Sinus arrhythmia vertical position eos. Deviation of the electrical axis of the heart to the right: why it occurs and what is dangerous

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

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

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

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

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

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

What should be its normal position?

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

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

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

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

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

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

In a healthy person, EOS can be in one of the following positions:

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

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

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

Why would she move to the right?

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

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

Axis shift can occur for the following pathological reasons:

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

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

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

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

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

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

Signs of bias on the ECG

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

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

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

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

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

Additional diagnostic methods

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

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

The following diagnostic methods are used:

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

Should I be concerned and what should I do?

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

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

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

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

The electrical axis of the heart (EOS) is one of the main parameters of the electrocardiogram. This term is actively used in cardiology and in functional diagnostics, reflecting the processes occurring in the most important organ of the human body.

The position of the electrical axis of the heart shows the specialist what exactly is happening in the heart muscle every minute. This parameter is the sum of all bioelectrical changes that are observed in the organ. When taking an ECG, each electrode of the system registers excitations passing at a strictly defined point. If we transfer these values ​​to a conditional three-dimensional coordinate system, we can understand how the electrical axis of the heart is located and calculate its angle with respect to the organ itself.

How is an electrocardiogram taken?

ECG recording is carried out in a special room, shielded as much as possible from various electrical interferences. The patient is comfortably positioned on the couch with a pillow under his head. To take an ECG, electrodes are applied (4 on the limbs and 6 on the chest). An electrocardiogram is recorded with quiet breathing. In this case, the frequency and regularity of heart contractions, the position of the electrical axis of the heart and some other parameters are recorded. This simple method allows you to determine if there are abnormalities in the functioning of the organ, and, if necessary, refer the patient for a consultation with a cardiologist.

What affects the location of the EOS?

Before discussing the direction of the electrical axis, you should understand what the conduction system of the heart is. It is this structure that is responsible for the passage of the impulse through the myocardium. The conduction system of the heart is atypical muscle fibers that connect various sections organ. It starts from the sinus node, located between the mouths of the vena cava. Further, the impulse is transmitted to the atrioventricular node, localized in the lower part of the right atrium. The next baton is taken by the bundle of Gis, which quickly diverges into two legs - left and right. In the ventricle, the branches of the His bundle immediately pass into the Purkinje fibers, which penetrate the entire heart muscle.

The impulse that came to the heart cannot escape the conduction system of the myocardium. This is a complex structure with fine settings, sensitively reacts to the slightest changes in the body. With any disturbances in the conduction system, the electrical axis of the heart is able to change its position, which will immediately be recorded on the electrocardiogram.

EOS location options

As you know, the human heart consists of two atria and two ventricles. Two circles of blood circulation (large and small) ensure the normal functioning of all organs and systems. Normally, the mass of the myocardium of the left ventricle is greater than that of the right one. In this case, it turns out that all impulses passing through the left ventricle will be somewhat stronger, and the electrical axis of the heart is oriented precisely towards it.

If you mentally transfer the position of the organ to a three-dimensional coordinate system, it will become clear that the EOS will be located at an angle of +30 to +70 degrees. Most often, these values ​​​​are recorded on the ECG. The electrical axis of the heart can be located in the range from 0 to +90 degrees, and this, according to cardiologists, is also the norm. Why are there such differences?

Normal location of the electrical axis of the heart

There are three main provisions of the EOS. The normal range is from +30 to +70°. This option is found in the vast majority of patients who visit a cardiologist. The electrical axis of the heart is vertical, found in thin asthenic people. In this case, the angle value will fluctuate from +70 to +90°. The horizontal electrical axis of the heart is evident in short, densely built patients. In their card, the doctor will mark the EOS angle from 0 to + 30 °. Each of these options is the norm and does not require any correction.

Pathological location of the electrical axis of the heart

A condition in which the electrical axis of the heart is deviated is not in itself a diagnosis. However, such changes on the electrocardiogram may indicate various disorders in the work of the important body. The following diseases lead to serious changes in the functioning of the conduction system:

Cardiac ischemia;

Chronic heart failure;

Cardiomyopathy of various origins;

congenital defects.

