Other diseases

Vertical electrical axis of the heart. What does it mean if the EOS is deviated to the right? How is an electrocardiogram taken?

Medical concept " electric axle heart" is used by cardiologists to reflect the electrical processes occurring in this organ. The location of the electrical axis must be calculated to determine the total component of the bioelectrical changes that occur in muscle tissue heart during its contractile activity. Main body 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 determine the angle of displacement - this is what cardiologists do.

Features of the conduction system

The cardiac conduction system is a collection of sections of muscle tissue in the myocardial region, which are fibers atypical type. These fibers have good innervation, which allows the organ to contract synchronously. The contractile activity of the heart begins 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 exciting signal is sent to the atrioventricular node, and then it travels along the His bundle. Such a bundle is located in the section that blocks the ventricles, where it is divided into two legs. The leg extending 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 is accordingly 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 left bundle branch is localized in two-thirds of the septal part separating the ventricles of the organ, the middle and lower, as well as the posterolateral and lower walls, located in the area of the left ventricle. Doctors say that the anterior branch is located slightly to the right of the posterior branch.

The conduction system is a powerful source that supplies electrical signals that make things work. main department body is normal the right rhythm. Only doctors can calculate any violations in this area; they cannot do this on their own. Both an adult and a newborn baby can suffer from pathological processes of this nature in cardiovascular system. If deviations occur in the conduction system of the organ, the axis of the heart may become confused. There are certain standards for the position of this indicator, according to which the doctor identifies 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 left ventricle usually significantly exceeds that of the right ventricle. You can find out whether a given measurement is a horizontal or vertical vector using these standards. Since the mass of the organ is distributed unevenly, it means electrical processes should occur more strongly in the left ventricle, and this shows that EOS is directed specifically to this department.

Doctors project this data using a specially developed coordinate system, from which we can conclude that the electrical axis of the heart is in the region of +30 and also +70 degrees. However, every person, even a child, has individual characteristics body, its anatomical characteristics. This shows that the EOS slope is healthy people can vary between 0-90 degrees. Based on such data, doctors have identified several areas of this indicator that are considered normal and do not interfere with the functioning of the organ.

What positions of the electrical axis exist:

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

It should be noted that all five positions can occur in a person who has good health. Finding the reason for such features is quite easy; human physiology explains everything.

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

In what cases are we talking about pathology, the causes of violations

Sometimes the direction of the indicator can indicate 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 detected, it means that the person has certain ailments, especially hypertrophic changes in the left ventricle. Often similar violation becomes a consequence of pathological processes, as a result of which the cavity of this section stretches and increases in size.

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

Ischemic damage to the main organ.
Arterial hypertension, especially with regular pressure surges up to high values tonometer.
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.
Chronic heart failure.
Violations in aortic valve, its insufficiency or stenosis. Pathological process This variety may be acquired or congenital in nature. Such diseases cause disruption of blood flow in the cavities of the organ, which leads to overload of the left ventricle.
In people involved sports activities professionally, these violations are also often detected.

In addition to hypertrophic changes, deviation of the heart axis sharply to the left may indicate problems with the conductive properties of the inner part of the ventricles, which usually arise with various blockades. What it is and what it threatens will be explained by the attending physician.

A blockade found in the left bundle branch is often diagnosed, which also refers to a pathology that displaces the EOS to the left.

The opposite condition also has its own reasons for its occurrence. 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 disorder.

What diseases lead to a tilt of the EOS to the right:

Pathological processes in the triscupid valve.
Stenosis and narrowing of the lumen of the pulmonary artery.
Pulmonary hypertension. This disorder often occurs against the background of other ailments, such as obstructive bronchitis, organ damage by emphysema, as well as 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: 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.

First of all, it is necessary to note the position of the EOS during the mother's pregnancy. Pregnancy changes the direction of this indicator, as serious changes occur in the body. The rapidly enlarging uterus puts pressure on the diaphragm, which leads to the displacement of all internal organs and changes the position of the axis, as a result of which its direction can become semi-vertical, semi-horizontal or other, 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. TO adolescence this angle is already established. Such changes are associated with the difference in the weight ratio and electrical activity of both ventricles of the organ, as well as with a change in the position of the heart in the area chest.

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

Symptoms

Changing the direction of the electrical axis cannot cause discomfort in humans. Health disorder usually provokes hypertrophic myocardial damage if it is accompanied pronounced violations hemodynamics, and also lead to the development of heart failure, which is very dangerous and requires treatment.

