N position eos. Diseases that are accompanied by a levogram

The verified working capacity of the heart is the guarantor of a long human life. And the decoded sinus rhythm and to the left is an indicator of the state of the heart muscle. Thanks to the electric axis, it is possible to diagnose at an early stage and cure it, prolonging normal condition organism and life span of a sick person.

According to the deviation of the EOS, you can determine the diagnosis of heart disease

EOS - the electrical axis of the heart - is a cardiological concept that means the electrodynamic strength of an organ, the level of its electrical activity. According to its position, the specialist deciphers the state of the processes taking place in the main organ every minute.

This parameter represents the total amount of bioelectric changes in the muscle. With the help, in which the electrodes fix certain points of excitation, it is possible to mathematically calculate the location of the electrical axis relative to the heart.

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

Part muscle tissue, formed from atypical fibers that regulate the synchronization of organ contractions, is called the conduction system of the heart.

The contractile property of the myocardium consists of the sequence of stages:

1. Organization of an electrical impulse in the sinus node
2. The signal enters the ventricular atrial node.
3. From there it is distributed along the bundle of His, located in the interventricular septum and divided into 2 branches
4. The activated bundle drives the left and right ventricles
5. With normalized signal wiring, both ventricles contract synchronously

The cardiac conduction system is a kind of energy supplier for the functioning of the body. It is in it that electrical changes initially occur, provoking the contraction of muscle fibers.

With a dysfunction of the wiring system, the electric axis changes its location. This point is easily determined.

What is sinus rhythm on an ECG

Sinus rhythm on an electrocardiogram shows that the signal electrical nature produced only in the sinus node. This site is located in the right-sided atrium under the membrane and is directly supplied with arterial blood.

The cells of this organ are spindle-shaped and are collected in small bundles. Low level the ability to contract is compensated by the production of electrical impulses, the analogues of which are nerve signals.

The sinus node produces low-frequency signals, but is able to deliver them at high speed to the muscle fibers. A run of 60-90 shocks in 60 seconds is considered an indicator of the quality functioning of the organ.

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

More common semi-vertical and semi horizontal position EOS

The state of the norm corresponds to the predominance of the left-sided mass over the right-sided ventricle. Thanks to this, the processes of the electrical nature of the former are stronger in total, and the EOS will be directed precisely at it.

When projecting the location of the cardiac organ onto the coordinate system, it will become noticeable that the left ventricle will be in the range from +30 to +70 °. This situation is considered to be the norm.

However, on an individual basis, due to anatomical features body structure, the location can vary and be in the range from 0 to + 90 °.

The location of the cardiac electrical axis is divided into 2 main types:

1. Vertical - an interval from +30 to +70 ° - This is typical for people of great stature, thin build.
2. Horizontal – range from 0 to +30°. Seen in a person with small stature, dense complexion of the body with a wide chest.

Since the physique and height are indicators of an individual plan, the most common are the intermediate subspecies of the location of the EOS: semi-vertical and semi-horizontal.

Rotations of the heart along the longitudinal axis reflect the location of the organ in the body, and their number becomes an additional indicator in the diagnosis of cardiovascular diseases.

Diagnostics on the ECG

Usually the position of the EOS is determined using an ECG.

An electrocardiogram is the most accessible, simple and painless way to determine the source of impulses for the heart, as well as their frequency and rhythm. ECG is characterized as the most informative method obtaining data on the functioning of the heart muscle.

Procedure process:

The examined person takes a supine position on a couch parallel to the floor, having previously exposed the torso, wrists and ankles.

On these parts of the body with the help of suction cups, through which data on electrical impulses will go to the computer. A specialized program reads these signals during normal breathing and during its delay.

The condition for the procedure is complete relaxation of the body. ECG removal is carried out with various loads, but this occurs with an in-depth study of the work of the heart to establish a diagnosis, as well as when checking progress from medical measures. After data collection, the printer prints an ECG graph on thermal paper. This printout, in turn, is deciphered by a medical professional who has completed special courses.

The cardiogram is a summary graph of arcuate and acute-angled lines, each of which reflects a certain process during the contraction of the heart. First of all, decipher the line denoting sinus rhythm.

If the number of contractile actions of the heart does not meet the standards of the norm, then the source of the signal is not indicated as sinus, and the study of the work of the heart is deepened.

Deciphering the electrocardiogram graph

Having deciphered the cardiogram, the specialist can make a diagnosis

The ECG graph consists of teeth, gaps and segmental segments. For these indicators, a range is clearly defined, beyond which it signals a violation of the heart.

Mathematical calculations of cardiogram lines determine the following indicators:

• The rhythm of the heart muscle
• The frequency of contractile processes of the body
• pacemaker
• Wiring quality
• cardiac electrical axis

Thanks to these data, as well as a detailed description of the meaning of the teeth, spaces and segmental segments, the specialist will be able to take an anamnesis, clarify the disease and establish appropriate therapeutic measures.

When the position of the EOS can talk about heart disease

EOS may be tilted to the left in cardiac ischemia

The tilt of the cardiac axis is not a symptom of the disease, but its deviation from the standard gives a signal of organ dysfunction. A non-standard slope of the EOS may indicate the presence of the following diseases:

• Heart disease
• Various origins
• Chronic course of the heart
• Congenital pathologies and non-standard structure of the heart

Reasons for deviating to the left

The side to which the axis is tilted also helps to determine the diagnosis.

The tilt of the EOS to the left most often occurs with left ventricular hypertrophy. In this case, there is an increase in the load on the functioning of the left side of the organ. The reason for the increase may be:

• Long, indicating high blood pressure
• Insufficient performance of the heart
• Dysfunction and abnormal structure of the valvular apparatus in the left heart ventricle
• rheumatic fever
• Dysfunction within the ventricular conduction system
• heart muscle

Causes of deviation to the right side

The tilt of the EOS to the right occurs with a hypertrophied state of the right-sided ventricular heart. The reason for this is:

• Bronchitis
• Asthma
• Chronic obstructive pulmonary disease
• pulmonary artery
• Abnormal structure of the heart organ from the moment of birth
• Insufficient performance of the tricuspid valve
• Blockade of the posterior branch of the left leg of the bundle of His

Symptoms

Diseases in which the EOS is tilted to the left are accompanied by chest pain

EOS displacement has no independent symptoms. In addition, there is a possibility of asymptomatic axis deviation. To prevent diseases of the heart and blood vessels, diagnosing them at the initial stage, regular electrocardiograms are taken.