Knowing about these pathologies, the cardiologist will be able to notice the problem in time and refer the patient to inpatient treatment. In some cases, when registering a deviation of the EOS, the patient needs emergency assistance in intensive care.

Deviation of the electrical axis of the heart to the left

Most often, such changes on the ECG are noted with an increase in the left ventricle. This usually happens with the progression of heart failure, when the organ simply cannot fully perform its function. It is possible that the development of such a condition, with arterial hypertension, is accompanied by pathology of large vessels and an increase in blood viscosity. In all these conditions, the left ventricle is forced to work hard. Its walls thicken, leading to the inevitable violation of the passage of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the left also occurs with narrowing of the aortic orifice. In this case, there is a stenosis of the lumen of the valve located at the outlet of the left ventricle. This condition is accompanied by a violation of the normal blood flow. Part of it lingers in the cavity of the left ventricle, causing it to stretch, and, as a result, compaction of its walls. All this causes a regular change in the EOS as a result of improper conduction of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the right

This situation clearly indicates hypertrophy of the right ventricle. Similar changes develop in some respiratory diseases (for example, in bronchial asthma or chronic obstructive pulmonary disease). Some congenital heart defects can cause an enlarged right ventricle. First of all, it is worth noting the stenosis of the pulmonary artery. In some situations, tricuspid valve insufficiency can also lead to the occurrence of such a pathology.

What is the danger of changing the EOS?

Most often, the deviation of the electrical axis of the heart is associated with hypertrophy of one or another ventricle. This condition is a sign of a long-standing chronic process and, as a rule, does not need emergency assistance cardiologist. The real danger is the change in the electrical axis in connection with the blockade of the bundle of His. In this case, the impulse conduction through the myocardium is disrupted, which means that there is a risk of sudden cardiac arrest. This situation requires urgent intervention by a cardiologist and treatment in a specialized hospital.

With the development of this pathology, EOS can be rejected both on the left and on the right, depending on the localization of the process. The cause of the blockade can be myocardial infarction, an infectious lesion of the heart muscle, as well as taking certain drugs. A conventional electrocardiogram allows you to quickly make a diagnosis, and therefore, enable the doctor to prescribe treatment, taking into account all important factors. In severe cases, it may be necessary to install a pacemaker (pacemaker), which will send impulses directly to the heart muscle and thereby ensure the normal functioning of the organ.

What to do if the EOS is changed?

First of all, it is worth considering that, in itself, the deviation of the axis of the heart is not the basis for making a particular diagnosis. The position of the EOS can only give impetus to a closer examination of the patient. With any changes in the electrocardiogram, one cannot do without consulting a cardiologist. An experienced doctor will be able to recognize the norm and pathology, and also, if necessary, prescribe an additional examination. This may be echocardioscopy for a targeted study of the state of the atria and ventricles, blood pressure monitoring and other techniques. In some cases, consultation is required related specialists to decide on the further management of the patient.

Summing up, several important points should be highlighted:

The normal value of EOS is the interval from +30 to +70 °.

Horizontal (from 0 to +30°) and vertical (from +70 to +90°) position of the axis of the heart are valid values and do not talk about the development of any pathology.

Deviation of the EOS to the left or right may indicate various disorders in the conduction system of the heart and need to be consulted by a specialist.

The change in the EOS, revealed on the cardiogram, cannot be set as a diagnosis, but is a reason to visit a cardiologist.

The heart is an amazing organ that ensures the functioning of all systems of the human body. Any changes occurring in it inevitably affect the work of the whole organism. Regular examinations of the therapist and the passage of an ECG will allow timely detection of the appearance serious illnesses and avoid the development of any complications in this area.

The cardiovascular system is a vital organic mechanism that provides various functions. For diagnosis, various indicators are used, the deviation of which may indicate the presence of a pathological process. One of them is the deviation of the electrical axis, which can indicate various diseases.

Characteristics of the electrical position of the heart

The electrical axis of the heart (EOS) is understood as an indicator that reflects the nature of the flow of electrical processes in the heart muscle. This definition widely used in the cardiology field, especially with. The electrical axis reflects the electrodynamic abilities of the heart, and is almost identical to the anatomical axis.