Symptoms:

pain in the head and chest area;
breathing problems, shortness of breath, suffocation;
swelling of the lower tissues, upper limbs and facial areas;
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

Typically, axis deviation is detected on an ECG (electrocardiogram). This method is not more often than others prescribed 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 disorder is detected on the cardiogram, then the doctor will need to carry out several additional examinations.

Diagnostic methods:

Ultrasound of an organ is considered one of the most informative methods. With the help of such a study, it is possible to identify ventricular hypertrophy, disturbances in the structure of the heart and evaluate its contractile characteristics.
X-ray of the chest area, allowing you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
ECG in the form daily monitoring. Needed for clarification clinical picture for violations concerning not only the axis itself, but also the origin of the rhythm not from the zone sinus node, which indicates a disorder of rhythmic data.
Coronary angiography or coronary angiography. Used to study the characteristics of damage coronary arteries with organ ischemia.
An exercise ECG can detect myocardial ischemia, which is usually the cause of a shift in the direction of the EOS.

It is necessary to treat not a change in the electrical axis indicator, but the disease that caused the pathology. Using diagnostics, doctors accurately determine the factors that provoked such disorders.

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

No class of medications will help in this case. The disease that led to such changes needs to be eliminated. 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 undergo surgery.

In order to determine the functional abilities of the heart, it is necessary to carry out special methods examinations. If it turns out that there are disturbances in the conduction system of the organ, there is no need to panic, you must follow all the doctor’s recommendations. 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 impulses of this organ, which are issued on a regular basis, blood is able to circulate throughout the body, saturating the body with vitality. important 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 suspects that something is wrong with his heart, he will send the patient for an ECG. Sinus rhythm on an ECG is very important indicator and clearly provides data on the real state of the human heart muscle. What exactly can be determined by looking at the cardiogram is worth considering in more detail.

What is sinus rhythm

According to medical staff, sinus rhythm of the cardiogram is the norm for the human body. If there are equal spaces between the teeth shown on the cardiogram, and the height of these columns is also the same, then there are no deviations in the functioning of the main organ.

This means that sinus rhythm on the cardiogram is as follows:

graphical representation of human pulse fluctuations;
set of teeth different lengths, between which there are different intervals showing the 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 functioning of the heart and its individual valves.

Normal sinus rhythm is only present when the heart rate is at least 60 and no more than 80 beats per minute. This is the rhythm that is considered normal for the human body. and on the cardiogram it is displayed as teeth of the same size, located at the same distance from each other.

It is clearly worth remembering that the results of a 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 a person’s health.

What criteria are used to decipher the ECG result?

The results of the cardiogram are deciphered by doctors according to a special scheme. Medical specialists have a clear understanding of which marks on the cardiogram are normal and which are abnormal. The ECG conclusion will be issued only after calculating the results, which were displayed in schematic form. A doctor, when examining a patient’s cardiogram in order to correctly and accurately decipher it, will turn Special attention on a number of such indicators:

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

A doctor who knows what each of these schematic marks means carefully studies them and can clearly determine what kind of diagnosis needs to be made. Cardiograms of children and adults are deciphered according to the same principle, but the normal indicators for people are 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 notice whether there is weakness of the sinus node, and what kind of health problems this causes. Considering the cardiogram indicators of a particular patient, medical specialist can decipher the presence of problems of the following nature:

sinus tachycardia on the ECG, indicating an excess of the contraction rhythm, 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 beats less than 60 times in one minute;
presence too small interval between the teeth of the cardiogram, which means disturbances in the functioning of the sinus node.

Sinus bradycardia is a common abnormality, especially if we're talking about about the child's health. This diagnosis can be explained by many factors, among which may be physiological defects or simply a factor of chronic fatigue.

Deviation of the EOS to the left also indicates that the work is vital important body not set up correctly. Having identified such deviations, the doctor will send the patient for additional examination and ask him to undergo a number of necessary tests.

If a vertical position of the EOS is observed, 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 fairly broad shoulders. If the axis deviates to the left or right, and this is very noticeable, then such indicators may indicate pathological condition organ, enlargement of the left or right ventricles. Axial displacement may indicate that certain valves are affected. 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 side. Such a deviation may also indicate abnormalities in the development of the heart muscle.

What can we say about normal indicators?

On ECG sinus the rhythm is always mandatory is compared with certain norm indicators. Only knowing these indicators completely will the doctor be able to understand the patient’s cardiogram and give the correct conclusion.

