must be calculated to determine the total component of the bioelectrical changes that occur in the muscle tissue of the heart during its contractile activity. The main organ is three-dimensional, and in order to correctly determine the direction of the EOS (which means the electrical axis of the heart), you need to imagine the human chest as a system with some coordinates that allow you to more accurately set the angle of displacement - this is what cardiologists do.

Features of the conductive system

The cardiac conduction system is an accumulation of areas of muscle tissue in the myocardial region, which is an atypical type of fiber. These fibers have good innervation, which allows the organ to contract synchronously. The beginning of the contractile activity of the heart occurs in the sinus node, it is in this area that the electrical impulse originates. Therefore, doctors call the correct heart rate sinus.

Originating in the sinus node, the excitatory signal is sent to the atrioventricular node, and then it goes along the bundle of His. Such a bundle is located in the section that blocks the ventricles, where it is divided into two legs. The leg leaving to the right leads to the right ventricle, and the other, rushing to the left, is divided into two branches - posterior and anterior. The anterior branch, respectively, is located in the region of the anterior zones of the septum between the ventricles, in the anterolateral compartment of the wall of the left ventricle. The posterior branch of the bundle of His left is localized in two-thirds of the partitioning part that separates the ventricles of the organ, the middle and lower, as well as the posterolateral and lower wall, located in the zone of the left ventricle. Doctors say that the anterior branch is slightly to the right of the posterior.

The conduction system is a strong source that supplies electrical signals that make the main part of the body work normally, in the right rhythm. Only doctors are able to calculate any violations in this area, it will not work on their own. Both an adult and a newborn baby can suffer from pathological processes of this nature in the cardiovascular system. If deviations occur in the conducting system of the organ, then the axis of the heart can be mixed. There are certain norms for the position of this indicator, according to which the doctor detects the presence or absence of deviations.

Parameters in healthy people

How to determine the direction of the electrical axis of the heart? The weight of the muscle tissue of the ventricle on the left usually significantly exceeds that of the right ventricle. You can find out whether the horizontal or vertical vector of a given measurement is based on these standards. Since the mass of the organ is unevenly distributed, it means that the electrical processes must occur more strongly in the left ventricle, and this shows that the EOS is directed specifically to this department.

Doctors project these data on a specially designed coordinate system, on the basis of which it can be concluded that the electrical axis of the heart is in the region of +30, as well as +70 degrees. However, each person, even a child, has individual features of the body, its own anatomical characteristics. This shows that the slope of the EOS in healthy people can vary between 0-90 degrees. Based on such data, doctors have identified several areas of this indicator, which are considered normal and do not interfere with the activity of the body.

What positions of the electric axis exist:

1. semi-vertical electrical position of the heart;
2. vertically directed electrical position of the heart;
3. horizontal state of the EOS;
4. vertical placement of the electrical axis.

It should be noted that all five positions can be found in a person who has good health. Finding the cause of such features is quite easy, the physiology of people explains everything.

• The horizontal axis of the heart is more often detected in people with a stocky figure and short stature, and these individuals usually have a wide sternum. This type of appearance is called hypersthenic, and the EOS direction indicator varies from 0 to +30 degrees. The horizontal position of the electrical cardiac axis is often the norm.
• The range of the vertical position of this indicator varies within 70 or 90 degrees. Such an EOS vector is detected in a person with an asthenic body type, who has a thin body structure and high growth.

Since the body composition of people is different, it is extremely rare to meet a pure hypersthenic or a very skinny individual, usually these types of structure are considered intermediate, and the direction of the axis of the heart can deviate from normal values ​​(semi-vertical state or semi-horizontal position).

In what cases is it a pathology, the causes of violations

Sometimes the direction of the indicator can mean the presence of a disease in the body. If, as a result of the diagnosis, deviations of the electrical axis of the heart to the left are found, then the person has certain ailments, in particular, hypertrophic changes in the left ventricle. Often, such a violation becomes the result of pathological processes, as a result of which the cavity of this department is stretched and increases in size.

What diseases cause hypertrophy and a sharp slope of the EOS to the left:

1. Ischemic damage to the main organ.
2. Arterial hypertension, especially with regular pressure surges to high tonometer values.
3. Cardiomyopathy. The disease is characterized by an increase in the weight of the muscle tissue of the heart and the expansion of all its cavities. This disease often appears after anemia, myocardial infarction, myocarditis or cardiosclerosis.
4. Chronic heart failure.
5. Abnormalities in the aortic valve, its insufficiency or stenosis. A pathological process of this kind may be acquired or congenital in nature. Such diseases cause a disorder of blood flow in the cavities of the organ, which leads to an overload of the left ventricle.
6. Professionally engaged in sports activities, these disorders are also often detected.

In addition to hypertrophic changes, the deviation of the axis of the heart sharply to the left may indicate problems with the conduction properties of the inner part of the ventricles, which usually occur with various blockades. What is it and what threatens - the attending physician will explain.

Often, a blockade is diagnosed, found in the left leg of the His bundle, which also refers to a pathology that shifts the EOS to the left.

The opposite state also has its causes. Deviation of the electrical axis of the heart to the other side, the right, indicates hypertrophy of the right ventricle. There are certain diseases that provoke such a violation.

What diseases lead to the inclination of the EOS to the right:

• Pathological processes in the tricuspid valve.
• Stenosis and narrowing of the lumen of the pulmonary artery.
• Pulmonary hypertension. This violation often occurs against the background of other ailments, such as obstructive bronchitis, organ damage, emphysema, and bronchial asthma.

In addition, diseases that lead to a shift in the direction of the axis to the left can also cause the EOS to be tilted to the right.

Based on this, doctors conclude that a change in the electrical position of the heart is a consequence of ventricular hypertrophy. In itself, such a disorder is not considered a disease, it is a sign of another pathology.

Norms in children

First of all, it should be noted the position of the EOS during the bearing of the baby by the mother. Pregnancy changes the direction of this indicator, as serious changes take place in the body. The rapidly growing uterus presses on the diaphragm, which leads to displacement of all internal organs and changes the position of the axis, as a result of which its direction may become semi-vertical, semi-horizontal or otherwise, depending on its initial state.

As for children, this indicator changes with age. In newborn babies, a significant deviation of the EOS to the right side is usually detected, which is absolutely normal. By adolescence, this angle is already established. Such changes are associated with the difference in the ratio of weight and electrical activity of both ventricles of the organ, as well as with a change in the position of the heart in the chest area.

A teenager already has a certain EOS angle, which normally persists throughout his life.

Symptoms

A change in the direction of the electrical axis cannot cause discomfort in a person. Disorder of well-being usually provokes hypertrophic damage to the myocardium, if they are accompanied by severe hemodynamic disorders, and also lead to the development of heart failure, which is very dangerous and requires treatment.

• pain in the head and chest area;
• breathing problems, shortness of breath, choking;
• swelling of the tissues of the lower, upper extremities and face area;
• weakness, lethargy;
• arrhythmia, tachycardia;
• disturbance of consciousness.

Determining the causes of such disorders is an important part of all therapy. The prognosis of the disease depends on the correctness of the diagnosis. If such symptoms occur, you should immediately consult a doctor, as cardiac problems are extremely dangerous.

Diagnosis and treatment

Usually, the deviation of the electrical axis is detected on the ECG (electrocardiogram). This method is not more often prescribed than others during a routine examination. The resulting vector and other characteristics of the organ make it possible to evaluate the activity of the heart and calculate deviations in its work. If such a violation is detected on the cardiogram, then the doctor will need to conduct several additional examination measures.

1. Ultrasound of the organ is considered one of the most informative methods. With the help of such a study, it is possible to identify ventricular hypertrophy, disorders in the structure of the heart and evaluate its contractile features.
2. X-ray of the chest area, which allows you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
3. ECG in the form of daily monitoring. It is necessary to clarify the clinical picture in case of violations related not only to the axis itself, but also to the origin of the rhythm not from the sinus node zone, which indicates a disorder of rhythmic data.
4. Coronary angiography or CAG. It is used to study the features of damage to the coronary arteries during organ ischemia.
5. An exercise ECG can detect myocardial ischemia, which is usually the cause of the direction of the EOS.

It is necessary to treat not a change in the index of the electrical axis, but the disease that caused the pathology. With the help of diagnostics, doctors accurately determine the factors that provoked such violations.

Changing the angle of the electrical axis of the heart does not require therapy.

No class of drugs will help in this case. You need to eliminate the disease that led to such changes. Drugs are prescribed to patients only after an accurate diagnosis has been made. Depending on the nature of the lesions, medications are used. Sometimes it is advisable to perform surgery.

In order to determine the functional abilities of the heart, it is necessary to conduct special examination methods. If it turned out that there were violations in the conducting system of the organ, you should not panic, you must follow all the recommendations of the doctor. Medicine today can eliminate almost any pathology, you just need to seek help in a timely manner.

What is sinus rhythm on an ECG

The human heart is a kind of trigger for the productive work of the whole organism. Thanks to the pulses of this organ, which are issued on a regular basis, the blood has the ability to circulate throughout the body, saturating the body with vital substances. If the heart is normal, then the whole body works as productively as possible, but sometimes you still have to face certain health problems.

If a person comes for an examination to a doctor and the specialist has suspicions that something is not right with his heart, then he sends the patient to an ECG. Sinus rhythm on the ECG is a very important indicator and clearly gives data on the real state of the human heart muscle. What exactly can be determined by looking at the cardiogram, it is worth considering in more detail.

What is sinus rhythm

In the concept of medical staff, the sinus rhythm of the cardiogram is the norm for the human body. If there are identical gaps between the teeth depicted on the cardiogram, the height of these columns is also the same, then there are no deviations in the work of the main organ.

So, the sinus rhythm on the cardiogram is the following:

• graphic representation of human pulse jumps;
• a set of teeth of different lengths, between which there are different intervals, showing a specific rhythm of heart impulses;
• schematic representation of the work of the heart muscle;
• an indicator of the presence or absence of abnormalities in the work of the heart and its individual valves.

Normal sinus rhythm is only present when the heart rate is between 60 and 80 beats per minute. It is this rhythm that is considered normal for the human body. and on the cardiogram it is displayed by teeth of the same size, located at the same distance from each other.

It is clearly worth remembering that the results of the cardiogram can be one hundred percent accurate only if the person is completely calm. Stressful situations and nervous tension contribute to the fact that the heart muscle begins to emit impulses faster, which means that it will definitely not be possible to obtain a reliable result about the state of human health.

What are the criteria for deciphering the result of the ECG

Deciphering the results of the cardiogram is performed by doctors according to a special scheme. Medical specialists have a clear idea of ​​which marks on the cardiogram are the norm and which are deviations. The conclusion of the ECG will be set only after the calculation of the results, which were displayed in a schematic form. The doctor, when examining the patient's cardiogram, in order to correctly and accurately decipher it, will pay special attention to a number of such indicators:

• the height of the bars displaying the rhythm of cardiac impulses;
• the distance between the teeth on the cardiogram;
• how sharply the indicators of the schematic image fluctuate;
• what is the specific distance observed between the columns displaying the pulses.

A doctor who knows what each of these schematic marks means, carefully studies them and can clearly orient himself in what kind of diagnosis should be made. The cardiograms of children and adults are deciphered according to the same principle, but the norm indicators for people of different age categories cannot be the same.