Symptoms of diseases associated with left-sided deviation of the EOS:

• Pain in the chest area
• Difficulty in breathing
• Arrhythmia and
• Dystonia blood pressure
• Headache
• Violation
• Dizziness
• Fainting state
• - slow heart rate
• face and limbs

Additional diagnostics

echocardiography is used to additional diagnostics when the EOS is tilted

To determine the reasons that provoked the deviation of the EOS, a number of additional studies are carried out:

1. Echocardiogram, abbreviated. This procedure consists in the study of the contractile and other abilities and the work of the main organ using special sound waves, determines the presence of probable heart defects.
2. Stress echocardiogram, stress echocardiogram. It is expressed in the study of ultrasonic waves of the functioning of the heart with an additional load, most often squats. Diagnose ischemic disease.
3. coronary vessels. This test detects blood clots and atherosclerotic plaques in the arteries and veins.
4. Holter mount, abbreviated. This procedure collects electrocardiogram data during the day. This method of research became possible after the creation of a portable ECG apparatus, which is distinguished by its small weight and size. However, with this method of verification, there are a number of limitations: constraint in movement, a ban on water procedures and a distance from pets. At the same time, the day of wearing a holter should be ordinary, without non-standard situations.

Treatment

Changing the slope of the EOS does not require self-treatment. To restore the position of the axis, it is necessary to eradicate the main sources of tilt - cardiovascular or pulmonary disease.

Therapeutic procedures, medications and other measures are prescribed by the attending physician after the diagnosis is established. The main points of the treatment process depend on the type of disease:

• - prescribed antihypertensive drugs that normalize blood pressure. Representatives of medicinal drugs are substances that help prevent vasoconstriction and increase the level of pressure: calcium channel antagonists, beta-blockers.
• Aortic stenosis - surgery in the form.
• – surgical installation of a valve prosthesis.
• Ischemia - drugs - ACE inhibitors, beta-blockers.
• - surgery for thinning of the myocardium.
• Blockade of the anterior branch of the left leg of the bundle of His - installation.
• A similar blockade that occurred during the restoration of blood circulation of the coronary vessels by surgical intervention.

It is possible to return the normal location of the electrical axis of the heart only if the size of the left ventricle is normalized or the path of the impulse along it is restored.

Preventive measures to deviate EOS from the norm

A balanced healthy diet will help prevent changes in the position of the EOS and the occurrence of cardiovascular diseases.

Observing a number simple rules it is possible to avoid dysfunction of the vessels and the heart muscle and prevent the deviation of the EOS from the normal position.

Prevention measures will be:

• Balanced healthy diet
• Clear and even daily routine
• Lack of stressful situations
• Replenishment of the level of vitamins in the body

The body can get the required amount in two ways: vitamin complex medicinal origin and the use of certain foods. Products - sources of antioxidants and trace elements:

• Citrus fruit
• dried grapes
• Blueberries
• Onions and green onions
• cabbage leaves
• Spinach
• Parsley and dill
• Chicken eggs
• red sea fish
• Dairy

The last method of prevention, but one of the most important in terms of value, will be moderate and regular physical activity. Sports, the plan of which is made taking into account the characteristics of the human body and its standard of living, will strengthen the heart muscle and allow it to function smoothly.

All these methods of prevention of disorders of the heart, and, consequently, deviations of the EOS from the norm can be called in a healthy way life. Subject to this principle, not only the well-being of a person will improve, but also his appearance.

In the following video, see what an electrocardiogram looks like in normal conditions:

Timely diagnosis and detection of deviations in the position of the EOS is the key to health and long life of a person. The annual cardiological study of the work of the heart contributes to early definition diseases and their speedy recovery.

The abbreviation "EKG" is well known to the layman and is often used by patients when describing problems that have fallen on them. Many even know that ECG is short for "electrocardiography" and that the term itself means recording the electrical activity of the heart. However, on this, as a rule, knowledge from the field of ECG in the average person ends and a misunderstanding begins, what the results of this study mean, what the detected deviations indicate, what to do so that everything returns to normal. About this - in our article.

What is an EKG?

From the moment the method appeared to the present day, ECG is the most accessible, simple to perform and informative cardiological study that can be performed in a hospital, clinic, ambulance, on the street and at the patient's home. In simple terms, an ECG is a dynamic recording of an electrical charge, thanks to which our heart works (that is, it contracts). To evaluate the characteristics of this charge, the recording is made from several sections of the heart muscle. For this, electrodes are used - metal plates- which are superimposed on different areas chest, wrist and ankles of the patient. The information from the electrodes enters the ECG machine and is converted into twelve graphs (we see them on a paper tape or on the monitor of the machine), each of which reflects the work of a particular 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 to decipher the ECG result (if the decoding is not carried out by a computer). An EKG is completely painless and safe study, it is carried out by adults, children and even pregnant women.

In what cases does the doctor prescribe an ECG?

A doctor of any specialty can give an ECG referral, but most often a cardiologist directs this study. The most common indications for ECG are discomfort or pain in the heart, chest, back, abdomen and neck (which is dictated by a variety of manifestations coronary disease hearts); dyspnea; interruptions in the work of the heart; high blood pressure; fainting; swelling in the legs; weakness; murmur in the heart; the presence of diabetes, rheumatism; suffered a stroke. ECG is also carried out as part of preventive examinations, in preparation for surgery, during pregnancy, before issuing permission to engage in active 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, in order to exclude asymptomatic coronary heart disease, disorders heart rate, transferred "on the legs" myocardial infarction.

ECG makes it possible to diagnose various violations heart rate and intracardiac conduction, detect changes in the size of the cavities of the heart, thickening of the myocardium, signs of violation electrolyte metabolism, to determine the localization, size, depth of ischemia or myocardial infarction, the duration of myocardial infarction, to diagnose toxic damage to the heart muscle.

ECG conclusion: terminology

All changes found on the electrocardiogram are evaluated by a functional diagnostician and briefly recorded as a conclusion on a separate form or right there on film. Most of the ECG findings are described in special terms that are 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. Normal heart rate in an adult is 60-90 beats 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 bradycardia. Both tachycardia and bradycardia can be both a manifestation of the norm (for example, tachycardia against the background of nervous experiences or bradycardia in trained athletes), and a clear sign of pathology.

EOS- short for "electrical axis of the heart" - this indicator allows you to approximately determine the location of the heart in chest, to get an idea of ​​the form and function of various parts of the heart. The conclusion of the ECG 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: physique, 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 location of the EOS. In chronic lung diseases (chronic obstructive bronchitis, bronchial asthma) EOS deviation 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. Of great importance is a sudden change in the position of the EOS: for example, there was a normal position, and suddenly it deviated sharply to the right or left. Such changes always alert the doctor and make a deeper examination of the patient mandatory.

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

The rhythm is non-sinus- means that the heart rhythm is not generated 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 - irregular sinus rhythm with periods gradual increase and decrease in heart rate. Sinus arrhythmia is of two types - respiratory and non-respiratory. Respiratory arrhythmia is associated with the act of breathing, is the norm and does not require treatment. Non-respiratory arrhythmia (for its detection, the patient is asked to hold his breath during ECG recording) is a symptom of the disease, the nature of which will be indicated by other changes on 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, 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 the muscle cells of the atria, which leads to inferior chaotic contractions of the atria, followed by 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 a serious risk of developing a 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- sudden onset of atrial fibrillation. Requires compulsory treatment. If treatment started on early stages development of paroxysmal atrial fibrillation - the chances of restoring a 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, the lower likelihood of a return to normal sinus rhythm. As in the case of atrial fibrillation, long-term, often lifelong treatment is necessary.