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

in children from birth to the first year of life, the direction 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 have a mainly vertical axis, but it can also be horizontal, without indicating deviations from the norm. Heart rate from 95 to 128;
children from seven years of age and adolescents should have a normal or vertical axis position on the cardiogram, the heart should contract from 65 to 90 beats per minute;
adults should have a normal axis direction 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, this does not always become a sign of the presence of some serious pathologies in the body.

Why ECG readings may deviate from the norm

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

the person regularly drinks alcoholic beverages;
the patient is quite long time smokes cigarettes on a regular basis;
a person is regularly exposed various kinds 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 may indicate problems of a more serious nature. If the results of the cardiogram are not normal, this may indicate acute heart failure, valve displacement, or 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 test?

The sinus rhythm, which is displayed on the ECG, clearly indicates whether there are deviations in the functioning of the heart and in which directions the problem is observed. Not only adults, but also children need to undergo such research regularly. The results of a completed cardiogram will help a person obtain the following information:

does he have any congenital pathologies or diseases;
What pathologies in the body cause heart problems;
could a person’s way of life become the cause of disturbances in the functioning of the main organ;
is the heart in correct position and whether its valves are working correctly.

Normal sinus rhythm on an ECG is displayed as waves of the same size and shape, and the distance between them is also the same. If any deviations from this norm are observed, then the person will have to be further 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 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 engage in comprehensive 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 undergo additional tests or repeat studies. Normal heart function, like pathological abnormalities, are always recorded with a cardiogram.

The sinus rhythm on the ECG should be smooth and clear, without any intermittent lines or 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 a reason for doctors to perform additional studies and prescribe tests. Only after additional examinations you can understand the exact cause of the deviations and begin treatment. A normal sinus rhythm is reflected by a clear and evenly spaced cardiogram. Additional attention will have to be paid to the location of the axis, regarding the parameters of which medical standards have also been established.

Cardiologist

Higher education:

Cardiologist

Saratov State medical University them. IN AND. Razumovsky (SSMU, media)

Level of education - Specialist

Additional education:

"Emergency Cardiology"

1990 - Ryazan medical school named after academician I.P. Pavlova

EOS (electrical axis of the heart) is an indicator of the electrical parameters of the heart muscle. Important information necessary to make a cardiac diagnosis is the direction of 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 relate to pathologies - they are often detected in a normal state of health. The vertical position of the EOS is typical for patients tall with a thin build, children, teenagers. Horizontal - found in short people with a wide chest.

In some cases, significant displacements of the EOS occur. The reasons for this are that the patient has:

coronary disease hearts;
cardiomyopathy;
chronic heart failure;
congenital anomalies of the heart muscle.

The position of the heart axis 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 consultation with a specialist and a thorough examination.

When is the diagnosis of “sinus tachycardia vertical position of the EOS” made?

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 operates. An electrical impulse emanates from this area, initiating contraction of the heart and determining the speed of its work.

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

Tachycardia requires more serious consideration when it appears:

various forms of shortness of breath;
feeling of constriction in the chest area;
chest pain;
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 when changing body position ( standing up abruptly). This is often observed in people professional activity which is associated with increased physical activity(for general workers, loaders, storekeepers).

Possible long-term consequences sinus tachycardia- 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 medical history and clarify information regarding the varieties medical supplies, used by him in the past. Such moments make it possible to identify the presence of factors and circumstances that caused the onset of the disease.

Mandatory are:

Physical examination of the patient, including examination of the condition skin, assessment of the degree of its oxygen saturation.
Listening to breathing and heart rate(in some cases - with little physical activity).
General and biochemical analysis blood, allowing you to determine the level of leukocytes, cholesterol, potassium, glucose, urea.
Urinalysis necessary to exclude diseases genitourinary system among the presumed causes of the development of pathology.

The state of the thyroid gland makes it possible to determine the degree of its influence on the heart rate. As additional methods diagnostics, vagal tests and daily monitoring are carried out.

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

Treatment methods

In uncomplicated cases of sinus tachycardia, changes in the patient's diet and lifestyle are sufficient. You will need to minimize the presence of spicy and excessively salty dishes on the menu, give up strong tea and coffee, alcohol, and chocolate. Walking on fresh air without intense physical activity.

If there is a need for therapeutic treatment, medications are selected based on the reasons for the development of the pathology. Various specialists are involved in drawing up a treatment plan - a cardiologist, an endocrinologist, a phlebologist, and 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, Persen, valerian extract).