What sinus rhythm problems can be seen on an ECG

Electrocardiogram readings can indicate clear signs of problems in the functioning of the heart muscles. With the help of this study, you can see if there is a weakness of the sinus node, and what kind of health problems this causes. Considering the indicators of the cardiogram of a particular patient, a medical specialist can decipher the presence of problems of the following nature:

• sinus tachycardia on the ECG, indicating an excess of the rhythm of contractions, which is considered normal;
• sinus arrhythmia on the ECG, indicating that the interval between contractions of the heart muscles is too long;
• sinus bradycardia on the ECG, indicating that the heart contracts less than 60 times in one minute;
• the presence of too small an interval between the teeth of the cardiogram, which means a violation in the sinus node.

Sinus bradycardia is a common abnormality, especially when it comes to the health of the child. This diagnosis can be explained by many factors, among which physiological defects or simply a factor of chronic fatigue may be hidden.

The deviation of the EOS to the left also indicates that the work of the vital organ is not set up correctly. Having determined such deviations, the doctor will send the patient for an additional examination and ask him to pass a number of necessary tests.

If the vertical position of the EOS is observed, then this means that the heart has a normal location and is in its place, there are no serious physiological abnormalities. This situation is an indicator of the norm, which is also indicated in the conclusion of the doctor who deciphered the cardiogram.

If a horizontal position of the EOS is observed, then this cannot immediately be considered a pathological condition. Such axis indicators are observed in people who are short in stature, but have rather broad shoulders. If the axis deviates to the left or right, and this is very noticeable, then such indicators may indicate a pathological condition of the organ, an increase in the left or right ventricles. Axial misalignment may indicate that there is damage to certain valves. If the axis shifts to the left, then the person most likely has heart failure. If a person suffers from ischemia, then the axis shifts to the right. Such a deviation can also tell about anomalies in the development of the heart muscle.

What can be said about the indicators of the norm

On the ECG, the sinus rhythm is always and without fail compared with certain indicators of the norm. Only knowing these indicators completely, the doctor will be able to deal with the patient's cardiogram and give the correct conclusion.

Normal indicators for children and adults are completely different factors. If we consider the questions of the norm for different age categories, then they will be something like this:

• in children from birth to the first year of life, the orientation of the axis is vertical, the heart beats with a heart rate of 60 to 150 beats per minute;
• children from one year to six years old have a mostly vertical orientation of the axis, but it can also be horizontal, without indicating deviations from the norm. Heart rate from 95 to 128;
• children from seven years old and adolescents on the cardiogram should have a normal or vertical axis position, the heart should contract from 65 to 90 beats per minute;
• adults should have a normal direction of the axis on the cardiogram, the heart contracts at a frequency of 60 to 90 times per minute.

The above indicators fall under the category of the established norm, but if they are slightly different, then this does not always become a sign of the presence of some serious pathologies in the body.

Because of what, ECG readings may deviate from the norm

If the result of the electrocardiogram does not always correspond to the norm, then this means that such a state of the body could be triggered by the following factors:

• a person regularly consumes alcoholic beverages;
• the patient smokes cigarettes for quite a long time on a regular basis;
• a person is regularly exposed to various kinds of stressful situations;
• the patient often uses antiarrhythmic drugs;
• a person has problems with the functioning of the thyroid gland.

Of course, an accelerated heart rate or too slow can indicate problems of a more serious nature. If the results of the cardiogram do not correspond to the norm, then this may indicate acute heart failure, valve displacement, congenital heart defects.

If the sinus rhythm is within the established norm, then the person should not worry, and the doctor will be able to make sure that his patient is healthy.

The sinus node regularly emits impulses that cause the heart muscles to contract correctly and carry the necessary signals throughout the body. If these impulses are given irregularly, which can be clearly recorded by a cardiogram, then the doctor will have every reason to assume that the person has health problems. After studying the heart rate, the doctor will determine the exact cause of all deviations and will be able to offer the patient competent treatment.

Why should a person undergo an ECG study?

The sinus rhythm, which is displayed on the ECG, clearly indicates whether there are deviations in the work of the heart and in which directions the problem is observed. Regularly undergo such a study is necessary not only for adults, but also for children. The results of the performed cardiogram will help a person get the following information:

• whether he has pathologies and diseases of a congenital nature;
• due to what pathologies in the body heart problems begin;
• whether a person's way of life can become a cause of disturbances in the work of the main organ;
• whether the heart is in the correct position and whether its valves work correctly.

Normal sinus rhythm on the ECG is displayed in the form of teeth of the same size and shape, while the distance between them is also the same. If any deviations from this norm are observed, then the person will have to be additionally examined.

The sinus rhythm on the cardiogram must coincide with the established norm, and only in this case can a person be considered healthy. If the impulses from the heart to other systems diverge too quickly or slowly, then this does not bode well. This means that doctors will have to further clarify the cause of the problem and deal with its complex treatment. If an uneven rhythm is observed on a teenager's cardiogram, then this cannot be considered a pathological deviation, because such a condition may be associated with hormonal changes and physiological maturation of the body.

If the sinus rhythm is within the normal range, then you will not have to take additional tests and undergo repeated studies. Normal work of the heart, as well as pathological deviations, is always recorded by a cardiogram.

The sinus rhythm on the ECG should be even and clear, without any broken lines, too long or short intervals. If the presented indicators are normal, then we can safely say that the person is completely healthy. Deviations in the cardiogram are the reason for doctors to perform additional studies and prescribe tests. Only after additional examinations can the exact cause of the deviations be understood and treatment can begin. A normal sinus rhythm displays a clear and even cardiogram in terms of the location of the lines. Additional attention will have to be paid to the location of the axis, with respect to the parameters of which medical standards are also established.

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EOS deviation to the left: causes, diagnosis and treatment

From this article you will learn what EOS is, what it should be like in the norm. When the EOS is deviated slightly to the left - what does this mean, what diseases can this indicate. What treatment may be required.

The electrical axis of the heart is a diagnostic criterion that displays the electrical activity of the organ.

The electrical activity of the heart is recorded using an ECG. Sensors are applied to various areas of the chest, and in order to find out the direction of the electrical axis, it is possible to represent it (the chest) in the form of a three-dimensional coordinate system.

The direction of the electrical axis is calculated by the cardiologist during the decoding of the ECG. To do this, he sums the values ​​of the Q, R and S waves in lead 1, then finds the sum of the values ​​of the Q, R and S waves in lead 3. Then he takes the two received numbers and calculates the alpha - the angle according to a special table. It is called the Died table. This angle is the criterion by which it is determined whether the location of the electrical axis of the heart is normal.

The presence of a significant deviation of the EOS to the left or right is a sign of a violation of the heart. Diseases that provoke EOS deviation almost always require treatment. After getting rid of the underlying disease, the EOS takes on a more natural position, but sometimes it is impossible to completely cure the disease.

To resolve this problem, contact a cardiologist.

The location of the electrical axis is normal

In healthy people, the electrical axis of the heart coincides with the anatomical axis of this organ. The heart is located semi-vertically - its lower end is directed down and to the left. And the electric axis, like the anatomical one, is in a semi-vertical position and tends down and to the left.

The norm of the alpha angle is from 0 to +90 degrees.

The norm of the angle alpha EOS

The location of the anatomical and electrical axes to a certain extent depends on the physique. In asthenics (thin people with tall stature and long limbs), the heart (and, accordingly, its axes) is located more vertically, and in hypersthenics (short people with a stocky build) - more horizontally.

The norm of the alpha angle, depending on the physique:

A significant shift of the electrical axis to the left or right side is a sign of pathologies of the conduction system of the heart or other diseases.

A negative angle alpha indicates a deviation to the left: from -90 to 0 degrees. About its deviation to the right - values ​​\u200b\u200bfrom +90 to +180 degrees.

However, it is not necessary to know these numbers at all, since in case of violations in the ECG decoding, you can find the phrase “EOS is rejected to the left (or right)”.

Reasons for shifting to the left

Deviation of the electrical axis of the heart to the left is a typical symptom of problems with the left side of this organ. It could be:

• hypertrophy (enlargement, growth) of the left ventricle (LVH);
• blockade of the anterior branch of the left leg of the bundle of His - a violation of the conduction of the impulse in the anterior part of the left ventricle.

Causes of these pathologies:

Symptoms

By itself, the displacement of the EOS has no characteristic symptoms.

The diseases that accompany it can also be asymptomatic. That is why it is important to undergo an ECG for preventive purposes - if the disease is not accompanied by unpleasant symptoms, you can learn about it and start treatment only after deciphering the cardiogram.

However, sometimes these diseases still make themselves felt.

Symptoms of diseases that are accompanied by a displacement of the electrical axis:

But we repeat once again - the symptoms do not always appear, they usually develop in the later stages of the disease.

Additional diagnostics

To find out the reasons for the deviation of the EOS, the ECG is analyzed in detail. They may also assign:

1. EchoCG (ultrasound of the heart) - to identify possible organ defects.
2. Stress EchoCG - ultrasound of the heart with a load - for the diagnosis of ischemia.
3. Angiography of the coronary vessels - their examination to detect blood clots and atherosclerotic plaques.
4. Holter monitoring - ECG recording using a portable device throughout the day.

After a detailed examination, appropriate therapy is prescribed.

Treatment

By itself, the deviation of the electrical axis of the heart to the left does not require specific treatment, since it is only a symptom of another disease.

All measures are aimed at eliminating the underlying disease, which is manifested by a shift in the EOS.

Treatment for LVH depends on what caused myocardial overgrowth

Treatment of the blockade of the anterior branch of the left leg of the bundle of His - the installation of a pacemaker. If arose as a result of a heart attack - surgical restoration of blood circulation in the coronary vessels.

The electrical axis of the heart returns to normal only if the size of the left ventricle is returned to normal or the impulse conduction through the left ventricle is restored.

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Deviation of the electrical axis of the heart to the left: everything you need to know about it

The electrical axis of the heart (EOS) is a clinical parameter that is used in cardiology and is reflected in the electrocardiogram. Allows you to evaluate the electrical processes that set the heart muscle in motion and are responsible for its correct operation.

From the point of view of cardiologists, the chest is a three-dimensional coordinate system in which the heart is enclosed. Each of its contraction is accompanied by a number of bioelectrical changes, which determine the direction of the cardiac axis.

Normal values ​​and causes of violation

The direction of this indicator depends on various physiological and anatomical factors. The position +59 0 is considered the average norm. But the normogram options fall into a wide range from +20 0 to +100 0.

In a state of health, the electrical axis shifts to the left under the following conditions:

• at the moment of deep exhalation;
• when the body position changes to horizontal, the internal organs exert pressure on the diaphragm;
• with a high-standing diaphragm - observed in hypersthenics (short, strong people).

The shift of the indicator to the right in the absence of pathology is observed in such situations:

• at the end of a deep breath;
• when changing the position of the body to the vertical;
• in asthenics (tall, thin people), the vertical position of the EOS is the norm.

Diagnostics on the ECG

An electrocardiogram is the main tool for determining EOS. To detect changes in the location of the axis, two equivalent methods are used. The first method is more often used by diagnosticians, the second method is more common among cardiologists and therapists.

Alpha Offset Detection

The value of the alpha angle directly shows the displacement of the EOS in one direction or another. To calculate this angle, find the algebraic sum of the Q, R and S waves in the first and third standard leads. To do this, measure the height of the teeth in millimeters, and when adding, the positive or negative value of a particular tooth is taken into account.

The value of the sum of the teeth from the first lead is found on the horizontal axis, and from the third - on the vertical one. The intersection of the resulting lines determines the alpha angle.

Visual Definition

A simpler and more visual way to determine the EOS is to compare the R and S waves in the first and third standard leads. If the absolute value of the R wave within one lead is greater than the value of the S wave, then one speaks of an R-type ventricular complex. If vice versa, then the ventricular complex is classified as S-type.