Extrasystole or extrasystole- an abnormal 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 extrasystoles are distinguished. Sometimes there are polytopic extrasystoles - 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 isolated. Sometimes extrasystole is ordered in nature and occurs, for example, every 2, 3 or 4 normal cardiac complexes - then bigeminy, trigeminy or quadrihymeny is written in conclusion.

Extrasystole 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 practice healthy people that do not have changes in the heart, in athletes, pregnant women, after stress, physical overstrain. Often extrasystoles are 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 extrasystoles that have developed against the background of an already known cardiac disease. In this case, treatment is necessary.

WPW syndrome or Wolff-Parkinson-White syndrome- a 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 arrhythmia. If the ECG results are suspicious for the presence of the WPW syndrome, the patient needs additional examination and treatment, sometimes a surgical operation that disrupts the conduction 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- violation of the impulse from the sinus node to the atrial myocardium - a frequent occurrence in myocarditis, cardiosclerosis, myocardial infarction, cardiopathy, overdose medicines(cardiac glycosides, beta-blockers, potassium preparations), after heart surgery. Requires examination and treatment.

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

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 myocardium of the ventricles. The detection of this sign indicates the presence of serious changes in the myocardium of the ventricles of the heart, which often accompany myocarditis, myocardial infarction, cardiosclerosis, heart defects, myocardial hypertrophy and arterial hypertension. It also occurs with an overdose of digitalis preparations. To eliminate the blockade of the legs of the bundle of His, 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 - thickening of the wall or increase in the size of the right ventricle. Among the causes are heart defects, chronic lung diseases (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 chambers of the heart (their dilatation).

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

Cicatricial changes, scars- These 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).

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

Dystrophic changes, cardiodystophic changes, metabolic changes, changes in myocardial metabolism, electrolyte changes, impaired repolarization processes - this is how a metabolic disorder in the myocardium that is not associated with acute circulatory disorders is designated. 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 violation of intracardiac conduction, which is characterized by a tendency to severe cardiac arrhythmias, fainting, cardiac arrest. Timely detection and treatment of this pathology is necessary. Sometimes a pacemaker is required.

Features of the ECG in children

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

Normal ECG in children aged 1-12 months. Typically fluctuations in heart rate depending on the behavior of the child (increase in crying, anxiety). Average heart rate- 138 beats per minute. The location of the EOS is vertical. Appearance of incomplete blockade of the right leg of a ventriculonector is allowed.

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

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 as a result of the ECG. But do not flatter 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. Interpretation of ECG data is carried out by a doctor in combination with all available information, taking into account the history of the disease, patient complaints, examination results and other research methods - this art cannot be learned by reading just one article. Take care of your health!

During the removal of an electrocardiogram, each electrode captures a bioelectrical reaction in a strictly assigned part of the myocardium. Then, doctors, in order to calculate the position and angle of the EOS, present the chest as a coordinate system in order to further project the indicators of the electrodes onto it. Perhaps the horizontal position of the EOS, vertical and a number of other options.

The importance of the conduction system of the heart for the EOS

The conduction system of the heart muscle is atypical muscle fibers that connect different parts of the organ and help it to contract synchronously. Its beginning is considered to be the sinus node, located between the mouths of the vena cava, therefore, in healthy people, the heart rhythm is sinus. When an impulse occurs in the sinus node, the myocardium contracts. If the conduction system fails, the electrical axis changes its position, since it is there that all changes occur before the contraction of the heart muscle.

Axis directions and offset

Since the weight of the left ventricle of the heart muscle in completely healthy adults is greater than the right one, all electrical processes take place there more strongly. Therefore, the axis of the heart is turned towards him.

Normal position. If we project the location of the heart onto the proposed coordinate system, then the direction of the left ventricle from +30 to +70 degrees will be considered normal. But it depends on the characteristics of each person, so the norm for this indicator is different people the range is from 0 to +90 degrees.

Horizontal position (from 0 to +30 degrees). It is displayed on the cardiogram in short people with a wide sternum.

vertical position. EOS is in the range from +70 to +90 degrees. It is observed in tall people with a narrow chest.

There are diseases in which the axis shifts:

Deviation to the left. If the axis deviates to the left, this may indicate an increase (hypertrophy) of the left ventricle, which indicates its overload. This condition is often caused by arterial hypertension, which occurs long time when blood is difficult to pass through the vessels. As a result, the left ventricle works hard. Deviation to the left occurs with various blockades, lesions of the valvular apparatus. With progressive heart failure, when the organ cannot fully perform its functions, the electrocardiogram also fixes an axis shift to the left. All these diseases cause the left ventricle to work for wear, so its walls become thicker, the impulse through the myocardium passes much worse, the axis deviates to the left.

Offset to the right. Deviation of the electrical axis of the heart to the right most often occurs with an increase in the right ventricle, for example, if a person has heart disease. It can be cardiomyopathy, ischemic disease, anomalies in the structure of the heart muscle. Right deviation causes such problems with respiratory system like lung obstruction, bronchial asthma.

EOS norm indicators

So, in healthy people, the direction of the axis of the heart can be normal, horizontal, vertical, the heart rate is sinus regular. If the rhythm is not sinus, then this indicates a disease. The sinus rhythm is irregular - this is an indicator of the disease, if it persists during the breath hold. Displacement of the cardiac axis to the left or right may indicate problems with the heart, respiratory organs. In no case should the diagnosis be made only on the basis of EOS displacement. A cardiologist can determine the disease and prescribe treatment after a series of additional studies.

Sinus rhythm

The rhythm of the heart that originates from the sinus node is called sinus rhythm. In healthy adults, the sinus rate is 60 to 100 beats per minute. Most patients with heart disease are also diagnosed with sinus rhythm.

Signs of sinus rhythm on the ECG are:

The presence of a tooth R in front of each complex QRS;

Prong R positive in leads I, II and negative in aVR;

Constant and normal interval P− Q(0.12−0.20 s).

Sinus tachycardia - sinus rhythm with a frequency of more than 100 per minute. The causes of sinus tachycardia may be an increase in the tone of the sympathetic nervous system (physical and emotional stress), a decrease in tone vagus nerve, damage to the sinus node, the influence of various toxic agents, infectious factors and fever, taking a number of medications.

Sinus bradycardia - sinus rhythm with a frequency of less than 60 per minute. The causes of sinus bradycardia may be an increase in vagal tone, a decrease in the tone of the sympathetic nervous system, an effect on the sinus node (hypoxia, myocardial infarction, especially rear wall), infectious and toxic effects (hypothyroidism, typhoid fever, diphtheria, taking cardiac glycosides and antiarrhythmic drugs).