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

Help from traditional medicine

Combination of nuts and dried fruits

The process of preparing a “medicine” from nuts (Brazil) and dried fruits will require combining 2 tbsp. l. main components, dried apricots, figs, raisins, hazelnuts. The ingredients are thoroughly crushed with a blender, pour 300 ml natural honey. The composition is taken 1 tsp. three times a day for a 3-week course. If you are obese and have problems with thyroid gland It is better to refuse the product.

Lemon-garlic mixture

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

Hawthorn infusion

A tablespoon of dried hawthorn flowers is poured with an incomplete glass of boiling water and left for at least half an hour. The infusion is drunk three times a day, 100 ml, regardless of meals. The recommended duration of treatment is 1–3 months.

Sinus tachycardia often requires integrated approach to treatment. For getting positive results therapy, the patient will need to comply with all medical prescriptions and recommendations, refuse bad habits, control your motor activity. When saving sedentary lifestyle life, smoking, eating high-calorie foods, alcohol, the effectiveness of even the most professional treatment, as well as the best traditional methods, will decrease significantly.

The abbreviation “ECG” is well known to the average person and is often used by patients when describing the problems that have befallen them. Many people even know that ECG is short for “electrocardiography” and that the term itself means recording the electrical activity of the heart. However, this is where, as a rule, the average person’s knowledge of ECG ends and a misunderstanding begins about what the results of this study mean, what the detected deviations indicate, and what to do to get everything back to normal. This is discussed in our article.

What is an ECG?

Since the advent of the method to the present day, the ECG has been the most accessible, easiest to perform and informative cardiological study that can be carried out in a hospital, clinic, ambulance, on the street and at the patient’s home. To put it simply, an ECG is a dynamic recording of the electrical charge that makes our heart work (that is, contract). To evaluate the characteristics of this charge, recordings are made from several areas of the heart muscle. To do this, electrodes are used - metal plates - which are applied to different parts of the patient's chest, wrist and ankles. Information from the electrodes enters the ECG machine and is converted into twelve graphs (we see them on a paper tape or on the device’s monitor), each of which reflects the work of a specific part of the heart. The designations of these graphs (they are also called leads) - I, II, III, aVR, aVL, aVF, V1-V6 - can be seen on the electrocardiogram. The study itself takes 5-7 minutes; the doctor will need the same amount of time to decipher the ECG result (if the decoding is not carried out by computer). ECG is a completely painless and safe research, it is performed on adults, children and even pregnant women.

In what cases does a doctor prescribe an ECG?

A doctor of any specialty can give a referral for an ECG, but most often a cardiologist refers for this study. The most common indications for an ECG are discomfort or pain in the heart, chest, back, abdomen and neck (which is dictated by the variety of manifestations of coronary heart disease); dyspnea; interruptions in heart function; high blood pressure; fainting; swelling in the legs; weakness; heart murmur; Availability diabetes mellitus, rheumatism; suffered a stroke. An ECG is also performed as part of preventive examinations, in preparation for surgery, during pregnancy, and before issuing a permit to practice. active species sports, when preparing documents for Spa treatment etc. All people over 40 years of age are recommended to undergo an ECG annually, even in the absence of any complaints, to exclude asymptomatic coronary heart disease, heart rhythm disturbances, myocardial infarction suffered “on your feet”.

An ECG makes it possible to diagnose various disturbances of heart rhythm and intracardiac conduction, identify changes in the size of the heart cavities, thickening of the myocardium, signs of electrolyte metabolism disorders, determine the location, size, depth of myocardial ischemia or infarction, the duration of the infarction, and diagnose toxic damage to the heart muscle.

ECG conclusion: terminology

All changes detected on the electrocardiogram are assessed by a functional diagnostician and are briefly recorded in the form of a conclusion on a separate form or right there on film. Most ECG findings are described in special terms, understandable to doctors, which after reading this article the patient himself will be able to understand.

Heart rate- this 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. Normally, an adult's heart rate is 60-90 beats per minute. When the heart rate increases above 91 beats/min, they speak of tachycardia; if the heart rate is 59 beats/min or less, this is a sign bradycardia. Both tachycardia and bradycardia can be either a manifestation of the norm (for example, tachycardia due to nervous experiences or bradycardia in trained athletes), or a clear sign pathology.