When the EOS deviates to the left, a picture of RI - SIII is observed, which means the R-type of the ventricular complex in the first lead and the S-type in the third. If the EOS is deviated to the right, then SI - RIII is determined on the electrocardiogram.

Establishing diagnosis

What does it mean if the electrical axis of the heart is deviated to the left? EOS displacement is not an independent disease. This is a sign of changes in the heart muscle or its conduction system, which lead to the development of the disease. The deviation of the electrical axis to the left indicates such violations:

• an increase in the size of the left ventricle - hypertrophy (LVH);
• malfunctions of the valves of the left ventricle, due to which the ventricle is overloaded with blood volume;
• cardiac blockades, for example, left bundle branch blockade of Hiss (it looks like this on the ECG, which you can learn about from another article);
• conduction disturbances within the left ventricle.

Diseases that are accompanied by a levogram

If a deviation of the EOS is found in a patient, then this may be the result of diseases such as:

In addition to diseases, certain medications can lead to blockade of the conduction system of the heart.

Additional Research

The detection on the cardiogram of the EOS deviation to the left side is not in itself the basis for the final conclusion of the doctor. In order to determine what specific changes occur in the heart muscle, additional instrumental studies are required.

• Bicycle ergometry (electrocardiogram while walking on a treadmill or on an exercise bike). Test to detect ischemia of the heart muscle.
• ultrasound. With the help of ultrasound, the degree of ventricular hypertrophy and violations of their contractile function are assessed.
• 24-hour Holter ECG monitoring. The cardiogram is removed during the day. Assign in cases of rhythm disturbance, which is accompanied by a deviation of the EOS.
• X-ray examination of the chest. With significant hypertrophy of myocardial tissues, an increase in the cardiac shadow in the picture is observed.
• Angiography of the coronary arteries (CAG). Allows you to determine the degree of damage to the coronary arteries in diagnosed coronary disease.
• Echocardioscopy. Allows you to purposefully determine the state of the patient's ventricles and atria.

Treatment

Deviation of the electrical axis of the heart to the left of the normal position in itself is not a disease. This is a sign determined with the help of instrumental research, which allows you to identify violations in the work of the heart muscle.

Ischemia, heart failure, and some cardiopathies are treated with drugs. Additional adherence to a diet and a healthy lifestyle leads to the normalization of the patient's condition.

In severe cases, surgery is required, for example, with congenital or acquired heart defects. If the conduction system is severely damaged, it may be necessary to transplant a pacemaker, which will send signals directly to the myocardium and cause it to contract.

Most often, the deviation is not a threatening symptom. But if the axis changes its position abruptly, reaches values ​​of more than 90 0, then this may indicate a blockade of the legs of the Hiss bundle and threatens with cardiac arrest. Such a patient requires urgent hospitalization in the intensive care unit. A sharp and pronounced deviation of the electrical axis of the heart to the left looks like this:

Detection of displacement of the electrical axis of the heart is not a cause for concern. But if this symptom is detected, you should immediately consult a doctor for further examination and identification of the cause of this condition. Annual scheduled electrocardiography allows you to timely detect abnormalities in the work of the heart and immediately begin therapy.

Regular sinus rhythm - this phrase means an absolutely normal heart rhythm that is generated in the sinus node (the main source of cardiac electrical potentials).

Left ventricular hypertrophy (LVH) is a wall thickening and/or enlargement of the left ventricle of the heart. All five positions (normal, horizontal, semi-horizontal, vertical and semi-vertical) are found in healthy people and are not pathological.

What does the vertical position of the axis of the heart on the ECG mean?

The situation should be alarming when, with the pre-existing position of the EOS, its sharp deviation occurs on the ECG. In this case, the deviation most likely indicates the occurrence of a blockade. 6.1. Wave P. Analysis of the P wave involves determining its amplitude, width (duration), shape, direction and severity in various leads.

The always negative wave of the P vector is projected onto the positive parts of most leads (but not all!).

6.4.2. The severity of the Q wave in various leads.

Methods for determining the position of the EOS.

In simple terms, an ECG is a dynamic recording of an electrical charge, thanks to which our heart works (that is, it contracts). The designations of these graphs (they are also called leads) - I, II, III, aVR, aVL, aVF, V1-V6 - can be seen on the electrocardiogram.

An ECG is a completely painless and safe study, it is performed for adults, children and even pregnant women.

Heart rate is not a disease or a diagnosis, but just an abbreviation for "heart rate", which refers to the number of contractions of the heart muscle per minute. With an increase in heart rate above 91 beats / min, they speak of tachycardia; if the heart rate is 59 beats / min or less, this is a sign of bradycardia.

Thin people usually have a vertical position of the EOS, while thick people and obese people have a horizontal position. Respiratory arrhythmia is associated with the act of breathing, is the norm and does not require treatment.

Requires compulsory treatment. Atrial flutter - this type of arrhythmia is very similar to atrial fibrillation. Sometimes there are polytopic extrasystoles - that is, the impulses that cause them come from various parts of the heart.

Extrasystole can be called the most common ECG finding, moreover, not all extrasystoles are a sign of the disease. In this case, treatment is necessary. Atrioventricular blockade, A-V (AV) blockade - a violation of the impulse from the atria to the ventricles of the heart.

Blockade of the legs (left, right, left and right) of the His bundle (RBNG, BLNG), complete, incomplete - this is a violation of the conduction of an impulse along the conduction system in the thickness of the ventricular myocardium.

The most common causes of hypertrophy are arterial hypertension, heart defects and hypertrophic cardiomyopathy. In some cases, next to the conclusion about the presence of hypertrophy, the doctor indicates - "with overload" or "with signs of overload."

Cicatricial changes, scars are signs of a myocardial infarction once transferred. In such a situation, the doctor prescribes treatment aimed at preventing a second heart attack and eliminating the cause of circulatory disorders in the heart muscle (atherosclerosis).

Timely detection and treatment of this pathology is necessary. Normal ECG in children aged 1-12 months. Typically fluctuations in heart rate depending on the behavior of the child (increase in crying, anxiety). At the same time, over the past 20 years, there has been a clear trend towards an increase in the prevalence of this pathology.

If we project the electrodes onto a conditional coordinate system, then we can also calculate the angle of the electric axis, which will be located where the electrical processes are strongest. The conduction system of the heart is a section of the heart muscle, consisting of the so-called atypical muscle fibers.

Normal ECG

Myocardial contraction begins with the appearance of an electrical impulse in the sinus node (which is why the correct rhythm of a healthy heart is called sinus). The conduction system of the myocardium is a powerful source of electrical impulses, which means that electrical changes that precede cardiac contraction occur in it first of all in the heart.

Rotations of the heart around the longitudinal axis help determine the position of the organ in space and, in some cases, are an additional parameter in the diagnosis of diseases. In itself, the position of the EOS is not a diagnosis.

These defects can be either congenital or acquired. The most commonly acquired heart defects are the result of rheumatic fever.

In this case, it is necessary to consult a highly qualified sports doctor to decide whether it is possible to continue playing sports.

A shift in the electrical axis of the heart to the right may indicate right ventricular hypertrophy (RVH). Blood from the right ventricle enters the lungs, where it is enriched with oxygen.

As with the left ventricle, RVH is caused by coronary heart disease, congestive heart failure, and cardiomyopathies.

Sinus arrhythmia vertical position eos what is it

Sinus (sinusoidal) cardiac arrhythmia

Heart rhythm disturbances quite often serve as a manifestation of various diseases, but in some cases it is not associated with a pathological process. Myocardial contraction originates automatically in the sinus node, then spreading to the atria, and then to the ventricles along the legs of the His bundle and Purkinje fibers.

In some conditions, the focus located in the myocardium becomes the source of excitation, then atrial or ventricular arrhythmia develops. If the contraction cycle is not broken, then sinus arrhythmia occurs. It can be accompanied by a fast (tachycardia), slow (bradycardia), or irregular heartbeat.

The reasons

Sinus arrhythmia can occur due to a number of reasons. Leads to tachycardia:

• anemia;
• hormonal disorders;
• hyperthermia;
• increased stress on the body (physical and emotional);
• activation of the sympathetic nervous system under the influence of drugs or other stimulants.

Causes of bradycardia can be:

• an overdose of drugs that depress the automatism of the sinus node (for example, beta-blockers);
• hypothermia of the body;
• deficiency of thyroid hormones;
• in professional athletes;
• in the elderly due to impaired blood supply;
• sick sinus syndrome, which is a sign of a number of diseases.

Irregularity of heartbeats in sinus arrhythmia is usually associated with breathing and is not a pathology if the fluctuations do not exceed 10%. In some people, rhythm disturbance is caused by a change in body position from horizontal to vertical. In this case, cardiac arrhythmia serves as a compensatory response of the body to acute orthostatic hypotension (vertical sinus arrhythmia).

Manifestations

Sinusoidal arrhythmia can produce different symptoms depending on the heart rate. With an increase in their number, it is noted:

• feeling of pulsation in the region of the heart and in the temples;
• pain in the left half of the chest or behind the sternum due to increased stress on the myocardium;
• feeling short of breath.

If bradycardia develops, then patients complain of a feeling of fading of the heart, weakness, dizziness.

With moderate arrhythmias, there may be no symptoms, and the diagnosis is made on the basis of examination data.

Diagnostics

The main method for diagnosing arrhythmias is electrocardiography, which can be recorded once or during the day (Holter monitoring).

With arrhythmia, the P wave must be present on the ECG, indicating that the sinus node is the source of contraction. The heart rate is usually changed up or down. To exclude the influence of the respiratory cycle on the ECG results, during the manipulation, the patient is asked to hold his breath at the height of inspiration.

To exclude organic pathologies of the heart, an ECHO-KG is performed. With the help of ultrasound, it is possible to determine the state of various structures and measure the dimensions of the chambers. With an invasive electrophysiological study, stimulation or inhibition of the sinus node is carried out and its response is evaluated. It is performed infrequently and only under strict indications.

Treatment Methods

Quite often, cardiac arrhythmias resolve on their own after the causes that caused them are eliminated, that is, they do not require specific treatment. However, severe sinus arrhythmia can lead to impaired blood supply to vital organs. Therefore, therapeutic methods and pacing can be used to treat it.

The choice of a particular drug is determined by individual characteristics and should be carried out by a doctor. With stress-related sinus tachycardia, sedatives, including those of natural origin, are used for treatment.

In case of arrhythmia with a heart rate of less than 45 per minute (in professional athletes, less than 35 per minute), which is accompanied by a violation of central hemodynamics, it is necessary to decide on the installation of a pacemaker. This miniature device is placed under the skin in the subclavian region. With the help of special programs, an electrical impulse is conducted along the electrodes to the ventricles and atria. In this case, the device starts to work when the natural frequency of contractions decreases below the established critical level.

Heart rhythm disturbances are not always associated with the disease, they can be caused by physiological processes and increased activity of the nervous system. Only a significant deviation from the noma of the heart rate can be manifested by serious hemodynamic disturbances. For the treatment of these conditions, drug methods or electrocardiostimulation are used. Preventive measures do not differ from the generally accepted ones and are aimed at maintaining a healthy lifestyle.

Normal heart rate in children and adults

Sinus arrhythmia in children: features of treatment

The child's body is not yet strong enough to fully resist external and internal factors. Sinus arrhythmia in children is considered the most common consequence of their exposure. The appearance is associated with disruption of the nervous and cardiovascular systems. In most cases, the resulting failure does not have a significant impact on health, but parents must take measures to prevent the occurrence of new seizures (paroxysms). They will have to take the baby to the doctor for an examination. The specialist will tell you what sinus arrhythmia is in children and, based on the results of the diagnosis, will conclude whether it is necessary to draw up a course of treatment, or it is enough to follow the rules of prevention.