Sinus arrhythmia - sinus rhythm with interval variability R−R (R− R) 0.16 s or more. Distinguish between respiratory and non-respiratory sinus arrhythmia. With respiratory arrhythmia, there is a clear relationship between the duration of the cardiac cycle and the phases of respiration, which is due to changes in the tone of the sympathetic and parasympathetic nervous systems. Non-respiratory sinus arrhythmia is most often associated with damage to the sinus node itself in coronary heart disease, myocarditis, intoxication with cardiac glycosides.

Ecg 1. Sinus rhythm, Normal

Heart rate = 68 per minute Email 46° axis is normal. P−Q= 0.148 s. P= 0.096 s. QRS= 0.068 s. Q−T= 0.353 s.

Sinus rhythm. The voltage is satisfactory. Normal position of the electrical axis of the heart.

ECG 2. sinus tachycardia

Heart rate = 107 per minute Email axis 85° - vertical. P−Q= 0.160 s. P= 0.098 s. QRS= 0.067 s. Q−T= 0.275 s. Sinus tachycardia. The voltage is satisfactory. Vertical position of the electrical axis of the heart.

ECG 3. Sinus bradycardia

Heart rate = 52 per minute Email 42° axis is normal. P−Q= 0.216 s. P= 0.110 s. QRS= 0.091 s. Q−T= 0.404 s. sinus bradycardia. The voltage is satisfactory. Normal position of the electrical axis of the heart.

ECG 4. Sinus arrhythmia

Heart rate \u003d 89 per minute. Email 60° axis is normal. P−Q= 0.192 s. P= 0.100 s. QRS= 0.074 s. Q−T= 0.316 s. sinus arrhythmia. The voltage is satisfactory. Normal position of the electrical axis of the heart.

Turns of the heart around the sagittal axis (position of the electrical axis of the heart)

The electrical axis of the heart is the average direction of the electromotive force of the heart during the entire period of depolarization. Distinguish:

normal position of the electrical axis of the heart: angle α is equal to +30-+70°;

horizontal position of the electrical axis of the heart: the angle α is 0- +30°:

Deviation of the electrical axis of the heart to the left: the angle α is −30-0°;

A sharp deviation of the electrical axis of the heart to the left: the angle α is less than −30 ° (see "Blockade of the anterior branch of the left leg of the bundle of His");

vertical position of the electrical axis of the heart: the angle α is equal to +70-+90°:

Deviation of the electrical axis of the heart to the right: the angle α is equal to +90- +120°;

A sharp deviation of the electrical axis of the heart to the right: the angle α is more than + 120 ° (see "Blockade of the posterior branch of the left leg of the bundle of His").

To continue downloading, you need to collect the image:

Cardiology online

Hello! My mother is 67 years old. She did an ECG and the result is as follows: sinus rhythm, the horizontal position of the EOS; LVH. What is it and how dangerous is it? Thank you very much.

Sinus rhythm means normal rhythm. The horizontal position of the electrical axis of the heart is also one of the variants of the norm, your mother is rather fat than thin. And LVH is an abbreviation (abbreviation) for Left Ventricular Hypertrophy - the muscle of the left ventricle of the heart is enlarged, it works with a greater than normal load. The reasons for this may be different: and obesity, and hypertension and heart disease. Depending on the cause and treatment will be different. But this is all beyond the scope of electrocardiography. How dangerous is it? It depends on the cause, and on the degree of LVH, and on the severity of the disease that led to LVH. There is no immediate, momentary danger, but to resolve this issue, you need to show your mother to a cardiologist.

leave a comment

Search

Common topics

Diseases

• Arrhythmias and heart blocks (2,352)
• Atherosclerosis (1 456)
• Pain in the region of the heart (2 279)
• Vegetative-vascular dystonia (1 617)
• Hypertension (3 450)
• Hypotension (700)
• Stroke (2 157)
• Heart attack (1 529)
• Ischemic heart disease (1 694)
• Cardiomyopathy (230)
• Tumors of the heart (433)
• Heart defects (1 362)
• Rheumatism (832)
• Septic endocarditis (175)
• Heart failure (1008)
• Angina (867)
• Tachycardia (2019)
• Heart injury (280)

Archive

Calendar

Recent questions

latest comments

• Julia: I constantly have a lack of air, I don’t know to whom.
• Anya: It's a migraine, I myself faced this problem, unfortunately.
• Ilya: Is it possible to do professional biathlon with ischemia?
• ayqun: Hello. My dad had insu a few days ago.
• Elena: My husband is 49 years old, there is no heart attack, but the test is positive, they did it.

Cardiology

Anonymous free online consultation with a cardiologist. Cardiology on the Internet, questions and answers. Ask a question about cardiology

Moscow Clinics

MMA named after Sechenov, Clinic of Cardiology

Address: st. B. Pirogovskaya, 6, building 1, 4th floor

Electrical axis of the heart: norm and deviations

The electrical axis of the heart - those words that are first encountered when deciphering an electrocardiogram. When they write that her position is normal, the patient is satisfied and happy. However, conclusions often write about the horizontal, vertical axis, its deviations. In order not to experience unnecessary anxiety, it is worth having an idea about the EOS: what it is, and what threatens its situation, which is different from normal.

General idea of ​​EOS - what is it

It is known that the heart during its tireless work generates electrical impulses. They originate in a certain zone - in the sinus node, then, normally, electrical excitation passes to the atria and ventricles, spreading along the conductive nerve bundle, called the bundle of His, along its branches and fibers. In total, this is expressed as an electrical vector that has a direction. EOS is the projection of this vector onto the front vertical plane.

Doctors calculate the position of the EOS by plotting the amplitudes of the ECG waves on the axis of the Einthoven triangle formed by the standard ECG leads from the limbs:

• the amplitude of the R wave minus the amplitude of the S wave of the first lead is plotted on the L1 axis;
• a similar value of the amplitude of the teeth of the third lead is deposited on the L3 axis;
• from these points, perpendiculars are set towards each other until they intersect;
• the line from the center of the triangle to the point of intersection is the graphic expression of EOS.

Its position is calculated by dividing the circle describing the Einthoven triangle into degrees. Usually, the direction of the EOS roughly reflects the location of the heart in the chest.

The normal position of the EOS - what is it

Determine the position of the EOS

• the speed and quality of the electrical signal passing through structural divisions conduction system of the heart
• the ability of the myocardium to contract,
• changes in internal organs that can affect the functioning of the heart, and in particular, on the conduction system.

In a person who does not have serious health problems, the electric axis can occupy a normal, intermediate, vertical or horizontal position.

It is considered normal when the EOS is located in the range from 0 to +90 degrees, depending on the constitutional features. Most often, normal EOS is located between +30 and +70 degrees. Anatomically, it is directed down and to the left.

Intermediate position - between +15 and +60 degrees.

On the ECG, positive waves are higher in the second, aVL, aVF leads.

Vertical position of the EOS

When verticalized, the electrical axis is located between +70 and +90 degrees.

It occurs in people with a narrow chest, tall and thin. Anatomically, the heart literally "hangs" in their chest.

On the ECG, the highest positive waves in are recorded in aVF. Deep negative - in aVL.

Horizontal position of the EOS

The horizontal position of the EOS is between +15 and -30 degrees.