EOS– abbreviation for “electrical axis of the heart” - this indicator allows you to approximately determine the location of the heart in the chest, get an idea of the form and function various departments hearts. The ECG conclusion indicates the position of the EOS, which can be normal, vertical or horizontal, deviated to the right or left. The position of the EOS depends on the influence of many factors: body type, age, gender, changes in the heart muscle, intracardiac conduction disorders, the presence of lung diseases, heart defects, atherosclerosis, etc. So with hypertension Often there is a deviation of the EOS to the left or a horizontal position of the EOS. In chronic lung diseases (chronic obstructive bronchitis, bronchial asthma), a deviation of the EOS to the right is often detected. Thin people usually have a vertical position of the EOS, while thick people and obese people have a horizontal position. Great importance has a sudden change in the position of the EOS: for example, there was normal position, and suddenly - it deviated sharply to the right or left. Such changes always alert the doctor and make a more in-depth examination of the patient mandatory.

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

Non-sinus rhythm– means that the heart rhythm is generated not in the sinus node, but in one of the secondary sources of potentials, which is a sign of cardiac pathology.

Sinus rhythm irregular- synonymous with sinus arrhythmia.

Sinus arrhythmia - abnormal sinus rhythm with periods of gradual increase and decrease in heart rate. There are two types of sinus arrhythmia - respiratory and non-respiratory. Respiratory arrhythmia is associated with the act of breathing, is normal and does not require treatment. Non-respiratory arrhythmia (to identify the patient during ECG registration asked to hold your breath) is a symptom of a disease, the nature of which will be indicated by other changes in the ECG and the results of further cardiac examination.

Atrial fibrillation or atrial fibrillation- the most common heart rhythm disorder in people over 60 years of age, it is often asymptomatic, but over time (if left untreated) leads to the development of heart failure and cerebral stroke. The source of electrical impulses in atrial fibrillation is not the sinus node, but muscle cells atria, which leads to defective chaotic contractions of the atria with subsequent irregular contractions of the ventricles of the heart. Abnormal contraction of the atria contributes to the formation of blood clots in their cavity, which creates serious danger development of cerebral stroke. Identification of ECG signs of atrial fibrillation in a patient requires the appointment of long-term antiarrhythmic and lifelong antithrombotic therapy, even in the absence of complaints.

Paroxysmal atrial fibrillation or paroxysmal atrial fibrillation- a sudden attack of atrial fibrillation. Requires compulsory treatment. If treatment is started on early stages development of paroxysmal atrial fibrillation - the chances of restoring normal heart rhythm are quite high.

Atrial flutter– this type of arrhythmia is very similar to atrial fibrillation. The main difference is the lower effectiveness of antiarrhythmic therapy, lower likelihood of a return to normal sinus rhythm. As is the case with atrial fibrillation Long-term, often lifelong treatment is required.

Extrasystole or extrasystole- an extraordinary contraction of the heart muscle, which causes an abnormal electrical impulse that does not come from the sinus node. Depending on the origin of the electrical impulse, atrial, atrioventricular and ventricular extrasystole. Sometimes polytopic extrasystoles occur - that is, the impulses that cause them come from various parts of the heart. Depending on the number of extrasystoles, single and group, single (up to 6 per minute) and frequent (more than 6 per minute) extrasystoles are distinguished. Sometimes the extrasystole is of an orderly nature and occurs, for example, every 2, 3 or 4 normal cardiac complexes - then the conclusion is written bigeminy, trigeminy or quadrigymeny.

Extrasystoles can be called the most common ECG finding; moreover, not all extrasystoles are a sign of the disease. So called functional extrasystoles often occur in practically healthy people who do not have changes in the heart, in athletes, pregnant women, after stress, physical overexertion. Extrasystoles are often found in people with vegetative-vascular dystonia. In such situations, extrasystoles are usually single, atrial, they are not dangerous to health, although they are accompanied by a lot of complaints.

Potentially dangerous is the appearance of polytopic, group, frequent and ventricular extrasystoles, as well as extrasystole, which developed against the background of an already known cardiac disease. In this case, treatment is necessary.

WPW syndrome or Wolf-Parkinson-White syndrome – congenital disease, which is characterized by ECG signs indicating the presence of additional (abnormal) pathways for conducting an electrical impulse through the myocardium, and dangerous attacks(paroxysms) of cardiac arrhythmias. If the ECG results are suspicious for the presence of WPW syndrome, the patient needs additional examination and treatment, and sometimes surgical operation, disrupting the conductivity of abnormal pathways. If ECG changes are not accompanied by the development of arrhythmia attacks, this condition is not dangerous and is called WPW phenomenon.

Sinoatrial blockade- disturbance of impulse conduction from the sinus node to the atrial myocardium - common occurrence for myocarditis, cardiosclerosis, myocardial infarction, cardiopathy, overdose medicines(cardiac glycosides, beta-blockers, potassium preparations), after heart surgery. Requires examination and treatment.