Definition

Sinus (sinus) arrhythmia that occurs in a child is a consequence of a malfunction in the natural pacemaker (sinus node). It arises due to the influence of various external and internal factors (stress, overwork, pathologies, endocrine disruptions). A cardiologist treats irregular heartbeat.

Any parent can identify arrhythmia, knowing the pulse rate by age:

A deviation from the norm of more than 20 beats per minute (up or down) is already considered a violation of the heart rhythm. The baby cannot fully express his discomfort, so it is advisable to show the child to the doctor.

Expert opinion

Evgeny Olegovich Komarovsky is one of the best specialists in the field of pediatrics. In his opinion, mild forms of arrhythmia are characteristic of virtually all children. It is extremely difficult to meet a baby who has never suffered from this problem. Treatment is prescribed by a doctor, focusing on the patient's condition. If the case is not severe, then the specialist will seek to limit himself to lifestyle correction and folk remedies. Medicines and surgical intervention in the treatment regimen for children are used only as needed.

Types of failure

Sinus failure in the heart rhythm is divided into the following types according to the nature of the manifestation:

• tachycardia (rapid heartbeat);
• bradycardia (slow rhythm);
• extrasystole (extraordinary contraction).

The classification of the failure according to the severity will help to understand what the sinus form of arrhythmia of the heart in a child is:

• A mild form of palpitations is a consequence of the immaturity of the nervous system. It passes on its own and is not considered dangerous.
• A moderate form of failure occurs in children 5-6 years old. It has no special symptoms, therefore it is detected only with the help of an electrocardiogram (ECG).
• Severe sinus arrhythmia in a child occurs in flight. It is manifested by fairly persistent paroxysms and a vivid clinical picture. Experts consider this species dangerous because of the likelihood of developing heart pathologies.

Non-dangerous forms of failure

Respiratory arrhythmia occurs in many children. It is characterized by an increase in heart rate on inspiration and a slowdown on exhalation. A similar reflex reaction is checked during electrocardiography by laying the patient on a couch, on top of which a cold oilcloth is laid. Because of its impact, the child instinctively holds his breath. In the presence of this form of arrhythmia, the heart rate will decrease slightly.

There is a respiratory type of failure in the rhythm of the heart due to the immaturity of the nervous system. The frequency of manifestations of seizures and their intensity depends on the age of the patient. This arrhythmia develops due to the influence of the following factors:

• postnatal (from birth to 1 week) encephalopathy;
• high level of pressure inside the skull;
• prematurity of the child;
• rickets, provoking excessive excitation of the nervous system;

• excess body weight causes tachyarrhythmia after physical exertion;
• phase of active growth (6-10 years).

The severity of the failure depends on the cause of its occurrence. Often, arrhythmia is provoked by the inability of the autonomic department to keep up with the active growth of the child. Over the years, this problem resolves itself.

The functional form is not as common as the respiratory form. It is not considered dangerous, and in most cases passes without the intervention of a doctor. Arrhythmia occurs for the following reasons:

• endocrine disruptions;
• weakened immune defense;
• immature nervous system.

More dangerous is a functional failure due to the following factors:

• diseases caused by infections (bacterial or viral);
• disrupted thyroid function.

Dangerous types of failure

The organic form of arrhythmia is considered the most severe. It is characterized by prolonged paroxysms or a constant flow. The sinus node continues to work, but due to a violation of the integrity of cardiomyocytes (heart cells) or failures in the conduction system, the heart rate (HR) jumps. An organic form develops under the influence of various diseases.

The incidence of dangerous forms of heart failure in children is 25-30% of the total. You can find the reasons for them in the list below:

• Hereditary predisposition is the main factor in the development of many pathologies. If mom or dad had diseases that provoke the occurrence of arrhythmias, then there is a possibility of their occurrence in a child.
• Pathologies caused by infections, combined with acute intoxication, fever and dehydration, have a negative effect on the heart muscle. The electrolyte balance and the composition of the interstitial fluid are disturbed, which causes failures in the conduction system.
• Vegetovascular dystonia is manifested by a violation of the function of constriction and expansion of blood vessels. The heart has to contract more often or more slowly, which leads to the development of arrhythmias and disruptions in hemodynamics (blood flow).
• Rheumatism affects the valvular apparatus, which can cause inflammatory diseases. It has a chronic course and develops due to angina. The disease is accompanied by high fever, intermittent joint pain and damage to the heart muscle.
• Inflammatory diseases of the myocardium (myocarditis, pericarditis, endocarditis), which are of a bacterial or viral nature, provoke the occurrence of various arrhythmias. Often a sinus type of failure occurs, but sometimes more dangerous forms develop (atrial fibrillation, blockade of the His bundle). The main pathological process is accompanied by pain in the chest, high fever, swelling of the lower extremities, shortness of breath and liver dysfunction.
• Malformations often provoke the occurrence of a pronounced form of arrhythmia. They are eliminated only by surgery, if it is not possible to stop seizures with the help of medications.
• Tumors of the heart are extremely rare, but can cause heart rate failures. It is treated exclusively by surgery.

Sports and sinus arrhythmia

Parents send many children to sports sections, thanks to which the body is strengthened and its full development becomes possible. When detecting sinus arrhythmia, it is important to find out its nature in order to understand what physical activity is acceptable for a child:

• Non-hazardous types of failure are not a contraindication to playing sports. It is enough for parents to show the baby to a cardiologist and conduct an electrocardiographic study several times a year. The purpose of diagnosis is to monitor the development of arrhythmia. If it begins to turn into more dangerous varieties, then the process must be stopped in a timely manner.
• Dangerous forms of failure should be treated as soon as they occur. Permissible physical activity is determined by the attending physician, focusing on the causative factor and the condition of the baby.

In most cases, arrhythmia manifests itself when receiving physical activity due to hereditary predisposition. Children involved in sports professionally need to periodically consult a doctor and do an ECG every 3-4 months. If respiratory arrhythmia is detected, the child may be allowed to compete, but if its form is more severe, then the issue of stopping the athlete’s career and reducing the resulting physical activity will be decided.

Diagnosis and treatment

To draw up a full-fledged course of therapy, the child should be shown to a cardiologist. The doctor will conduct an examination and prescribe the necessary examinations. Chief among them is electrocardiography. Perform it in a standing and lying position, as well as with a load and during the day (daily monitoring).

An important indicator that is indicated on the electrocardiogram is the electrical axis of the heart (EOS). With its help, you can determine the location of the body and evaluate its size and performance. The position can be normal, horizontal, vertical or shifted to the side. This nuance is influenced by various factors:

• With hypertension, there is a shift to the left or a horizontal position.
• Congenital lung diseases cause the heart to move to the right.
• Thin people tend to have a vertical EOS, and full people have a horizontal one.

During the examination, it is important to identify the presence of a sharp change in the EOS, which may indicate the development of serious malfunctions in the body. Other diagnostic methods can be used to obtain more accurate data:

• rheoencephalography;
• ultrasound examination of the heart;
• x-ray of the thoracic and cervical spine.

Based on the results obtained, a treatment plan is drawn up. Functional and respiratory arrhythmias are not eliminated by medication. Doctors give advice on lifestyle changes. The main focus will be on the following points:

Moderate arrhythmia is stopped not only by lifestyle correction, but also by sedatives (Corvalol, tinctures of hawthorn, mint, glod) and tranquilizers (Oxazepam, Diazepam). Preparations and their dosages are selected exclusively by the attending physician.

The pronounced variety is eliminated by the correction of nutrition, rest and physical activity in combination with drug therapy. In advanced cases, as well as in the absence of the result of treatment with tablets, surgery is used.

To begin with, the specialist will have to stop the negative influence of the factor that causes arrhythmia. The following measures will help with this:

• elimination of the main pathological process;
• treatment of chronic infection;
• the abolition of medications that provoke a failure in the rhythm of the heart.

Supplement the treatment regimens with folk remedies and physiotherapy procedures. They are selected depending on the characteristics of the child's body and the presence of other pathologies.

Medical treatment

With sinus arrhythmia, the following drugs are prescribed to stabilize heart rate:

• Drugs with arrhythmic effects (Digoxin, Adenosine, Bretilium) dilate blood vessels and normalize heart rate.
• Tablets to improve metabolic processes ("Inosine", "Riboxin") protect the myocardium from oxygen starvation, thereby eliminating arrhythmia.
• Preparations based on magnesium and potassium ("Panangin", "Orokamag") normalize electrolyte balance, regulate blood pressure and stimulate neuromuscular transmission.

Surgery

If drug treatment has not helped to eliminate severe arrhythmia, then the following types of minimally invasive surgical intervention are used:

• Radiofrequency ablation, the purpose of which is to cauterize the focus of an ectopic signal in the heart by passing a catheter through the femoral artery.
• Installation of an artificial pacemaker (pacemaker, defibrillator).

Physiotherapeutic procedures complement the treatment regimen well. Their list is given below:

• acupuncture;
• therapeutic baths
• laser or magnetic therapy.

ethnoscience

Traditional medicines are prepared from plants with healing properties and have a minimum number of contraindications. Before using them, you should consult your doctor to avoid undesirable consequences. The most popular recipes are:

• 300 g of dried apricots, 130 g of raisins and walnuts must be thoroughly ground and mixed with 150 ml of honey and lemon. Such a gruel helps cleanse the blood and improve the functioning of the heart muscle. Use it in an amount of 1 to 2 tbsp. l., depending on age (up to 3 years old, over four ml).
• The daily diet must be saturated with fruits. They can be cut into cereals, desserts and other dishes. Instead of a regular drink, it is recommended to drink fresh juice (apple, grape).
• Pour 30 g of dry lemon balm with a glass of boiling water and let it brew for half an hour. It is advisable to drink such a tea with a sedative effect for at least 2 weeks.

• A decoction of valerian is prepared from the roots of the plant. They must be cleaned and poured with boiling water in a ratio of 30 g per 250 ml. Then put on fire. Remove from stove after 10 minutes and let cool. Take a decoction with a pronounced sedative effect of 0.5 tbsp. l. It can also be added to the bathroom.
• Pour 30 g of rose hips with 1 cup of boiling water and add 20 ml of honey. Ready drink well tones the nervous system and improves heart function.
• Adding celery and greens to salads will saturate the body with useful substances, which will have a beneficial effect on the functioning of the heart and nervous system.

Preventive measures

Compliance with the rules of prevention will prevent attacks of arrhythmia and improve the overall well-being of the child. They can be found below:

• Make the right diet, saturating it with herbs, vegetables, fruits and berries. Cooking is recommended by steaming or by boiling. Eat small meals, but 5-6 times a day, avoiding overeating. Dinner should be no later than 3-4 hours before bedtime.
• It is better to forget about intense physical activity. The child needs more rest. Among sports, it is recommended to choose running or swimming, but initially you should limit yourself to morning exercises.

• Regardless of the season, the child should be outdoors more. It is recommended to reduce the amount of time at the computer and TV to a minimum.
• From stressful situations, the child should be completely protected. Any experiences and conflicts can aggravate his condition.
• In case of complications, side effects and other problems, you should consult your doctor. Self-medication is strictly prohibited.