It is typical for healthy people with a hypersthenic physique - a wide chest, short stature, increased weight. The heart of such people "lies" on the diaphragm.

On the ECG, aVL has the highest positive waves, while aVF has the deepest negative waves.

Deviation of the electrical axis of the heart to the left - what does it mean

EOS deviation to the left - its location in the range from 0 to -90 degrees. Up to -30 degrees can still be considered a variant of the norm, but a more significant deviation indicates a serious pathology or meaningful change location of the heart. for example, during pregnancy. It is also observed with the deepest exhalation.

Pathological conditions accompanied by EOS deviation to the left:

• hypertrophy of the left ventricle of the heart - a companion and a consequence of prolonged arterial hypertension;
• violation, blockade of conduction along the left leg and fibers of the bundle of His;
• left ventricular myocardial infarction;
• heart defects and their consequences that change the conduction system of the heart;
• cardiomyopathy, which disrupts the contractility of the heart muscle;
• myocarditis - inflammation also disrupts the contractility of muscle structures and the conductivity of nerve fibers;
• cardiosclerosis;
• myocardial dystrophy;
• calcium deposits in the heart muscle, preventing it from contracting normally and disrupting innervation.

These and similar diseases and conditions lead to an increase in the cavity or mass of the left ventricle. As a result, the excitation vector longer goes on the left side and the axis deviates to the left.

On the ECG in the second, third lead, deep S waves are characteristic.

Deviation of the electrical axis of the heart to the right - what does it mean

Eos is rejected to the right if it is in the range from +90 to +180 degrees.

Possible reasons for this phenomenon:

• violation of the conduction of electrical excitation along the fibers of the bundle of His, its right branch;
• myocardial infarction in the right ventricle;
• overload of the right ventricle due to narrowing of the pulmonary artery;
• chronic pulmonary pathology, the consequence of which is a "cor pulmonale", characterized by intense work of the right ventricle;
• the combination of coronary artery disease with hypertension - depletes the heart muscle, leads to heart failure;
• PE - blockage of blood flow in the branches of the pulmonary artery, of thrombotic origin, as a result, the blood supply to the lungs is depleted, their vessels spasm, which leads to a load on the right heart;
• mitral heart disease valve stenosis causing congestion in the lungs, which causes pulmonary hypertension and increased work of the right ventricle;
• dextrocardia;
• emphysema - shifts the diaphragm down.

On the ECG in the first lead, a deep S wave is noted, while in the second, third it is small or absent.

It should be understood that a change in the position of the axis of the heart is not a diagnosis, but only signs of conditions and diseases, and only an experienced specialist should understand the reasons.

Alas, there are no comments yet. Be the first!

Sinus arrhythmia horizontal position eos what is it

Sinus rhythm of the heart on the ECG - what does it mean and what can it tell

What does it mean and what are the rules

Sinus rhythm of the heart on the ECG - what does it mean and how to determine it? There are cells in the heart that create an impulse due to a certain number of beats per minute. They are found in the sinus and atrioventricular nodes, as well as in the Purkinje fibers that make up the tissue of the heart ventricles.

Sinus rhythm on the electrocardiogram means that this impulse is generated precisely by the sinus node (the norm is 50). If the numbers are different, then the impulse is generated by another node, which gives a different value for the number of beats.

Normally, a healthy sinus rhythm of the heart is regular with varying heart rates depending on age.

Normal indicators in the cardiogram

What do you pay attention to when performing electrocardiography:

1. The P wave on the electrocardiogram necessarily precedes the QRS complex.
2. Distance PQ corresponds to 0.12 seconds - 0.2 seconds.
3. The shape of the P wave is constant in each lead.
4. In an adult, the rhythm frequency corresponds to 60 - 80.
5. The P–R distance is similar to the R–R distance.
6. The P wave in the normal state should be positive in the second standard lead, negative in lead aVR. In all other leads (this is I, III, aVL, aVF), its shape may vary depending on the direction of its electrical axis. Usually, P waves are positive in both lead I and aVF.
7. In leads V1 and V2, the P wave will be 2-phase, sometimes it can be predominantly positive or predominantly negative. In leads V3 to V6, the waveform is predominantly positive, although there may be exceptions depending on its electrical axis.
8. Normally, each P wave must be followed by a QRS complex, a T wave. The PQ interval in adults is 0.12 seconds - 0.2 seconds.

Sinus rhythm, together with the vertical position of the electrical axis of the heart (EOS), shows that these parameters are within the normal range. vertical axis shows the projection of the position of the organ in the chest. Also, the position of the body can be in semi-vertical, horizontal, semi-horizontal planes.

When the ECG registers sinus rhythm, it means that the patient has no problems with the heart yet. It is very important not to worry and not be nervous during the examination, so as not to receive inaccurate data.

It is not necessary to do an examination immediately after physical exertion or after the patient has climbed to the third or fifth floor on foot. You should also warn the patient that you should not smoke half an hour before the examination, so as not to get unreliable results.

Violations and criteria for their determination

If the description contains the phrase: sinus rhythm disturbances, then a blockade or arrhythmia is registered. An arrhythmia is any failure in the rhythm sequence and frequency.

Blockades can be caused if the transmission of excitation from nerve centers to the heart muscle. For example, the acceleration of the rhythm shows that with a standard sequence of contractions, the heart's rhythms are accelerated.

If the phrase about an unstable rhythm appears in the conclusion, this is a manifestation of a small heart rate or the presence of sinus bradycardia. Bradycardia adversely affects the human condition, since the organs do not receive the amount of oxygen required for normal activity.

If an accelerated sinus rhythm is recorded, then most likely this is a manifestation of tachycardia. Such a diagnosis is made when the number of heart rhythm beats exceeds 110 beats.

Interpretation of results and diagnosis

In order to make a diagnosis of arrhythmia, it is necessary to compare the obtained indicators with those of the norm. Heart rate for 1 minute should not be more than 90. To determine this indicator, you need to divide 60 (seconds) by the duration R-R gap(also in seconds) or multiply the number of QRS complexes in 3 seconds (section equal to 15 cm of tape) by 20.

Thus, the following deviations can be diagnosed:

1. Bradycardia - heart rate / min is less than 60, sometimes an increase in the P-P interval up to 0.21 seconds is recorded.
2. Tachycardia - heart rate increases to 90, although other signs of the rhythm remain normal. Often there can be observed slanting depression of the PQ segment, and the ST segment is ascending. At a glance, it may look like an anchor. If the heart rate rises above 150 beats per minute, blockades of the 2nd tbsp occur.
3. Arrhythmia is an irregular and unstable sinus rhythm of the heart, when the R-R intervals differ by more than 0.15 seconds, which is associated with changes in the number of inhalation and exhalation beats. Often found in children.
4. Rigid rhythm - excessive regularity of contractions. R-R differs by less than 0.05 sec. This may be due to a defect in the sinus node or a violation of its neurovegetative regulation.