Atrioventricular block, А-V (АВ) block- disturbance of impulse conduction from the atria to the ventricles of the heart. The result of this disorder is asynchronous contraction of various parts of the heart (atria and ventricles). Grade A-B blockade indicates the severity of the conduction disorder. Reasons A-B blockades often become myocarditis, cardiosclerosis, myocardial infarction, rheumatism, heart defects, overdose of beta blockers, calcium antagonists, digitalis preparations, antiarrhythmic drugs. A-B blockade of the first degree is often found in athletes. Atrioventricular block, with rare exceptions, requires treatment, in severe cases- installation of a pacemaker.

Block of the bundle branches (left, right, left and right) (RBBB, LBBB), complete, incomplete- this is a violation of the conduction of an impulse through the conduction system in the thickness of the ventricular myocardium. Identification of this sign indicates the presence major changes in the myocardium of the ventricles of the heart, which often accompany myocarditis, myocardial infarction, cardiosclerosis, heart defects, myocardial hypertrophy and arterial hypertension. Also occurs with an overdose of digitalis drugs. To eliminate bundle branch block, treatment of the underlying cardiac disease is required.

Left ventricular hypertrophy (LVH)- this is a thickening of the wall and/or an increase in the size of the left ventricle of the heart. The most common causes of hypertrophy are arterial hypertension, heart defects and hypertrophic cardiomyopathy.

Right ventricular hypertrophy is a thickening of the wall or an increase in the size of the right ventricle. Among the reasons are heart defects, chronic diseases lungs (chronic obstructive bronchitis, bronchial asthma), cor pulmonale.

In some cases, next to the conclusion about the presence of hypertrophy, the doctor indicates “with overload” or “with signs of overload.” This conclusion indicates an increase in the size of the heart chambers (their dilatation).

Myocardial infarction, Q-myocardial infarction, non-Q-myocardial infarction, transmural myocardial infarction, non-transmural myocardial infarction, large-focal myocardial infarction, small-focal myocardial infarction, intramural myocardial infarction - these are all options for ECG description of myocardial infarction (necrosis of the heart muscle resulting from a violation its blood supply). Next, the location of the myocardial infarction is indicated (for example, in the anterior wall of the left ventricle or posterolateral myocardial infarction). Such ECG changes require emergency treatment. medical care and immediate hospitalization of the patient in a cardiology hospital.

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

Cardiodystrophic changes, ischemic changes, acute ischemia, ischemia, changes in the T wave and ST segment, low T waves - this is a description of reversible changes (myocardial ischemia) associated with a disorder coronary blood flow. Such changes are always a sign of coronary heart disease (CHD). The doctor will definitely respond to these ECG signs and prescribe appropriate anti-ischemic treatment.

Dystrophic changes, cardiodystrophic changes, metabolic changes, changes in myocardial metabolism, electrolyte changes, disruption of repolarization processes - this is how metabolic disorders in the myocardium are not associated with acute disorder blood supply Such changes are characteristic of cardiomyopathy, anemia, endocrine diseases, diseases of the liver, kidneys, hormonal disorders, intoxications, inflammatory processes, heart injuries.

Long QT syndrome– congenital or acquired disorder of intracardiac conduction, which is characterized by a tendency to severe disorders heart rate, fainting, cardiac arrest. Timely detection and treatment of this pathology is necessary. Sometimes a pacemaker needs to be implanted.

Features of ECG in children

Normal ECG readings in children are somewhat different from normal indicators in adults and change dynamically as the child grows older.

Normal ECG in children aged 1 – 12 months. Typically, heart rate fluctuates depending on the child’s behavior (increased frequency when crying, restlessness). Average heart rate is 138 beats per minute. The location of the EOS is vertical. Allowed to appear incomplete blockade right bundle branch.

ECG in children aged 1 year - 6 years. Normal, vertical, less often - horizontal position of the EOS, heart rate 95 - 128 per minute. Sinus respiratory arrhythmia appears.

ECG in children aged 7–15 years. Characterized by respiratory arrhythmia, heart rate 65-90 per minute. The position of the EOS is normal or vertical.

Finally

Of course, our article will help many people far from medicine to understand what is written in ECG result. But do not delude yourself - after reading and even memorizing all the information presented here, you will not be able to do without the help of a competent cardiologist. The interpretation of ECG data is carried out by a doctor in conjunction with all available information, taking into account the medical history, patient complaints, examination results and other research methods - this art cannot be learned by reading just one article. Take care of your health!