The definition of EOS is possible due to the presence of a conducting system. It consists of tissue sections, the components of which are atypical muscle fibers. Their distinguishing feature is enhanced innervation, which is necessary to ensure the synchrony of the heartbeat.

The type of heartbeat of a healthy person is called, since it is in the sinus node that a nerve impulse occurs, which causes compression of the myocardium. In the future, the impulse moves along the atrioventricular node, with further penetration into the bundle of His. This element of the conduction system has several branches into which the nerve signal passes, depending on the heartbeat cycle.

Normally, the mass of the left ventricle of the heart exceeds the right one. This is due to the fact that this organ is responsible for the release of blood into the arteries, as a result of which the muscle is much more powerful. In this regard, the nerve impulses in this area are also much stronger, which explains the natural location of the heart.

The position axis can vary from 0 to 90 degrees. In this case, the indicator from 0 to 30 degrees is called horizontal, and the position from 70 to 90 degrees is considered the vertical position of the EOS.

The nature of the situation depends on individual physiological characteristics in particular body structure. Vertical OES is most often found in people who are tall and have an asthenic body constitution. The horizontal position is more typical for short people with a wide chest.

The heart, like any other human organ, is controlled by packets of impulses coming from the brain through nervous system. Obviously, any violation of the control system leads to serious consequences for the body.

The electrical axis of the heart (EOS) is the total vector of all impulses observed in the conducting system of this organ in one cycle of contraction. Most often it coincides with the anatomical axis.

The norm for the electric axis is the position in which the vector is located diagonally, that is, directed down and to the left. However, in some cases this parameter may deviate from the norm. According to the position of the axis, a cardiologist can learn a lot about the work of the heart muscle and possible problems.

Depending on the physique of a person, there are three main values ​​​​of this indicator, each of which, under certain conditions, is considered normal.

• In most patients with a normal physique, the angle between the horizontal coordinate and the vector of electrodynamic activity is from 30° to 70°.
• For asthenics and thin people, the normal value of the angle reaches 90 °.
• In short, dense people, on the contrary, the value of the angle of inclination is less - from 0 ° to 30 °.

Thus, the position of the EOS is affected by the constitution of the body, and for each patient the norm of this indicator is relatively individual.

The possible position of the EOS is shown in this photo:

Reasons for change

By itself, the deviation of the vector of electrical activity of the heart muscle is not a diagnosis, but may indicate, among other things, serious disorders. Its position is influenced by many parameters:

• organ anatomy, leading to hypertrophy or;
• malfunctions in the conductive system of the organ, in particular, which is responsible for conducting nerve impulses to the ventricles;
• cardiomyopathy due to various reasons;
• chronic heart failure;
• persistent hypertension for a long time;
• chronic respiratory diseases, such as obstructive pulmonary disease or bronchial asthma, can lead to a deviation of the electrical axis to the right.

In addition to the above reasons, temporary EOS deviations can cause phenomena that are not directly related to the heart: pregnancy, ascites (accumulation of fluid in the abdominal cavity), intra-abdominal tumors.

How to determine on the electrocardiogram

The EOS angle is considered one of the main parameters that is studied at. For a cardiologist, this parameter is important diagnostic indicator, whose anomalous value clearly indicates various disorders and pathologies.

By studying the patient's ECG, the diagnostician can determine the position of the EOS, considering teeth of the QRS complex, which show the work of the ventricles on the graph.

An increased amplitude of the R wave in I or III chest leads of the graph indicates that the electrical axis of the heart is deviated to the left or right, respectively.

In the normal position of the EOS, the greatest amplitude of the R wave will be observed in the II chest lead.

Diagnosis and additional procedures

As mentioned earlier, EOS deviation to the right on the ECG is not considered a pathology in itself, but serves diagnostic sign dysfunction in its functioning. In the vast majority of cases this symptom suggests that the right ventricle and/or right atrium abnormally enlarged, and finding out the causes of such hypertrophy allows you to make a correct diagnosis.