Forecast

Non-dangerous forms of arrhythmias pass virtually without the participation of a doctor and do not provoke the development of complications. Organic types of failure often lead to heart failure, asystole, atrial fibrillation and other dangerous consequences. Because of them, the child can become disabled or die. The prognosis will depend on the severity of the underlying pathological process and the effectiveness of the course of therapy. In advanced cases, surgical intervention is used.

The sinus form of arrhythmia occurs in every second baby. It rarely leads to complications and is virtually invisible. In most cases, a similar failure is detected using an ECG. If it was caused by pathologies of the heart or other organs, then the course of therapy will be aimed at eliminating them. The treatment regimen will include medications, physiotherapy and lifestyle changes. In the absence of a result, surgical intervention will be applied. Milder cases of arrhythmia are eliminated by reducing physical activity, avoiding stress and proper dietary intake.

What is the electrical axis of the heart?

The electrical axis of the heart is a concept that reflects the total vector of the electrodynamic force of the heart, or its electrical activity, and practically coincides with the anatomical axis. Normally, this organ has a cone-shaped shape, directed with its narrow end down, forward and to the left, and the electrical axis has a semi-vertical position, that is, it is also directed down and to the left, and when projected onto a coordinate system, it can be in the range from +0 to +90 0.

• Causes of deviations from the norm
• Symptoms
• Diagnostics
• Treatment

An ECG conclusion is considered normal, which indicates any of the following positions of the axis of the heart: not rejected, has a semi-vertical, semi-horizontal, vertical or horizontal position. Closer to the vertical position, the axis is in thin tall people of asthenic physique, and to the horizontal position - in strong stocky faces of hypersthenic physique.

The range of position of the electrical axis is normal

For example, in the conclusion of the ECG, the patient may see the following phrase: "sinus rhythm, EOS is not rejected ...", or "the axis of the heart is in a vertical position", which means that the heart is working correctly.

In the case of heart diseases, the electrical axis of the heart, along with the heart rhythm, is one of the first ECG criteria that the doctor pays attention to, and when deciphering the ECG by the attending physician, it is necessary to determine the direction of the electrical axis.

How to determine the position of the electrical axis

Determining the position of the axis of the heart is carried out by a doctor of functional diagnostics, deciphering the ECG, using special tables and diagrams, according to the angle α ("alpha").

The second way to determine the position of the electrical axis is to compare the QRS complexes responsible for the excitation and contraction of the ventricles. So, if the R wave has a greater amplitude in the I chest lead than in the III one, then there is a levogram, or a deviation of the axis to the left. If there is more in III than in I, then a rightogram. Normally, the R wave is higher in lead II.

Causes of deviations from the norm

Axis deviation to the right or to the left is not considered an independent disease, but it can indicate diseases that lead to disruption of the heart.

Deviation of the axis of the heart to the left often develops with left ventricular hypertrophy

Deviation of the axis of the heart to the left can occur normally in healthy individuals who are professionally involved in sports, but more often develops with left ventricular hypertrophy. This is an increase in the mass of the heart muscle with a violation of its contraction and relaxation, necessary for the normal functioning of the whole heart. Hypertrophy can be caused by such diseases:

• cardiomyopathy (increase in mass of the myocardium or expansion of the heart chambers) caused by anemia, hormonal disorders in the body, coronary heart disease, postinfarction cardiosclerosis, changes in the structure of the myocardium after myocarditis (inflammatory process in the heart tissue);
• long-term arterial hypertension, especially with constantly high pressure figures;
• acquired heart defects, in particular stenosis (narrowing) or insufficiency (incomplete closure) of the aortic valve, leading to impaired intracardiac blood flow, and, consequently, increased stress on the left ventricle;
• congenital heart defects are often the cause of the deviation of the electrical axis to the left in a child;
• violation of conduction along the left leg of the bundle of His - a complete or incomplete blockade, leading to a violation of the contractility of the left ventricle, while the axis is rejected, and the rhythm remains sinus;
• atrial fibrillation, then the ECG is characterized not only by axis deviation, but also by the presence of non-sinus rhythm.

In adults, such a deviation, as a rule, is a sign of right ventricular hypertrophy, which develops with such diseases:

• diseases of the bronchopulmonary system - prolonged bronchial asthma, severe obstructive bronchitis, pulmonary emphysema, leading to an increase in blood pressure in the pulmonary capillaries and increasing the load on the right ventricle;
• heart defects with damage to the tricuspid (tricuspid) valve and the valve of the pulmonary artery extending from the right ventricle.

The greater the degree of ventricular hypertrophy, the more deviated the electrical axis, respectively, sharply to the left and sharply to the right.

Symptoms

The electrical axis of the heart itself does not cause any symptoms in the patient. Disorders of well-being appear in a patient if myocardial hypertrophy leads to severe hemodynamic disturbances and to heart failure.

The disease is characterized by pain in the region of the heart

Of the signs of diseases accompanied by a deviation of the axis of the heart to the left or right, headaches, pains in the region of the heart, swelling of the lower extremities and on the face, shortness of breath, asthma attacks, etc. are characteristic.

If any unpleasant cardiac symptoms appear, you should consult a doctor for an ECG, and if an abnormal position of the electrical axis is found on the cardiogram, an additional examination should be performed to establish the cause of this condition, especially if it is found in a child.

Diagnostics

To determine the cause, if the ECG axis of the heart deviates to the left or right, a cardiologist or therapist may prescribe additional research methods:

1. Ultrasound of the heart is the most informative method that allows you to assess anatomical changes and identify ventricular hypertrophy, as well as determine the degree of violation of their contractile function. This method is especially important for examining a newborn child for congenital heart disease.
2. ECG with exercise (walking on a treadmill - treadmill test, bicycle ergometry) can detect myocardial ischemia, which can be the cause of deviations of the electrical axis.
3. 24-hour ECG monitoring in the event that not only axis deviation is detected, but also the presence of a rhythm not from the sinus node, that is, there are rhythm disturbances.
4. Chest X-ray - with severe myocardial hypertrophy, an expansion of the cardiac shadow is characteristic.
5. Coronary angiography (CAG) is performed to clarify the nature of coronary artery lesions in coronary artery disease a.

Treatment

Directly, the deviation of the electrical axis does not need treatment, since this is not a disease, but a criterion by which it can be assumed that the patient has one or another cardiac pathology. If any disease is detected after the additional examination, it is necessary to begin its treatment as soon as possible.

In conclusion, it should be noted that if the patient sees in the conclusion of the ECG a phrase that the electrical axis of the heart is not in a normal position, this should alert him and prompt him to consult a doctor to find out the cause of such an ECG - a sign, even if there are no symptoms does not occur.

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Vertical position of the EOS in sinus tachycardia

EOS (electrical axis of the heart) - an indicator of the electrical parameters of the heart muscle. Important information necessary for making a cardiac diagnosis is the direction of the EOS.

What is the vertical position of the EOS

There are several options for the position of the electrical axis of the heart. It can have a horizontal (semi-horizontal) and vertical (semi-vertical) direction. All of the listed varieties do not belong to pathologies - they are often detected in a normal state of health. The vertical position of the EOS is typical for tall patients with a thin physique, children, adolescents. Horizontal - found in short people with a wide chest.

In some cases, there are significant EOS shifts. The reason for this is that the patient has:

• ischemic heart disease;
• cardiomyopathy;
• chronic heart failure;
• congenital anomalies of the heart muscle.

The position of the axis of the heart is considered by cardiologists as an additional indicator in the diagnosis of heart disease, and not as an independent disease. If its deviation is outside the norm (more than +90 degrees), you will need a consultation with a specialist and a thorough examination.

When is the diagnosis "sinus tachycardia vertical position of the EOS"

The diagnosis of "sinus tachycardia with a vertical position of the EOS" is often found in children and adolescents. It implies an acceleration of the rhythm in which the sinus node works. From this area comes an electrical impulse that initiates the contraction of the heart and determines the speed of its work.

Sinus tachycardia at this age refers to the variants of the norm. Heart rate readings may exceed 90 beats per minute. In the absence of serious complaints, normal test results, this condition is not regarded as a manifestation of pathology.

Tachycardia requires more serious consideration when:

• various forms of shortness of breath;
• feeling of pressure in the chest area;
• soreness in the chest;
• dizziness, fainting, low blood pressure (in cases where orthostatic tachycardia develops);
• panic attacks;
• increased fatigue and loss of performance.

Postural orthostatic tachycardia syndrome leads to an increase in heart rate with a change in body position (suddenly getting up). This is often observed in people whose professional activities are associated with increased physical exertion (among handymen, movers, storekeepers).

A possible long-term consequence of sinus tachycardia is heart failure and other diseases.

Diagnosis of sinus tachycardia

Diagnosis of sinus tachycardia requires the use of various analytical techniques. It becomes mandatory to study the patient's history, clarify information regarding the types of medications used by him in the past. Such moments allow you to identify the presence of factors and circumstances that caused the onset of the disease.

1. Physical examination of the patient, including the study of the condition of the skin, an assessment of the degree of its saturation with oxygen.
2. Listening to breathing and heart rate (in some cases - with little physical exertion).
3. General and biochemical blood test, which allows you to determine the level of leukocytes, cholesterol, potassium, glucose, urea.
4. Urinalysis, necessary to exclude diseases of the genitourinary system from among the alleged causes of the development of pathology.

The state of the thyroid gland allows you to find out the degree of its influence on the heart rate. As additional diagnostic methods, vagal tests and daily monitoring are carried out.

The most important method for diagnosing sinus tachycardia is the cardiogram, based on the registration of electrical oscillations that occur during the work of the heart.

Treatment Methods

In uncomplicated cases of sinus tachycardia, it is enough to change the diet and lifestyle of the patient. It will be necessary to minimize the presence of spicy and immoderately salty dishes on the menu, to give up strong tea and coffee, alcohol, and chocolate. Useful walks in the fresh air without intense physical exertion.

If there is a need for therapeutic treatment, medications are selected based on their causes of pathology. Various specialists are involved in drawing up a treatment regimen - a cardiologist, an endocrinologist, a phlebologist, a vascular surgeon.

Traditionally, therapy is carried out with the appointment:

• beta-blockers (Bisoprolol, Metoprolol);
• non-dihydropyridine calcium antagonists (Verapamid, Diltiazem);
• drugs that suppress the synthesis of thyrotropin (Metizol, Carbimazole);
• sedatives (tinctures of motherwort, Persena, valerian extract).

In the case of diagnosing highly symptomatic sinus tachycardia, it becomes advisable to use surgical methods of treatment - radiofrequency catheter ablation of the sinus node with the installation of a permanent pacemaker.

Help of traditional medicine

A combination of nuts and dried fruits

The process of preparing a "medicine" from nuts (Brazilian) and dried fruits will require you to combine 2 tbsp. l. main components, dried apricots, figs, raisins, hazelnuts. The ingredients are carefully ground with a blender, 300 ml of natural honey is poured. The composition is taken in 1 tsp. three times a day for a 3-week course. With obesity and the presence of problems with the thyroid gland, it is better to refuse the product.

Lemon garlic mixture

Lemon-garlic mixture contains 10 heads of garlic, peeled, 10 diced and peeled citrus fruits. The components are mixed in a blender, liquid honey is introduced. After thorough mixing, store in a dark place for at least 1 week. Then take 4 times a day for 1 dessert spoon. The course lasts 1 month.

Hawthorn infusion

A tablespoon of dried hawthorn flowers is poured with an incomplete glass of boiling water, kept for at least half an hour. The infusion is drunk three times a day, 100 ml at a time independent of food intake. The recommended duration of treatment is 1-3 months.