Reasons for deviations

The most common causes of rhythm disturbances can be considered:

• excessive alcohol abuse;
• any heart disease;
• smoking;
• long-term use of glycosides and antiarrhythmic drugs;
• protrusion mitral valve;
• pathology of the functionality of the thyroid gland, including thyrotoxicosis;
• heart failure;
• myocardial diseases;
• infectious lesions of valves and other parts of the heart - a disease of infective endocarditis (its symptoms are quite specific);
• overload: emotional, psychological and physical.

Additional Research

If the doctor, when examining the results, sees that the length of the area between the P waves, as well as their height, are unequal, then the sinus rhythm is weak.

To determine the cause, the patient may be advised to undergo additional diagnosis: pathology of the node itself or nodal problems can be detected vegetative system.

Then Holter monitoring is prescribed or a drug test is performed, which allows you to find out whether there is a pathology of the node itself or if the regulation of the vegetative system of the node is disturbed.

For more details about the syndrome of weakness of this node, see the video conference:

If it turns out that the arrhythmia was the result of disturbances in the node itself, then corrective measurements of the vegetative status are assigned. If for other reasons, then other methods are used, for example, the implantation of a stimulator.

Holter monitoring is a common electrocardiogram, which is carried out during the day. Due to the duration of this examination, specialists can examine the condition of the heart during varying degrees loads. When conducting a conventional ECG, the patient lies on the couch, and when conducting Holter monitoring, it is possible to study the state of the body during physical exertion.

Treatment tactics

Sinus arrhythmia does not require special treatment. The wrong rhythm does not mean that there is any of the listed diseases. Cardiac arrhythmia is a common syndrome characteristic of any age.

Can help prevent heart problems proper diet, daily routine, lack of stress. It will be useful to take vitamins to maintain the work of the heart and improve the elasticity of blood vessels. In pharmacies you can find a large number complex vitamins containing all the necessary components and specialized vitamins to maintain the functioning of the heart muscle.

In addition to them, you can enrich your diet with foods such as oranges, raisins, blueberries, beets, onions, cabbage, spinach. They contain many antioxidants that regulate the number of free radicals, an excessive amount of which can cause myocardial infarction.

For the smooth functioning of the heart, the body needs vitamin D, which is contained in parsley, chicken eggs, salmon, milk.

If you make a diet correctly, stick to the daily routine, you can achieve a long and uninterrupted work of the heart muscle and not worry about it until old age.

Finally, we suggest you watch a video with questions and answers about heart rhythm disorders:

Classification of sinus rhythm: what can a cardiogram tell about the state of the heart?

The sinus rhythm of the heart is just one of many indicators that are paid attention to when analyzing a cardiogram. Any deviation from the norm can be evidence developing disease or already running problems. Often, patients with unstable sinus rhythm do not even feel it. In order not to miss a symptom, it is worth visiting the clinic at least once a year. This is especially recommended for people:

• in the family of which cases of such diseases have already been recorded;
• working in stressful conditions;
• leading a sedentary lifestyle.

Of course, stress and long sitting at the computer does not always mean that the patient will find an irregular sinus rhythm or other disorders, it only puts him at risk.

Read more about what the heart rhythm is, what is its norm, what threatens its violations, and what diseases it can signal - later in the article.

What is sinus rhythm on an ECG, why is it so important?

An ECG can be used to judge the condition of the heart and its problems. As a result of taking a cardiogram, the doctor receives information about the following points:

• the functioning of the nodes of the conducting system;
• heart rate (HR);
• the presence of pathological processes;
• functional disorders.

A patient who does not have the necessary knowledge is unlikely to be able to give an objective assessment of a cardiac cardiogram. Therefore, you should not worry if the doctor does not give the cardiogram and is going to take it to a specialist on his own. If the visitor has serious problem, such as acute heart failure or myocardial infarction, then he is immediately taken to a cardiologist.

On an ECG, sinus rhythm indicates that the heart is beating correctly. Any violations can signal that the sinus node is weak and cannot cope with its functions. This is fraught with violations of the normal frequency of beats per minute and their regularity.

Read more about how to decipher the cardiogram of the heart, read further in the article.

ECG decoding: general rules

What does sinus rhythm of a particular nature mean, only a doctor can judge. However, he focuses on the norms of indicators - in adults and children they are somewhat different. This article discusses an adult electrocardiogram.

On the latter, several sections are distinguished, which are signs of sinus rhythm:

• the P wave in the second standard lead is positive and necessarily precedes the QRS complex;
• the PQ interval in duration is 0.12-0.2 seconds, the same throughout the entire cardiogram;
• the shape of the P waves has the same appearance in one lead;
• the distance R-R is equal to the distance R-R.

All this indicates a relatively normal functioning of the heart. You need to pay attention to the fact that the heart rate on the ECG of an adult should be within beats in 60 seconds. For children under 12, this figure is different. You can see it in the table below.

Note! As you can see, in adults the norm is much stricter. Any deviations can indicate violations in the rhythm.

The results of the ECG can be considered favorable if the rhythm is sinus, the heart rate is in order and the EOS - the electrical axis of the heart is vertical. If the EOS is rejected, then this may indicate some problems. A change in position can provoke pressure on some areas, thereby preventing the normal functioning of the heart.

In fact, the deviation of the EOS to the left or to the right is not critical. The axis of the heart can be in the position:

However, a certain reversal of the heart can signal problems. If the axis is tilted to the left, this may indicate left ventricular hypertrophy, hypertension, heart block, or intraventricular conduction disturbances. If the position of the electrical axis of the heart is deviated to the right, left ventricular hypertrophy or blockade may also be noted. The altered position of the electrical axis of the heart is considered normal, but at the first detection it is recommended to undergo a thorough examination.

Some patterns are interesting:

• the vertical position of the EOS is characteristic of tall and thin people of the asthenic type;
• the horizontal position of the EOS is typical for short and dense people with a wide chest.

The position of the axis of the heart must be taken into account when drawing up the conclusion.

What can a violation in sinus rhythm on a cardiogram indicate?

First of all, it is worth understanding that the normal rhythm of the heart is easily spoiled by the slightest stress or hassle. Before making a diagnosis, the doctor will have to make sure that the abnormalities on the ECG are not caused by external factors. This is especially true for children who are afraid of sensors - their cardiogram may be incorrect.

Attention: the sinus rhythm of the heart is the norm, which indicates correct work conducting system of this organ.

The following deviations in the contractions of the heart are distinguished:

1. Bradycardia. The heart rate decreases, the patient feels dizzy, tired, apathetic, tends to faint. P-P interval extended to 0.21 seconds.
2. Tachycardia. With a normal heart rate of 70 beats, the performance of such a patient may be higher than 90 even in calm state. Such a pulse can cause a blockade of the 2nd level. There is an accelerated sinus rhythm.
3. Arrhythmia. It is characterized by irregular intervals R-R (more than 0.15 seconds). In this case, the patient may feel discomfort, severe anxiety, be sensitive to pressure drops. Normal heart rate in patients at rest is 75, 80 or 85 beats per second. This uneven rhythm is often found in children - this is the norm, and the vast majority outgrow this condition.
4. ectopic rhythm. In this case, the rhythm is not set by the sinus node, but by other conducting fibers. Atrial rhythm, AV node rhythm, ventricular idioventricular rhythm, and coronary sinus or coronary sinus rhythm are distinguished when the site of excitation is very close to the coronary sinus (registered only by ECG).