For more accurate diagnosis, the following procedures can be used:

• ultrasound is a method with the highest information content showing changes in the anatomy of an organ;
• chest x-ray may reveal myocardial hypertrophy;
• apply if, in addition to EOS deviation, there are also rhythm disturbances;
• ECG under stress helps in the detection of myocardial ischemia;
• coronary angiography (CAG) diagnoses lesions coronary arteries, which can also lead to the slope of the EOS.

What diseases are caused

A pronounced deviation of the electrical axis to the right can signal the following diseases or pathologies:

• Cardiac ischemia. , characterizing the blockage of the coronary arteries that feed the heart muscle with blood. With uncontrolled development leads to myocardial infarction.
• congenital or acquired. This is the name given to the narrowing of this large vessel, which prevents the normal exit of blood from the right ventricle. Leads to increased systolic blood pressure and consequently to myocardial hypertrophy.
• Atrial fibrillation. Random electrical activity of the atria, which, as a result, can cause a cerebral stroke.
• Chronic cor pulmonale. Occurs when there is a malfunction of the lungs or pathologies of the chest, which lead to the inability of the left ventricle to fully work. Under such conditions, the load on the right ventricle increases significantly, which leads to its hypertrophy.
• Atrial septal defect. It is expressed in the presence of holes in the septum between the atria, through which blood can be discharged from the left side to the right. As a result, heart failure and pulmonary hypertension develop.
• mitral valve stenosis- between the left atrium and the left ventricle, which leads to difficulty in diastolic blood flow. Refers to acquired vices.
• Pulmonary embolism. It is caused by blood clots, which, after occurring in large vessels, move through the circulatory system and.
• primary pulmonary hypertension- blood in the pulmonary artery, which is caused by various reasons.

In addition to the above, the EOS tilt to the right may be a consequence of poisoning with tricyclic antidepressants. The somatotropic effect of such drugs is achieved by the influence of the substances contained in them on the conductive system of the heart, and thus they can harm it.

What to do

If the electrocardiogram showed an inclination of the electrical axis of the heart to the right, it should without delay, conduct a more extensive diagnostic examination at the doctor's. Depending on the problem identified during a deeper diagnosis, the doctor will prescribe the appropriate treatment.

The heart is one of the most important parts human body, and therefore his condition should be the subject of increased attention. Unfortunately, it is often remembered only when it starts to hurt.

To prevent such situations, should at least stick to general recommendations for the prevention of heart disorders: eat right, do not neglect a healthy lifestyle, and at least once a year undergo an examination by a cardiologist.

If in the results of the electrocardiogram there is a record of the deviation of the electrical axis of the heart, a deeper diagnosis should be immediately carried out to determine the causes of this phenomenon.

The electrical axis of the heart is diagnostic criterion, which displays the electrical activity of the organ.

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

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

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

To resolve this problem, contact a cardiologist.

The location of the electrical axis is normal

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

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

The norm of the angle alpha EOS

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

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

: everything you need to know about it

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

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

Normal values ​​and causes of violation

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

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

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

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

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

Diagnostics on the ECG

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

Alpha Offset Detection

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

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

Visual Definition

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

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

Establishing diagnosis

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

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

Diseases that are accompanied by a levogram

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

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

Additional Research

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

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

Treatment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

EOS deviations to the left

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

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

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

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

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

EOS deviations to the right

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

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

None of the above diagnoses can be made on the basis of EOS displacement alone. The position of the axis serves only as an additional indicator in the diagnosis of a particular disease. When the axis of the heart deviates beyond normal values(from 0 to +90 degrees), you need to consult a cardiologist and a number of studies.

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

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

If the EOS is deflected to the left or to the right - what does this mean?

If the EOS is deviated to the left, what does this mean, you need to ask your doctor. The conclusion is made after examining the patient and analyzing the clinical parameter.

Using the electrical axis of the heart, cardiologists evaluate the electrical processes that set the heart muscles in motion. The direction of the EOS depends on various anatomical and physiological factors. Average rate indicator is +590. Normally, the EOS value fluctuates within +200. +1000.