Sinus tachycardia often requires a complex approach to treatment. To obtain positive results of therapy, the patient will need to comply with all medical prescriptions and recommendations, give up bad habits, and control their physical activity. While maintaining a sedentary lifestyle, smoking, eating high-calorie foods, alcohol, the effectiveness of even the most professional treatment, as well as the best folk methods, will significantly decrease.

The electrical axis of the heart (EOS): the essence, the norm of the position and violations

The electrical axis of the heart (EOS) is a term used in cardiology and functional diagnostics, reflecting the electrical processes occurring in the heart.

The direction of the electrical axis of the heart shows the total amount of bioelectrical changes occurring in the heart muscle with each contraction. The heart is a three-dimensional organ, and in order to calculate the direction of the EOS, cardiologists represent the chest as a coordinate system.

Each electrode, when taking an ECG, registers the bioelectrical excitation that occurs in a certain area of ​​the myocardium. If we project the electrodes onto a conditional coordinate system, then we can also calculate the angle of the electric axis, which will be located where the electrical processes are strongest.

The conduction system of the heart and why is it important to determine the EOS?

The conduction system of the heart is a section of the heart muscle, consisting of the so-called atypical muscle fibers. These fibers are well innervated and provide synchronous contraction of the organ.

Myocardial contraction begins with the appearance of an electrical impulse in the sinus node (which is why the correct rhythm of a healthy heart is called sinus). From the sinus node, the electrical excitation impulse passes to the atrioventricular node and further along the bundle of His. This bundle passes in the interventricular septum, where it is divided into the right, heading to the right ventricle, and the left legs. The left leg of the bundle of His is divided into two branches, anterior and posterior. The anterior branch is located in the anterior sections of the interventricular septum, in the anterolateral wall of the left ventricle. The posterior branch of the left leg of the bundle of His is located in the middle and lower third of the interventricular septum, the posterolateral and lower wall of the left ventricle. We can say that the back branch is somewhat to the left of the front.

The conduction system of the myocardium is a powerful source of electrical impulses, which means that electrical changes that precede cardiac contraction occur in it first of all in the heart. In case of violations in this system, the electrical axis of the heart can significantly change its position, which will be discussed later.

Variants of the position of the electrical axis of the heart in healthy people

The mass of the cardiac muscle of the left ventricle is normally much greater than the mass of the right ventricle. Thus, the electrical processes occurring in the left ventricle are stronger in total, and the EOS will be directed specifically to it. If we project the position of the heart on the coordinate system, then the left ventricle will be in the region of +30 + 70 degrees. This will be the normal position of the axis. However, depending on the individual anatomical features and physique, the position of the EOS in healthy people ranges from 0 to +90 degrees:

• Thus, the EOS in the range from + 70 to + 90 degrees will be considered a vertical position. This position of the axis of the heart is found in tall, thin people - asthenics.
• The horizontal position of the EOS is more common in short, stocky people with a wide chest - hypersthenics, and its value ranges from 0 to + 30 degrees.

The structural features for each person are very individual, there are practically no pure asthenics or hypersthenics, more often these are intermediate body types, therefore the electric axis can also have an intermediate value (semi-horizontal and semi-vertical).

All five positions (normal, horizontal, semi-horizontal, vertical and semi-vertical) are found in healthy people and are not pathological.

So, in the conclusion of an ECG in an absolutely healthy person, it can be said: “EOS is vertical, the rhythm is sinus, the heart rate is 78 per minute”, which is a variant of the norm.

Rotations of the heart around the longitudinal axis help determine the position of the organ in space and, in some cases, are an additional parameter in the diagnosis of diseases.

The definition "rotation of the electrical axis of the heart around the axis" may well be found in descriptions of electrocardiograms and is not something dangerous.

When the position of the EOS can talk about heart disease?

In itself, the position of the EOS is not a diagnosis. However, there are a number of diseases in which there is a displacement of the axis of the heart. Significant changes in the position of the EOS lead to:

1. Cardiac ischemia.
2. Cardiomyopathy of various origins (especially dilated cardiomyopathy).
3. Chronic heart failure.
4. Congenital anomalies of the structure of the heart.

EOS deviations to the left

Thus, the deviation of the electrical axis of the heart to the left may indicate left ventricular hypertrophy (LVH), i.e. its increase in size, which is also not an independent disease, but may indicate an overload of the left ventricle. This condition often occurs with long-term arterial hypertension and is associated with significant vascular resistance to blood flow, as a result of which the left ventricle must contract with greater force, the muscle mass of the ventricle increases, which leads to its hypertrophy. Ischemic disease, chronic heart failure, cardiomyopathies also cause left ventricular hypertrophy.

hypertrophic changes in the myocardium of the left ventricle - the most common cause of EOS deviation to the left

In addition, LVH develops when the valvular apparatus of the left ventricle is damaged. This condition leads to stenosis of the mouth of the aorta, in which the ejection of blood from the left ventricle is difficult, insufficiency of the aortic valve, when part of the blood returns to the left ventricle, overloading it with volume.

These defects can be either congenital or acquired. The most commonly acquired heart defects are the result of rheumatic fever. Left ventricular hypertrophy is found in professional athletes. In this case, it is necessary to consult a highly qualified sports doctor to decide whether it is possible to continue playing sports.

Also, the EOS is deviated to the left with violations of intraventricular conduction and various heart blocks. E-mail deviation the axis of the heart to the left, along with a number of other ECG signs, is one of the indicators of the blockade of the anterior branch of the left leg of the bundle of His.

EOS deviations to the right

A shift in the electrical axis of the heart to the right may indicate right ventricular hypertrophy (RVH). Blood from the right ventricle enters the lungs, where it is enriched with oxygen. Chronic respiratory diseases accompanied by pulmonary hypertension, such as bronchial asthma, chronic obstructive pulmonary disease with a long course cause hypertrophy. Pulmonary artery stenosis and tricuspid valve insufficiency lead to right ventricular hypertrophy. As with the left ventricle, RVH is caused by coronary heart disease, congestive heart failure, and cardiomyopathies. Deviation of the EOS to the right occurs with a complete blockade of the posterior branch of the left leg of the bundle of His.

What to do if an EOS shift is found on the cardiogram?

None of the above diagnoses can be made on the basis of EOS displacement alone. The position of the axis serves only as an additional indicator in the diagnosis of a particular disease. If the axis of the heart deviates beyond normal values ​​(from 0 to +90 degrees), a consultation with a cardiologist and a series of studies is necessary.

Nevertheless, the main cause of EOS displacement is myocardial hypertrophy. The diagnosis of hypertrophy of one or another part of the heart can be made according to the results of ultrasound. Any disease that leads to a displacement of the axis of the heart is accompanied by a number of clinical signs and requires additional examination. The situation should be alarming when, with the pre-existing position of the EOS, its sharp deviation occurs on the ECG. In this case, the deviation most likely indicates the occurrence of a blockade.

By itself, the displacement of the electrical axis of the heart does not need treatment, it refers to electrocardiological signs and requires, first of all, finding out the cause of the occurrence. Only a cardiologist can determine the need for treatment.

Unstable sinus rhythm vertical position eos. How dangerous is sinus arrhythmia

The heart is undoubtedly the most important organ in the human body. By nature, it has a complex structure, and its activity is regulated by the structures of the central nervous system. The simplest and most widely available method for assessing the work of all heart structures is a cardiogram.

A lot of incomprehensible, at first glance, lines depicted on paper after taking an ECG carry the most useful information. The main thing is to know certain features and subtleties of the decoding, as well as the age criteria for the norm of all cardiac indicators.

Electrical processes occurring in the structures of the "motor" of a person are due to the movement of sodium ions. Initially, they are outside the myocardial cell. Potassium ions take over their transportation inside. This movement will create conditions for changes in transmembrane potentials during the entire cycle of relaxation and contraction of the atria and ventricles.

Excitation, moving through the conductive elements of the heart, consistently covers it all. Debuting in the sinus node, localized in the wall of the right atrium, which has optimal automatism, the impulse moves through the thickness of the muscle fibers of the chamber. Then the atrioventricular node is excited. After that, the impulse flows through the bundle of His with its fibers and is directed to the ventricular chambers.

The processes of excitation observed on the outer surface of the myocardium, however, leave this part of the organ electronegative in relation to the zones that were not affected by the excitation. However, by nature, body tissues have energy conduction, therefore, biocurrents are projected onto the surface of the human body and can therefore be registered in the form of specific lines on paper.

How is an ECG performed?

The very procedure for taking readings of the activity of the heart is familiar to many, since it is included in the mandatory list of diagnostic studies for many pathologies. But in order to perform the entire sequence of fixing with an electrocardiogram, special training is required. Therefore, admission to the examination of patients is given only to medical workers.

It is important for patients to follow certain preparation rules:

• it is allowed to have a light snack, but you should not overeat, the active activity of the digestive structures can disrupt the correct recording of heart impulses;
• do not smoke immediately a couple of hours before the procedure;
• do not drink alcohol the day before, as well as on the day of the study;
• if a person is taking any medications that can adversely affect the result, it is necessary to warn a specialist;
• adjust physical activity: hard work will also affect the cardiogram in a negative way.

So, having fulfilled the above rules, a person comes to the functional diagnostics room, where he is instructed to undress to the waist and lie down on the couch. After that, the nurse applies a special liquid conductor to certain parts of the body, which facilitates the conduction of electrical impulses. And only then the electrodes are placed, with the help of which the electrocardiogram will be recorded.

Decryption principles

The main elements of each cardiogram are bulges directed upwards or downwards, called teeth, as well as the distance between such bulges - segments.

The ST and PQ segments are of particular diagnostic value for cardiologists. Behind each is a certain process that takes place in the heart.

After the electrocardiogram is recorded on paper, it needs to be decoded. The specialist evaluates the parameters in the following sequence:

1. Attention is drawn to the rhythm of atrioventricular contractions - the correctness of the rhythm. For this purpose, the intervals between the teeth are measured: they must necessarily be equivalent. If this is not observed, the patient's description indicates the irregularity of the rhythm.
2. Then the rate of contraction of the chambers of the heart is calculated. It is easy to perform actions if you know in advance the recording speed of the device and the corresponding number of cells between adjacent teeth. The conditionally accepted parameters of the norm for any person are 55–90 beats / min.
3. The P wave determines the main source of impulse excitation. As a rule, it is understood as the sinus node, therefore, in a healthy individual, it is the sinus rhythm that is considered normal. Its failure will be indicated by atrial, ventricular or atrioventricular rhythms.
4. Be sure to evaluate such parameters as the conductivity of the pulse: the duration of the teeth and segments. In addition, the position of the electrical axis of the heart is determined. For example, for thin people it is described as vertically located, but for full people it is more horizontal. If the pathology of the organ has already formed, the axis is significantly shifted to the right or to the left.
5. All segments, teeth and intervals are analyzed in detail. Modern electrocardiographs automatically perform a similar analysis of these parameters. They immediately give ready-made results, which simplifies encryption for a specialist.

The result of all the above work is a conclusion, which lists all the main characteristics of the electrocardiogram, and also highlights the patient's syndromes, for example, the presence of an overload of individual heart chambers, myocardial hypertrophy.

What is sinus rhythm

The most common inscription in the conclusion of the cardiogram issued to the patient is sinus rhythm. Then follows the number of atrioventricular contractions. For a person who is poorly versed in medical terms, such a record is incomprehensible. However, this is the safest option. It indicates that the body is working in the correct mode.

The sinus rhythm, set by the node of the same name, assumes that the conduction of electrical impulses corresponds to their natural purpose. The absence of other records directly indicates that the heart is healthy, there are no pathological foci in it, and the electrocardiogram is normal.