For example, in Fig. 5-3 high teeth visible R in leads II, III, aVF, which is considered as a sign vertical position EOS (vertical middle electrical axis QRS).

Rice. 5-3.

The QRS angle is +90°. R In addition, the height of the teeth R is the same in leads II and III. In Fig. 5-3 teeth height QRS in three leads (II, III and aVF) is the same; in this case, the EOS is directed to the middle lead aVF (+90°). Therefore, a simple assessment of the electrocardiogram can assume that directed between positive poles

leads II and III to the positive pole aVF (+90°).

Method No. 2 In Fig. 5-3 the direction of the EOS can be calculated in another way. Remember that if the wave is perpendicular to the axis of any lead, it is recorded two-phase complex or R.S. QR QRS(see section ""). And vice versa, if in any limb lead the complex QRS two-phase, average electrical axis of the complex complex should be directed at an angle of 90° to this lead. Look again at Fig. 5-3. Do you see any biphasic complexes? It is obvious that in lead I there is a two-phase complex

, therefore, the EOS should be perpendicular to lead I. QRS Since lead I in the six-axis diagram corresponds to 0°, the electrical axis lies at right angles to 0° (angle QRS can be -90° or +90°). If the axis angle were -90°, the depolarization would be directed from the positive pole of lead aVF and the complex would be in it negative QRS. In Fig. 5-3 there is a positive complex in lead aVF R(high prong

), so the axis must have an angle of +90°.

Rice. 5-4.

The QRS angle is -30°. QRS Method No. 3 Another example is in Fig. 5-4. At a quick glance, the average electrical axis of the complex complex. horizontal, the axis should be directed at right angles to lead II. It is located at an angle of +60° in a six-axis system, so the axis angle can be -30° or +150°. If it were +150°, in leads II, III, aVF complexes QRS would be positive. So the axis angle is -30°.

Method No. 4

The next example is in Fig. 5-5. Complex QRS positive in leads II, III and aVF, so the EOS is relatively vertical. Prongs R have equal heights in leads I and III - hence, the average electrical axis of the complex QRS should be located between these two leads at an angle of +60°.

Rice. 5-5.

QRS angle +60°.

Method No. 5 QRS According to Fig. 5-5 average electrical axis of the complex can be calculated differently complex taking into account the two-phase complex-type in lead aVL R.

. The axis should be perpendicular to lead aVL (-30°), i.e. at an angle of -120° or +60°. Obviously the axis angle is +60°. The EOS should be directed to lead II with a high tooth

Consider the example in Fig. 5-6.

Rice. 5-6. QRS QRS angle -90°. R EOS is directed from leads II, III, aVF to leads aVR and aVL, where the complexes positive. Because the teeth complex have equal heights in leads aVR and aVL, the axis should be located exactly between these leads at an angle of -90°. In addition, in lead I -

two-phase complex

. In this case, the axis should be located perpendicular to lead I (0°), i.e. The axis angle can be -90° or +90°. Since the axis is directed from the positive pole of lead aVF to its negative pole, the axis angle should be -90°.

Look at fig. 5-7.

Rice. 5-7. complex QRS angle -60°. Method No. 6 Since in lead aVR there is a two-phase complex QRS-type, EOS should be located QRS perpendicular axis of this lead. The lead axis angle aVR is -150°, so the average electrical axis of the complex in this case it should be -60° or +120°. It is clear that the axis angle is -60°, since in lead aVL the complex is positive, and in lead III it is negative. In Fig. 5-7 average electrical axis of the complex R you can also calculate from lead I, where the amplitude of the tooth

equal to the amplitude of the tooth S QRS Lead II. The axis should be located between the positive pole of lead I (0°) and the negative pole of lead II (-120°); The axis angle is -60°. These examples show. Thus, it is possible to determine the electrical axis of the heart by the lead where the complex QRS close to biphasic, or in two leads, where the amplitudes of the waves R(or calculate from lead I) are approximately equal.

For example, if the amplitudes of the teeth R or calculate from lead I in two leads are only approximately equal, the average electrical axis of the complex QRS does not lie exactly between these leads. The axis is deviated towards the lead with a larger amplitude. In the same way, if there is a two-phase complex in the lead ( complex or R.S.) with teeth R And calculate from lead I(or teeth Q And R) of different amplitudes, the axis is not exactly perpendicular to this lead. If the tooth R more than a tooth calculate from lead I(or prong Q), the axis points are less than 90° from the lead. If the tooth R less than a tooth calculate from lead I or Q, the axis points are more than 90° away from this lead.