The patient is examined in a specialized room, which is shielded from various electrical interferences. The patient takes a supine position, a pillow is placed under the head. To take an ECG, electrodes are applied. The data is recorded during quiet breathing. At the same time, the device registers the frequency and regularity of heart contractions, including the position of the EOS and other parameters.

In a healthy person, the deviation of the electrical axis of the heart to the left is allowed when:

• deep exhalation;
• change in body position;
• body features (hypersthenic).

EOS shifts to the right in a healthy person with:

• the end of a deep breath;
• body features (asthenic).

The location of the EOS is determined by the mass of 2 parts of the ventricle. The definition of the indicator under consideration is carried out by 2 methods.

In the first case, the specialist detects a shift in the alpha angle. The value of the main indicator is calculated using a special table according to Died.

In the second case, the specialist compares the R and S waves in leads 1 and 3. A sharp deviation of the EOS in any direction is not an independent pathology.

The electrical axis, shifted to the left, indicates the following problems:

• left ventricular hypertrophy;
• impaired functioning of the left ventricular valve;
• cardiac block.

The above phenomena lead to incorrect work of the left ventricle. Any deviation of the EOS indicates pathologies such as ischemia, CHF, congenital heart disease, heart attack. The blockade of the conduction system of the main organ is associated with the intake of certain medications.

If a deviation of the electrical axis to the left is registered on the cardiogram, an additional instrumental examination of the patient is performed. It is recommended to have an electrocardiogram while walking on a treadmill or on an exercise bike. With the help of ultrasound, the degree of ventricular hypertrophy is assessed.

If sinus rhythm is disturbed, EOS is rejected, an daily monitoring Holter ECG. Data is recorded throughout the day. If the myocardial tissue is significantly hypertrophied, a chest x-ray is performed. With the help of angiography of the coronary arteries, the degree of damage to the vessels during the current ischemia is determined. Echocardioscopy allows you to determine the condition of the atria and ventricles of the heart.

Therapy of the phenomenon under consideration is aimed at eliminating the main disease. Some heart conditions are treated medical means. In addition, it is recommended to eat right and lead a healthy lifestyle.

At severe course disease requires surgical intervention. If the conduction system is seriously disturbed, a pacemaker transplant is performed. This device sends signals to the myocardium, causing it to contract.

Most often, the phenomenon under consideration does not threaten human life. But, if a sharp change in the position of the axis is diagnosed (a value greater than +900), this can lead to cardiac arrest. This patient needs to be urgently hospitalized intensive care. To prevent this condition, annual scheduled examinations by a cardiologist are shown.

Axis deviation to the right is not an independent pathology, but is a diagnostic symptom of a disorder in the functioning of the main organ. Most often, such a clinic indicates an abnormal increase in the right atrium or ventricle. After finding out the exact cause of the development of this anomaly, the doctor makes a diagnosis.

If necessary, the patient is prescribed additional diagnostics:

1. 1. Ultrasound - provides information about changes in the anatomy of the main organ.
2. 2. Chest x-ray - reveals myocardial hypertrophy.
3. 3. Daily ECG - performed with concomitant rhythm disturbance.
4. 4. ECG during exercise - helps to detect myocardial ischemia.
5. 5. CAG - is carried out to diagnose the lesion of the CA.

Axis deviation to the right can be triggered by the following pathologies:

1. 1. Ischemia is an incurable pathology in which there is a blockage of the coronary arteries. If left untreated, the disease can lead to myocardial infarction.
2. 2. Acquired or congenital stenosis of the pulmonary artery - due to the narrowing of the vessel, the normal outflow of blood from the right ventricle stops, which provokes an increase in blood pressure.
3. 3. Atrial fibrillation - can provoke a brain stroke.
4. 4. Chronic cor pulmonale - observed with impaired lung function, pathology of the chest. Under such conditions, hypertrophy can develop.
5. 5. The presence of a hole in the septum between the atria, through which blood is ejected from left to right. This provokes the development of heart failure.
6. 6. Valve stenosis - manifests itself as a narrowing of the opening between the left ventricle and the corresponding atrium, which makes diastolic blood flow difficult. This pathology is acquired.
7. 7. Thromboembolism of the pulmonary artery - provoked by blood clots that occur in large vessels. Then they move through the system, blocking the artery and its branches.
8. 8. Primary pulmonary hypertension, which is accompanied by high blood pressure caused by various reasons.