In addition to the sinus, however, other rhythm options may also occur:

They will indicate that the rhythm is set by a different node of cells, which is recognized by cardiologists as a pathology of the organ. Many internal and external factors are capable of pushing for the appearance of such deviations. Their identification and elimination is the main task of the therapeutic measures recommended by the specialist.

What are the reasons for the differences in the electrocardiogram

In most cases, the parameters of the norm of cardiograms in people of the same age category and physical data are significantly similar. However, some have to face a situation where, after the study, a specialist’s conclusion indicates a significant difference from the norm.

This may well be due to the following reasons:

• failure of technical equipment, unfortunately, the technique is imperfect;
• the notorious “human” factor: there are situations when the nurse incorrectly compared the fragments of the cardiogram, many Roman numerals are similar even when they are reversed, or the graph was cut incorrectly, and because of this, one of the teeth was lost;
• it is important to observe certain preparation for the procedure, for example, do not drink strong caffeinated drinks before visiting the functional diagnostics room, do not overeat on the day of the examination, come to the examination in advance and take a break;
• unprepared surface of the body, especially for brutal men, whose chest is all covered with hairs: it is recommended to shave them in advance;
• incorrect location of the electrodes, if the nurse has practically no experience, breakage, a hidden defect of the electrodes are also possible.

You should not panic in advance, the specialist will analyze all the information about the patient, his complaints, the results of a physical examination, for example, auscultation of the activity of the heart. And only then it is compared with the conclusion of the electrocardiogram. If there is a discrepancy in information, additional studies, for example, electrocardiography, will be recommended.

What should be the ECG in children

All stages of electrocardiogram interpretation in pediatric practice are consistent with those in adult patients. However, due to the physiological and anatomical features of the children's heart, there are certain differences in the interpretation of the indicators of its activity.

First of all, this will concern the frequency of atrioventricular contractions. For example, in babies 3.5-4.5 years old, they can reach beats / min. In addition, a variant of sinus or respiratory arrhythmia, which is not considered a pathology, is often recorded in children. The heart only slightly speeds up its contractions on inhalation, and on exhalation everything returns to normal.

Separate teeth and intervals will have slightly different characteristics: in children, incomplete blockades of one or another part of the conduction system of the heart are observed, more often the right leg of the n. Hisa. Therefore, it is so important that only a specialist who takes into account all of the above features is engaged in deciphering the cardiogram.

Features of ECG parameters during pregnancy

At the moment of carrying a baby, a double burden falls on the heart of his mother. It takes a certain period of time to undergo adaptation to a new state for a woman.

Certain deviations in the cardiovascular system will certainly be reflected in the results of the electrocardiogram in the expectant mother. First of all, in the later stages of bearing a baby, a shift of the EOS will be observed: to its horizontal position. The explanation is the change in the mutual position of the internal organs against the background of the growing uterus.

However, sinus rhythm should be maintained. Only a slight increase in the number of contractions is possible, but not more than 100 beats / min and signs of a slight overload in any chamber of the organ. They will also be associated with an increase in the volume of blood moved. Such deviations disappear on their own after the birth of the baby, but you should not leave them unattended, nevertheless. A specialist should conduct in-depth instrumental studies, for example, ECHO KG.

Possible options for rhythm deviations

To date, the studies carried out by specialists have allowed them to distinguish between abnormal sinus rhythm into pathologically conditioned and physiologically conditioned.

The distinguishing criteria are the frequency of atrioventricular contractions and their rhythm:

1. A deviation characterized by a regular acceleration of the rhythm is sinus tachycardia. The description will indicate the heart rate: 100-120 bpm, as well as the shortening of the RR interval. In severe cases, heart rate can even reach 200-220 bpm. At the time of exacerbation, a person feels a sharp deterioration in well-being, he has severe shortness of breath, as well as discomfort and a feeling of an accelerated heartbeat, anxiety up to panic and fainting.
2. Deviation, in which there will be a decrease in the frequency of atrioventricular contractions: sinus bradycardia. The description of the electrocardiogram indicates a heart rate of less than 60–55 bpm. in combination with a pronounced prolongation of the RR interval. Against the background of such a condition, a person will be disturbed by intense dizziness, weakness, tinnitus, and fainting sensations.
3. Characteristic of sinus arrhythmia will be the general irregularity of the number of atrioventricular contractions. Such a heart rhythm is not stable: the heart rate either increases sharply, or also decreases rapidly. Various parameters of the P-P interval will also be indicated.

It is unacceptable to ignore such pathological conditions. It is imperative to establish the true root cause of the disruption of the activity of the "motor" and eliminate it.

Main causes of failures

A variety of internal as well as external causes can lead to episodic or permanent failure of the heart rhythm. The experts indicate the following:

• abuse of alcohol, tobacco, narcotic products;
• congenital or acquired anomalies and defects of the organ;
• prolonged use of medications from a subgroup of glycosides or antiarrhythmic drugs;
• prolapses of varying severity of the cusps of the heart valves;
• malfunctions in the activity of the thyroid gland;
• decompensation of cardiovascular structures;
• myocardial pathology;
• infective endocarditis;
• frequent various overloads: emotional, physical, psychological.

To establish one or a combination of the above root causes of failures in the conduction of the rhythm through the structures of the heart, both a thorough collection of the patient's history and additional laboratory and instrumental studies help.

Diagnostics

To fix failures in the region of the sinus node and find out their root causes, such a study as Holter monitoring is mandatory. Its essence lies in the removal of the electrocardiogram in the daily mode. At the same time, all the actions and events of this day must be indicated so that the specialist can later compare them with the results of the decryption.

A similar procedure is used to establish various violations of the conduction of electrical impulses, which are rarely detected during a standard cardiogram. The total duration of monitoring the activity of cardiac structures is determined by the goals set by the specialist.

For example, if a painless form of coronary disease is suspected, the study is also carried out for three days. The indication will also be the need to control the functioning of an artificial pacemaker implanted in a person, or the adequacy of doses of recommended antiarrhythmic drugs.

Another modern method for establishing the cause of a failure in the sinus node and conducting electrical impulses is a bicycle ergometer test. This is the simultaneous removal of a cardiogram at the time of physical exertion on the patient's body. The parameters are taken into account based on the age category of a person, his weight, initial state of health and level of physical fitness. Indications for its implementation will be:

• the need to confirm the diagnosis of coronary artery disease;
• evaluation of the effectiveness of ongoing therapeutic measures;
• selection of adequate physical activity, the level of tolerance to it;
• prognostic assessment of the capabilities of a patient with pathologies of the cardiovascular system.

However, the need for, indications and contraindications for diagnostic procedures are determined by a specialist strictly individually.

Treatment tactics

When deciphering the cardiogram of the heart, where the rhythm is sinus with deviations, timely adequate measures must be taken to eliminate them. For example, with physiological root causes - excessive physical exertion, psycho-emotional stress - an adjustment of work and rest is required. With a tendency to excessive emotional outbursts, try to avoid situations where they are possible.

If there are deviations in the activity of organs and systems that have the ability to influence the conduction of electrical impulses through the heart, they also need to be cured. So, thyrotoxicosis or vegetative-vascular insufficiency is quite amenable to appropriate pharmacotherapy. For female representatives, it is necessary to exclude the possibility of pregnancy, which they do not yet suspect. And for babies - the presence in the body of congenital anomalies and heart defects.

With persistent arrhythmia, leading to a significant deterioration in a person's well-being, conservative treatment is first performed. The doses of medications, the frequency of their intake, the total duration of the course are selected individually. An electrocardiogram monitoring is mandatory. In the absence of pronounced positive dynamics, a decision is made on surgical intervention: the installation of an artificial pacemaker.

• Violations of the sinus rhythm of the heart: the causes of the pathological condition
• What changes occur in violation of the sinus rhythm of the heart

Quite often, patients who turn to cardiologists are faced with such a concept as "sinus rhythm". Few people know that this is not a diagnosis, but rather a statement that the human heart is working normally and there are no pathological disorders on the part of the system that generates and conducts impulses, which are the basis of heart contraction. If, for one reason or another, malfunctions occur in the operation of the apparatus that generates impulses, then this leads to the fact that a person’s normal heart rhythm and coordination of the work of individual parts of this organ are disturbed. Such deviations from the norm become the causes of quite serious diseases of the cardiovascular system. And if in order for muscle damage to cause certain diseases, pathological changes must be widespread and very serious, then in order to disrupt the physiological rhythm of the heart, a small focus of myocardial damage is sufficient.

Sinus rhythm of the heart: features of anatomy and physiology

Before starting a conversation about the sinus rhythm of the heart, I would like to dwell on some issues of the anatomy and physiology of the cardiovascular system. Without exception, all organs and systems of the human body constantly need to be supplied with oxygen and other useful substances that the circulatory system delivers. The human heart is a fairly simple but powerful pump that provides constant blood circulation through the circulatory system.

The human heart is able to make more than beats per day and has a certain "pacemaker", which is called the sinus node and is located in the right atrium. It is this node that generates impulses or electrical signals that first enter the atria, forcing them to contract and push blood into the ventricles. After that, a certain pause occurs, allowing the ventricles of the heart to fill with blood, and then the impulse passes through the ventricle and blood, and goes further along the circulatory system to all organs and tissues of the human body. In this way, the heart is constantly contracting at a certain frequency. Normal sinus rhythm is considered with a heart rate (heart rate) of 60 to 70 per minute.

The electrical axis of the heart is associated with the total vector of the electrodynamic force of the heart. Most often, it coincides with the anatomical axis of the organ. As a rule, the heart has the shape of a cone, it is directed by a narrow part down to the left and forward. In this case, the position of the electric axis is in the range from 0 to 90 degrees.

The presence of an electrical axis is due to, which consists of muscle fibers. Due to their contractions, the heart contracts.

The contraction originates in the sinus node, where an electrical impulse occurs. This impulse passes through the atrioventricular node and is directed to the bundle of His. With disturbances in the conduction system, the electrical axis of the heart can change its position.

How can the EOS be located?

It is possible to determine the features of the location of the electrical axis of the heart using an ECG. The following options are usually considered normal:

• Vertical (location range from 70 to 90 degrees).
• Horizontal (location range from 0 to 30 degrees).
• Semi-horizontal.
• Semi-vertical.
• No slope.

The figure shows the main options for the passage of the electrical axis of the heart. It is possible to determine what type of axis arrangement is characteristic of a particular person (vertical, horizontal or intermediate) using an ECG.

Electrical axis of the heart

Often the position of the EOS depends on the physique of a person.

For tall people with a lean physique, a vertical or semi-vertical type of arrangement is characteristic. Short and dense people have a horizontal and semi-horizontal position of the EOS.

Intermediate options for the placement of EOS are formed due to the fact that the physique of each person is individual, and there are many others between a thin and dense body type. This explains the different position of the EOS.

Deviations

Deviation of the electrical axis of the heart to the left or right is not a disease in itself. Most often, this phenomenon is a symptom of another pathology. Therefore, doctors pay attention to this anomaly and conduct diagnostics to determine the reasons why the axis has changed its position.

Axis deviation to the left side is sometimes observed in healthy people who are actively involved in sports.

But most often this phenomenon indicates hypertrophy of the left ventricle. This disease is characterized by an increase in the size of this part of the heart. It may be accompanied by the following diseases:

If the electrical axis of the heart is shifted to the right, this can also be considered normal, but only in the case of a newborn baby. The baby may even have a strong deviation from the norm.