Rules for determining the average electrical axis of the complex QRS:

The average electrical axis of the complex QRS located in the middle between the axes of the two limb leads with high teeth R equal amplitude.
The average electrical axis of the complex QRS directed at an angle of 90° to any limb lead with a biphasic complex ( R.S. or complex) and to a lead that has relatively high teeth R.

The medical concept of “electrical axis of the heart” is used by cardiologists to reflect the electrical processes occurring in this organ. 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 determine the angle of displacement - this is what cardiologists do.

The cardiac conduction system is a collection of sections of muscle tissue in the myocardium, which is an atypical type of fiber. These fibers have good innervation, which allows the organ to contract synchronously. The contractile activity of the heart begins in the sinus node; it is in this area that the electrical impulse originates. Therefore, doctors call the correct heart rate sinus.

The conduction system is a powerful source that supplies electrical signals that cause the main part of the body to work normally, in the correct rhythm. Only doctors can calculate any violations in this area; they cannot do this 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 conduction system of the organ, the axis of the heart may become confused. There are certain standards for the position of this indicator, according to which the doctor identifies 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 left ventricle usually significantly exceeds that of the right ventricle. You can find out whether a given measurement is a horizontal or vertical vector using these standards. Since the mass of the organ is distributed unevenly, it means that electrical processes should occur more strongly in the left ventricle, and this shows that the EOS is directed specifically to this section.

Doctors project this data using a specially developed coordinate system, from which we can conclude that the electrical axis of the heart is in the region of +30 and also +70 degrees. However, every person, even a child, has individual body characteristics, 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 that are considered normal and do not interfere with the functioning of the organ.

What positions of the electrical axis exist:

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

It should be noted that all five positions can occur in a person in good health. Finding the reason for such features is quite easy; human physiology explains everything.

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

In what cases are we talking about pathology, the causes of violations

Sometimes the direction of the indicator can indicate 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 detected, it means that the person has certain ailments, especially hypertrophic changes in the left ventricle. Often such a violation becomes a consequence of pathological processes, as a result of which the cavity of this section stretches and increases in size.

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

Ischemic damage to the main organ.
Arterial hypertension, especially with regular pressure surges to high tonometer values.
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.
Chronic heart failure.
Disturbances in the aortic valve, its insufficiency or stenosis. A pathological process of this type can be acquired or congenital in nature. Such diseases cause disruption of blood flow in the cavities of the organ, which leads to overload of the left ventricle.
People involved in sports activities professionally also often exhibit these disorders.

A blockade found in the left bundle branch is often diagnosed, which also refers to a pathology that displaces the EOS to the left.

What diseases lead to a tilt of the EOS to the right:

Pathological processes in the triscupid valve.
Stenosis and narrowing of the lumen of the pulmonary artery.
Pulmonary hypertension. This disorder often occurs against the background of other ailments, such as obstructive bronchitis, organ damage by 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.

First of all, it is necessary to note the position of the EOS during the mother's pregnancy. Pregnancy changes the direction of this indicator, as serious changes occur in the body. The rapidly enlarging uterus puts pressure on the diaphragm, which leads to a displacement of all internal organs and changes the position of the axis, as a result of which its direction can 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 a difference in the weight ratio 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 angle of EOS, which normally remains throughout his life.

Symptoms

Changing the direction of the electrical axis cannot cause unpleasant sensations in humans. Disorders of well-being usually provoke hypertrophic damage to the myocardium if they are accompanied by severe hemodynamic disturbances, and also lead to the development of heart failure, which is very dangerous and requires treatment.

Symptoms:

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

Diagnosis and treatment

Diagnostic methods:

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, disturbances in the structure of the heart and evaluate its contractile characteristics.
X-ray of the chest area, allowing you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
ECG in the form of daily monitoring. It is necessary to clarify the clinical picture in case of disorders related not only to the axis itself, but also to the origin of the rhythm not from the sinus node area, which indicates a disorder of the rhythmic data.
Coronary angiography or coronary angiography. It is used to study the characteristics of damage to the coronary arteries during organ ischemia.
An exercise ECG can detect myocardial ischemia, which is usually the cause of a shift in the direction of the EOS.

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

In order to determine the functional abilities of the heart, it is necessary to conduct special examination methods. If it turns out that there are disturbances in the conduction system of the organ, there is no need to panic, you must follow all the doctor’s recommendations. Medicine today can eliminate almost any pathology, you just need to seek help in a timely manner.