Axis tilt to the right is a consequence of poisoning with a tricyclic antidepressant. The somatotropic effect of these drugs is observed due to the presence in them of substances that affect the conductive system of the heart. If the ECG diagnosed a deviation of the axis to the right side, a deeper diagnosis of the patient is required.

There is a direct relationship between the anatomical position of the main organ and the EOS of the QRS complex. This relationship is confirmed by the effect of respiration. When inhaling, the diaphragm lowers, the heart changes its position, which provokes a shift of the EOS to the right. In patients with emphysema, the anatomical position of the main organ is observed. On the contrary, when exhaling, the diaphragm rises, the heart occupies horizontal position shifting the axis to the left.

There is also a direct influence of the direction of ventricular depolarization on the EOS value. This phenomenon is confirmed by partial blockade of the LBPH. In this case, the impulses propagate along the upper left ventricle, which provokes a deviation of the axis to the left.

If the value of the parameter in question in a newborn baby deviates from the norm to the right, there is no pathology.

Doctors do not consider this condition as right ventricular hypertrophy. This is explained by the fact that the deflection angle +100 - normal phenomenon observed in many newborns. This is especially true for those who live in harsh climatic conditions and in the mountains.

But the deviation of the axis to the right in the baby may be associated with the blockade of the LBPH. Therefore, when identifying the considered diagnostic symptom a complete examination of a small patient is carried out.

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Deviation of the electrical axis of the heart to the left

Deviation of the electrical axis of the heart to the left - this conclusion of a specialist during the decoding of the cardiogram can seriously scare the patient. After all, a person who is far from medicine is unlikely to know what the electrical axis of the heart is, but the word "deviation" will alert anyone.

Let's see what this conclusion implies, and whether it is worth sounding the alarm if a shift in the cardiac electrical axis is observed on your cardiogram.

1 Cardiac axis and ECG

Deviation of the electrical axis of the heart to the left

The human heart has the ability to contract. Electrical impulses sequentially cover the cardiac chambers, originating in the atrial sinus node. If we represent the course of these impulses in the form of directed vectors, then we can see that they have a similar direction. By summing the directions of the vectors, you can get one main vector. This will be the electrical axis of the heart (EOS).

Doctors of functional diagnostics determine the EOS according to the cardiogram, often visually, but it is more accurate to do this using special tables. If you carefully look at the QRS complex in leads I, II, III on the ECG, you can see that R II> RI> R III, which means that the EOS on the cardiogram is normal.

If it is difficult for a doctor to visually determine the axis of the heart, he determines the alpha angle, and calculates the EOS from special tables. Without delving into the course of measurements, we note that for a normal EOS, the alpha angle (RII> RIII, then the doctor’s conclusion will be as follows: deviation of the electrical axis of the heart to the left. EOS deviation is confirmed when the alpha angle is in the range from 00 to -900.

2 When does the axis of the heart "walk to the left"?

Sharp deviation of the electrical axis of the heart to the left

The conclusions of the doctor of functional diagnostics about the deviation of the cardiac axis to the left are not an independent diagnosis. But they always give reason to wonder why the axis of the heart "went to the left." A slight displacement of the EOS up to -190, as well as its semi-vertical position, in some cases is not considered a pathology. This position of the axis can be observed in healthy, tall, thin people, in athletes with a trained heart, in asthenic children, with a high standing dome of the diaphragm.

If the cardiac axis is significantly deviated to the left side, then this pathological condition indicates problems with the heart, the cause of such a shift must be established. After all, this symptom can sometimes be the first "bell" in the pathology of the heart and blood vessels. According to some reports, the deviation of the electrical axis of the heart to the left is sometimes called a slight deviation, and if the angle is from -450 to -900, they speak of a sharp deviation.