Note! In other cases, this position of the electrical axis is a symptom of right ventricular hypertrophy.

Diseases that cause it:

• Problems with the respiratory system (asthma, obstructive bronchitis).
• Heart defects.

The more pronounced hypertrophy, the more EOS changes position.

Tetralogy of Fallot (blemish)

Also, the electrical axis of the heart can be displaced due to coronary disease or heart failure.

Whether it is necessary to treat?

If the EOS has changed its position, as a rule, there are no unpleasant symptoms. More precisely, they do not arise due to axis deviation. All difficulties are usually associated with the cause that caused the displacement.

Most often, such a cause is hypertrophy, so the symptoms occur are the same as with this disease.

Sometimes no signs of the disease may appear until more serious diseases of the heart and cardiovascular system form due to hypertrophy.

Hypertrophy of the heart

To avoid danger, any person needs to carefully monitor their well-being and pay attention to any discomfort, especially if they are often repeated. You should consult a doctor if you have the following symptoms:

All these signs can indicate the development of heart disease. Therefore, the patient needs to visit a cardiologist and undergo an ECG. If the electrical axis of the heart is displaced, then additional diagnostic procedures must be carried out to find out what caused it.

Diagnostics

To determine the cause of the deviation, the following diagnostic methods are used:

• Ultrasound of the heart
• Holter monitoring
• Coronary angiography

Ultrasound of the heart

This diagnostic method allows you to identify changes in the anatomy of the heart. It is with its help that hypertrophy is detected, and the features of the functioning of the heart chambers are also determined.

This diagnostic method is used not only for adults, but also for very young children to make sure that they do not have serious pathologies.

Holter monitoring

In this case, the ECG is performed during the day. The patient performs all his usual activities during the day, and the devices record the data. This method is used in case of deviations in the position of the EOS, accompanied by a rhythm outside the sinus node.

This method also allows you to judge the presence of hypertrophy, since the heart shadow will be expanded in the picture.

ECG during exercise

The method is a conventional ECG, the data of which are recorded while the patient is performing physical exercises (running, push-ups).

In this way, it is possible to establish coronary heart disease, which can also affect the change in the position of the electrical axis of the heart.

Coronary angiography

I use this method to diagnose problems with blood vessels.

EOS deviation does not imply therapeutic effects. The disease that caused such a defect should be treated. Therefore, after a thorough examination, the doctor must prescribe the necessary therapeutic effects.

This defect, revealed during the examination, needs to be examined, even if the patient does not have any complaints about the heart. Heart diseases often occur and develop asymptomatically, which is why they are detected too late. If the doctor, after diagnosing, prescribed treatment and advised to adhere to certain rules, this must be followed.

The treatment of this defect depends on what disease provoked it, so the methods may be different. The main one is drug therapy.

In extremely life-threatening situations, the doctor may recommend surgery to neutralize the disease-cause.

With the timely detection of the pathology of the EOS, it is possible to return to a normal state, which occurs after the elimination of the underlying disease. However, in most cases, the actions of doctors are aimed at preventing deterioration in the patient's condition.

As a treatment, folk methods with the use of medicinal fees and tinctures can also be useful. But before using them, you need to ask your doctor if such actions will harm. It is unacceptable to start taking medications on your own.

It is also important to observe measures to prevent heart disease. They are associated with a healthy lifestyle, good nutrition and rest, and a decrease in the amount of stress. It is necessary to perform feasible loads and lead an active lifestyle. From bad habits and abuse of coffee should be abandoned.

Changes in the position of the EOS do not necessarily indicate problems in the human body. But the detection of such a defect requires attention from doctors and the patient himself.

If therapeutic measures are prescribed, then they are associated with the cause of the defect, and not with it itself.

In itself, the incorrect location of the electrical axis does not mean anything.

In contact with

During a routine examination, a person after 40 years of age should make a cardiogram in order to identify heart pathologies. The location of the teeth allows you to determine the state of the organ during excitation.

The deviation of the electrical axis of the heart to the left indicates some diseases and requires clarification of the diagnosis.

General information about pathology

Registration of the electrical activity of the "motor" of the body is carried out on the ECG. To imagine what the axis of the heart is, it is necessary to build a coordinate scale and mark the directions with a step of 300. The semi-vertical position of the organ in the chest, when superimposed on the coordinate system, sets the electrical axis.

The vectors form an angle, so the direction of the EOS is measured in degrees from -180 to +1800. In a normal location, it should be within +30 - +69.

If under the influence of any factors there is a change in the position of the organ and the vector of signal transmission, then they talk about its change in the coordinate system.

Normally, the heart has a sinus rhythm, the electrical impulse starts from the atrium and then passes to the ventricles. On the electrocardiogram, it is possible to determine the normal position of the organ if the P wave is determined, which indicates atrial contraction, the QRS complex, the contraction of the ventricles and T, their repolarization.

The location of the terminals when taking an ECG is the direction of the electrical impulse of the heart. When removing the leads, 3 main and 3 auxiliary lines are determined, as well as chest indicators.

You can talk about the normal value of the axis if the R wave has the highest value in the 2nd main lead, and the value of R1>R3.

If there is a shift of the electrical axis to the left, what does this mean? There are factors due to which there is an overweight of the organ to the left side. A levogram is observed if the axis position is between 0 and -900.

Reasons for rejection

EOS is deviated to the left not only in cardiac pathologies. The reasons for the deviation are left ventricular hypertrophy, provoked by the following disorders:

• heart failure;
• hypertension with congestive manifestations;
• heart disease;
• blockade of the left leg of the bundle of His;
• flickering arrhythmia.

In the course of the cardiac cycle, during the first contraction, blood is pushed into the atrium, the valve closes, then it is transferred to the ventricle, and with the next contraction, all the blood must go into the vessels.

In case of violation of the pumping function, when the organ is not able to contract with such force as to push out all the fluid, part of it constantly remains inside the cavity. It gradually expands.

This phenomenon is provoked by cardiomyopathy due to coronary artery disease due to a heart attack, myocarditis.

The second reason for the residual accumulation of fluid: the valve does not close completely, or there is stenosis, narrowing of the vessel lumen. Then part of the blood returns back or cannot enter the aorta in one cycle.

Heart disease can be congenital or acquired. In the first case, it is detected during examination of a newborn child, in the second case, in an adult.

If the conduction of the left branch of the His bundle is disturbed, the functioning of the left ventricle is disrupted, because of which it does not contract as it should. At the same time, sinus rhythm is maintained, but the axis is deviated.

With arterial hypertension, blood pressure on the vessels increases, which affects their condition. The more often the blood pressure rises, the greater the likelihood of a decrease in vascular elasticity and expansion of the ventricle, which has a large load.

With atrial fibrillation, in addition to changes in the electrical axis of the heart, there is no atrial contraction, and ventricular complexes are formed at different intervals.

Symptoms and manifestations

The deviation itself does not manifest itself with symptoms, but since the violation is caused by certain reasons, the signs appear with a significant spread of the process.

There is a violation of hemodynamics, there are accompanying symptoms.

If the patient has heart failure or heart disease, then this is manifested by the appearance of shortness of breath when walking or climbing stairs, blue extremities and nasolabial triangle, shortness of breath and dizziness.

Atrial fibrillation is manifested by seizures, during which there is not enough breathing, there is a feeling of palpitations, pain behind the sternum, pulse interruptions.

Arterial hypertension is manifested by a headache, mainly in the back of the head, heaviness in the chest, and at high values ​​- flashing flies before the eyes.

Diagnostics

It helps to establish a violation by bringing together the symptoms of a violation, functional diagnostics, and other methods:

• Holter monitoring;
• x-ray;
• coronary angiography.

Thanks to these studies, it is possible to visually assess the organ, its departments, determine the size of the enlarged cavity, and establish the cause of the insufficiency.

With the help of electrocardiography with a load in the form of a bike path or an exercise bike, it is possible to determine at what point myocardial ischemia appears.

The doctor prescribes a daily study if he suspects that the patient has a rhythm disorder. To “catch” periods of arrhythmia, a person is hung up for a day with an apparatus that registers the contraction of the heart.

Angiocoronary angiography is a study of blood vessels that allows you to see their condition and circulatory disorders. The picture allows you to determine the expansion of the shadow of the organ, which indicates hypertrophy.

When additional testing is required

Standard EOS values ​​are approximately equal for everyone, but in a tall person, the size of the heart and its position may be somewhat different, although he will not be sick. Therefore, during the initial examination, if a violation is established, additional research methods are required.

A change in the parameter normally also occurs in athletes.

Since they endure significant stress during constant training, their heart pumps large volumes of fluid, so the cavities stretch. They may show a horizontal type of deviation when the organ occupies a position from -15 to +30.

If a person during the study took a deep breath or changed the position of the body, then even at the norm, the deviation of a healthy heart to the left will be determined.

Manifestations on the ECG

During the examination, it is possible to determine the presence of a deviation to the left side by an electrocardiogram. In the diagram, the R wave is largest in 1 main lead.

An additional sign is the location of the QRS complex below the isoline in the 3rd column, that is, S prevails. If you pay attention to the leads from the arms and legs, then in AVF the ventricular complex will be the same as III.

What does drastic deviation mean?

Since the angle of deviation from the norm can be different, the degrees of the process are different. Changing degrees is a gradual process. The larger the size of the cavity grows, the more the indicator deviates from the norm. If the deviation is from -450 to -900 degrees relative to the norm, then they say that the organ is sharply shifted to the left.

In adults

A shift in the axis of the heart in the chest may indicate a violation of the ECG, if a person is in good health and no other health disorders have been identified.

Normally, it is observed in people who regularly engage in physical education and in athletes.

The pronounced deviation is not random, it is a sign of pathology in adults. There may be stagnation that accumulates over several years.

In children

A child in the neonatal period has a sharp deviation of the axis to the right, this is the norm. If an adult has such a violation, then he has signs of right ventricular hypertrophy.

In a child, this is due to the fact that the right parts of the heart have a large mass, prevailing over the left. By the year, the condition is normalized, and the organ should take a vertical position in the chest. During this period, it can rotate around the axis in different directions.

Then the left ventricle gains mass, ceases to adhere to the chest. By the age of 6-7, the body acquires a correct, semi-vertical position.

Is treatment needed

The axis of the heart is a criterion by which a health disorder can be determined, therefore, in case of deviation, therapy is aimed at combating the cause established during the diagnosis. If you eliminate it, you will be able to restore the normal functioning of the heart.

These may include the following procedures:

• installation of an artificial valve;
• implantation of a pacemaker;
• shunting;
• administration of antihypertensive and antiarrhythmic drugs.

The set of measures depends on what degree of health impairment is present..

If the arrhythmia is of a periodic nature and can be eliminated with the help of drugs, then a suitable remedy is selected. When there is a threat to life, the issue of installing a pacemaker is decided.

Coronary bypass surgery - cleaning of blood vessels from plaques, lipid deposits, which expands their lumen and eliminates ischemia.

In the case of congenital and acquired heart disease or CHF, it helps to establish a normal cardiac cycle. If the pumping function of the heart has suffered, then a weak contractility of the myocardium will still be observed.

Possible consequences and complications

It is not the deviation of the position of the heart that is dangerous, but the reasons why it occurs. Complications of left ventricular hypertrophy:

• heart failure;
• angina;
• heart failure.

All causes of disruption of the body are interconnected. If the heart disease led to the expansion of the left ventricle, then with the development of the pathological process, rhythm disturbances should be expected. If the myocardium becomes so weak that the contraction of the fibers does not lead to the ejection of blood further, then circulatory failure and cardiac arrest occur.