It is important to understand that normosystole speaks about the health of the heart muscle.

Any changes in the normal sinus rhythm are reflected in the ECG, so that a professional can easily diagnose the disease.

What affects the contractions of the heart?

When the doctor deciphers the data, he takes into account not only what value he sees on paper, but also the patient's lifestyle. Negatively affect cardiac activity:

• stress;
• smoking;
• alcohol consumption;
• taking antiarrhythmic drugs;
• physical overload.

Often the situation is normalized when a person gets into a calm environment. More than half of heart rate problems go away with stress relief. As a percentage, this figure is 62%. It is important to understand that most patients feel discomfort due to busy work. Regardless of the reasons, if there are clear signs of a violation, it is recommended to visit a doctor.

The number of beats per minute also depends on age. So, for children, 160 beats per minute can be the norm, while for adults (over 12), this figure should be 75 beats per minute.

Sometimes, to clarify the details of the rhythm, doctors prescribe a daily study. In this case, sensors and a memory device are attached to the patient, which he must wear all day. This allows you to track the behavior of the heart muscle throughout the day in various conditions.

There is an irregular rhythm on the ECG: how to treat?

If the heart rhythm deviates from the norm, then this does not mean pathological changes. Only if the doctor has made a diagnosis, we can talk about the appointment medical preparations. The conclusion of the ECG only gives a direction for additional research, but does not become a sentence.

Often problems with cardiac rhythm are eliminated by organizing correct mode work and rest, normalization of nutrition, elimination of stress.

Preventing problems is best, so it's important to:

It is worth noting that the patient does not have to understand what this or that disease means. It is enough for him to adhere to the treatment plan and the recommendations of the attending doctor.

If the rhythm (sinus) is somewhat abnormal, it can be normalized with medication. They are prescribed by a cardiologist.

These products strengthen cardiovascular system, reduce the risk of rhythm interruptions. A well-chosen diet at the same time will reduce the likelihood of myocardial infarction, which is especially important for older people.

When should you visit a cardiologist?

Cardiology is a developed branch of medicine, and now all diseases are amenable to drug treatment. Normally, it is worth visiting a doctor at least once a year - this will help to detect the onset of pathological process. Even in paid clinics, the average cost of a comprehensive consultation is 1,100 rubles, which is affordable for most people.

In any case, the ECG, the interpretation of which should be carried out only by a doctor, is considered the basis for recognizing the cause of the disease. Each number from the electrocardiogram carries a certain meaning. What they mean - the cardiologist will help you figure it out.

Note! It should be remembered that in children, some symptoms appear differently. Therefore, the SPR (Union of Pediatricians of Russia) has its own prescriptions for the treatment of such diseases in children.

Sinus Rhythm Disorder: Summary

Sinus rhythm accompanies normal work heart, its changes: tachycardia, bradycardia. arrhythmias indicate disturbances in the conduction system and require careful study of the ECG by a cardiologist.

It is worth warning about the peculiarities of the location of the organ in advance, since the deviation of the heart along the axis makes some adjustments to the cardiogram. Otherwise, you will have to re-pass a thorough examination each time. Knowing the characteristics of the patient's body, the doctor can make an accurate conclusion.

To prevent rhythm disturbance, it is worth reconsidering lifestyle and diet. This will reduce the risk of symptoms. It is recommended to visit a cardiologist at least once a year. If there are already violations, you need to go to the appointment strictly according to plan. The doctor appoints the dates of visits, based on the severity of the disease. In severe cases, special sensors are attached to a person, which immediately record critical changes and inform others about it.

Even if there are no complaints, a visit to a cardiologist should not be neglected. Some diseases are hidden, without causing inconvenience to the patient until a certain time.

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying materials is allowed only with an active link to the source.

In cardiology practice, there is special term, reflecting cardiac electroprocesses. It is called the electrical axis of the heart (EOS). Its direction characterizes the flowing inside the heart bioelectrical changes with its reduction, or rather their total value.

Atypical muscles make up the conduction system. They provide synchronization of heartbeats. An electrical impulse is generated in the sinus node. This gives rise to myocardial contraction. It is for this reason that the normal rhythm of the human heart is called sinus.

As already mentioned, various diseases differently affect the angle of inclination of the EO.

What does it mean if the electrical axis of the heart is deviated to the left? This may be a symptom of left ventricular hypertrophy. That is, it increases and its overload occurs. This may occur with a prolonged increase in pressure. Vessels have great resistance to blood flow. Therefore, the left ventricle makes great efforts. It grows, which means it develops. This is what is most main reason move the axis to the left.

Hypertrophy can develop when the valvular section of the left ventricle is damaged. It is caused by ostial stenosis of the aorta. In this state, there is great difficulty in sending blood from the left ventricle, or there is an overload of the returned blood. Such disorders may be acquired or may be congenital. In most cases, the ventricle enlarges after bouts of rheumatism. The disease also occurs in athletes. In the latter case, a sports career may suddenly end.

If the electrical axis of the heart is shifted to the left, this may indicate all kinds of heart blockade and conduction disturbances inside the ventricle.

The electrical axis of the heart is shifted to the right with an increase in the right ventricle. Coming out of it, the blood is transported to the lungs for oxygenation. Hypertrophy can be provoked by various diseases of the pulmonary system, such as asthma, increased pulmonary pressure or obstructive disease. Also, hypertrophy occurs with stenosis of the lung or incorrect operation of the tricuspid valve. In addition, the disease can be a consequence of ischemia, cardiomyopathy and.

These diagnoses cannot be made only by the location of the EOS. This is only an additional indicator, determined when identifying different kind ailments. If the electrical axis of the heart is deviated from the range from zero to plus ninety degrees, you need to consult a doctor and do some research.

As is known, the main factor regulating axis displacement is hypertrophy. This disease can be determined by ultrasound. In general, all diseases that cause a displacement of the electrical axis of the heart are characterized by a variety of clinical manifestations and more research is needed to identify them. A sudden change in the position of the axis, detected for the first time on an electrocardiogram, can be provoked by some kind of cardio blockade.

Treatment of the displacement of the electrical axis of the heart is not required. This parameter is one of the electrocardiological signs, based on which, it is necessary to find out the reasons for its manifestation. And this will be done only by an experienced cardiologist based on the results of the prescribed examination.

Electrocardiography retains its high diagnostic significance even despite the emergence of new methods for studying the function and structure of the heart. A doctor of any profile is able to interpret the results. The electrical axis of the heart, or EOS, roughly tells the doctor what condition the organ is in, whether there is pathological changes. She can move. More often, a deviation of the electrical axis of the heart to the left is detected.

Normal options for EOS

The described parameter is functional. It reflects cardiac activity depending on the size and variants of violations of its work. The electrical axis is the resultant of all biopotentials of the organ in relation to the median line of the human body. It practically coincides with the anatomical axis of the organ.

There are five normal variants of EOS. Most often you can find a normogram. The normal position of the electrical axis of the heart is diagnosed when the summing angle alpha will be from +30 to +70 degrees. Only functional diagnosticians can calculate it.

Semi-vertical and vertical, semi-horizontal and horizontal position of the electrical axis of the heart are variants of the norm. For vertical position the alpha angle is characteristic, the value of which is in the range from 69 to 89 degrees. It is detected in patients with asthenic complexion.

The horizontal and semi-horizontal position of the EOS is set by functionalists when the alpha angle is from 0 to + 29 degrees. This is considered normal for stocky or obese individuals.

The reasons for the appearance of a levogram or rightogram are various heart diseases. EOS shift to the left or right is not considered the norm.

Reasons for deviating to the left

The main reason for changing the location of the axis of the heart is hypertrophy of the left. In this case, there is a predominance of the left parts of the heart. This situation is possible with the following pathologies:

1. Arterial hypertension accompanied by remodeling of the cardiac chambers;
2. Defects of the aortic and mitral valves;
3. Ischemic heart disease, including heart attack and post-infarction cardiosclerosis;
4. Inflammation of the heart muscle (myocarditis);
5. Myocardial dystrophy;
6. Cardiomyopathy (ischemic, dilated, hypertrophic).

In all the listed clinical situations, the wall thickness or volume of the left ventricle increases, and in case of decompensation, the left atrium also increases. As a result, the electrocardiogram shows the displacement of the electrical axis to the left side.

Symptoms

Displacement of the electrical axis of the heart is not an independent diagnosis. This is only a functional parameter that reflects the activity of the organ at a given time and orients the doctor to the search for pathology.

The levogram tells the general practitioner or cardiologist that the patient needs to be examined for diseases such as:

• Hypertonic disease;
• Heart valve defects;
• Ischemic or hypertrophic;
• Myocardial dystrophy;
• Hypertonic or remodeled heart;
• Heart failure.

When examining and collecting anamnestic data, complaints, attention is paid to symptoms such as headache, flies before the eyes, pain behind the sternum, shortness of breath, swelling lower extremities in the area of ​​feet and legs. The specialist correlates all the obtained data with each other and makes a diagnostic hypothesis. Further, based on the situation, a number of additional studies and medications are prescribed, if necessary.

Diagnostics on the ECG

There are several methods for determining the location of the electrical axis of the heart. The most common of them is based on comparing the size of the teeth in standard leads. The R and S waves are evaluated. If the first of them has a greater amplitude in lead 1, then they speak of the R-type of this lead. The detection of the R-type in standard lead 1 and the deepest S wave in lead 3 indicate a shift in the electrical axis of the heart to the left.

Diagnostics of the levogram on the ECG

The second way is less reliable. It is based on comparing the size of the R waves in the first three leads. If in the first of them the amplitude of the tooth is maximum, and in the third - the minimum, they say from the levogram.

More complex methods are based on the calculation of the alpha angle. For this, doctors functional diagnostics using tabular data. They substitute the necessary values, calculate the value of the desired angle in degrees. Ultimately, the location of the axis of the heart is judged depending on the result obtained. The most famous table is the Died table.

Independent determination of the value of the angle alpha is difficult. It is necessary to understand the projections of ECG leads and the anatomical structures of the heart very well. This is done by doctors of functional diagnostics.

Establishing diagnosis

After the electrocardiography, the functionalist writes his opinion. It includes data on cardiac activity, indicates the presence or absence of focal changes, and writes about EOS.

Shift of the axis of the heart to the left is not a diagnosis. This is the conclusion of a specialist, which helps the internist to navigate in terms of further diagnostic measures. It does not appear in either the diagnosis or the International Classification of Diseases (ICD).

Diseases accompanied by a levogram

The most common heart disease, leading to a shift of the EOS to the left, is hypertension. With constantly elevated pressure, the hemodynamic load falls on the left parts of the heart: first on the ventricle, and then on the atrium. The myocardium becomes more massive, it hypertrophies.

With a long course without adequate control, the heart remodels. The thickness of the wall of the interventricular septum, the left ventricle (especially its posterior wall) increases. Then the chamber itself becomes more voluminous. There is left ventricular hypertrophy. The predominance of the left chambers of the heart will lead to a shift in the electrical axis of the heart.

Hypertrophic cardiomyopathy is less common than hypertension. With this pathology, myocardial hypertrophy is detected, but it is clearly asymmetric. The reasons for the displacement of the axis of the heart are identical to those described above.

Valvular defects in adults are more often non-rheumatic. They are based on atherosclerotic changes. The levogram is observed in patients with lesions of the aortic and mitral valves. At the same time, the hemodynamic load on early stages falls on the left chambers of the heart. Only during decompensation is hypertrophy of the right sections possible.

The levogram is found in myocarditis. This is an inflammatory change in the myocardium of the walls of the heart. It is not possible to confirm the disease in everyone. medical institution. This requires a scintigraphic study.

Additional Research

Additional Research

An additional examination when detecting a levogram is always required, since the electrical axis of the heart and its location are a non-specific ECG sign that occurs in various heart diseases.

The first thing that can be prescribed in this situation in terms of diagnosis is echocardioscopy. Another name is ultrasound of the heart. The study allows you to assess the condition of the chambers of the heart, its valvular structures. Hemodynamic parameters can be determined, including ejection fraction. This indicator is very important for determining the presence and its severity.

By ECHO-CS or ultrasound of the heart, it is easy to determine the presence valvular defects, their degree of compensation. Based on the size of the interventricular septum, the posterior wall of the left ventricle, it is competent to confirm or reject a hypertensive heart, hypertrophic or dilated cardiomyopathy. With a heart attack in history, ischemic cardiomyopathy is exhibited.

If the patient is concerned about headaches, visual impairment, including passing, it is necessary to examine it for the presence of hypertension. For this, there is a daily control of pressure in a hospital: therapeutic or cardiological. Alternative option- Daily Holter monitoring. A cuff is put on the arm, which measures blood pressure at certain time intervals.

If myocarditis is suspected, myocardial scintigraphy or its puncture biopsy is prescribed. With this disease, a shift in the electrical axis of the heart to the left can also be detected.

Treatment

Therapy is prescribed only if the cause that caused the displacement of the electrical axis is identified. Just a deviation of the EOS to the left is not an indication for starting treatment.

When hypertension or hypertensive heart is detected, adequate combinations of antihypertensive agents are prescribed. They can be purchased separately or as part of combined preparations. The same groups of drugs, but in different doses, are used in the treatment of cardiomyopathies. Heart failure is a reason to shift the focus towards diuretic therapy, especially with severe fluid stasis.

How to determine the heart rate and the electrical axis of the heart:

Liked? Like and save on your page!