3 Pathological causes of EOS shift to the left

Pathological conditions in which there is a displacement of the cardiac axis to the left

As mentioned above, a slight deviation of the EOS to the left can be considered by doctors as a variant of the norm, if, upon a more thorough examination, the doctor did not reveal any diseases in the patient and the patient is in good health. If the EOS deviates significantly to the left, or with small ECG changes, the patient has health problems, the following pathological conditions should be suspected, in which displacement to the left of the cardiac axis is most common:

4 Left ventricular hypertrophy

The deviation of the cardiac axis to the left with an increase in the left ventricle is quite understandable, because physiologically this chamber of the heart is already the most powerful in terms of mass. And this means that the vector of the heart will “take over” exactly the left ventricle. And the more it will increase in size and grow, the more the EOS will “go to the left”. This pathology occurs at high pressure or arterial hypertension, when the chambers of the heart, unable to withstand high blood pressure and loads, begin to gain weight compensatory - to hypertrophy. Hypertrophy as one of the symptoms occurs in heart failure, atherosclerotic vascular changes, angina pectoris, cardiac asthma, cardiomyopathies.

5 Conduction disorders

Blockade of the left leg of the Bundle of His

Disturbances in the conduction system will lead to a change in the cardiac vector and a deviation of the cardiac axis. Most often this is observed with the blockade of the left leg of the Bundle of His, or with the blockade of its anterior-superior branching. There are other ECG signs, thanks to which this type of arrhythmia can be diagnosed. Holter monitoring of the ECG will also help in establishing the diagnosis.

6 Special forms of ventricular tachycardia

Some forms of ventricular tachycardia can also cause EOS values ​​to be far from normal.

7 Heart defects

Heart defects, the ECG symptom of which can be a left-sided axis of the heart, by their nature can be both congenital and acquired. Defects of any etiology, accompanied by an overload of the left heart sections, will be characterized by this ECG symptomatology.

Based on the above reasons for the deviation of the EOS, we can conclude that the displacement to the left of the cardiac axis is not such a harmless ECG sign. It may indicate the presence of serious problems in the patient's body. But at the same time, don't panic! At good health a patient with a stable ECG for several years, in the absence of supporting data on pathological changes in the heart and blood vessels after a thorough examination, a slight deviation of the cardiac axis to the left may be a variant of the norm! But the conclusion that this is the norm can be made by a doctor after a thorough examination of the patient, and in the absence of data on the pathology of the cardiovascular system. What examinations should be prescribed by a doctor who diagnosed a patient with a displacement to the left of the axis of the heart?

8 A set of examinations to clarify the diagnosis

Removal of a repeated cardiogram

1. Repeat ECG. It is obligatory to take a repeated cardiogram, especially if the displacement of the EOS was detected for the first time and the previous ECGs were normal. An error in the application of electrodes, which may show a distorted result, or a malfunction of the cardiograph, is not ruled out. It is also always necessary, if possible, to compare the "fresh" ECG with the previous cardiogram, to assess the dynamics of the patient's condition, to track changes in the work of the heart.
2. Ultrasound of the heart. The most informative way to tell about the state of the heart, its chambers, cardiac ejection fraction, about the course of blood through the heart cavities, can be ultrasound or echocardiography. This method of examination can be supplemented, if necessary, with dopplerography.
3. Holter ECG. If the doctor suspects a patient of conduction disorders or rhythm disturbances, then Holter ECG monitoring will become a faithful assistant in making a diagnosis. Daily recording of the cardiogram will allow the doctor to "catch" the arrhythmia, to see in which part of the heart the conductivity is changed. To ensure that Holter data are not distorted, the patient should be given detailed instructions on how to behave during the study.

Ambulatory blood pressure monitoring

It should be understood that the deviation of the EOS to the left is not a diagnosis, but an ECG sign, which can be both a variant of the norm and a symptom of numerous diseases. The conclusion about what information this symptom carries can only be made by a doctor after a complex of diagnostic procedures.

9 Should an axle bent to the left be treated?

Is treatment necessary?

As the only isolated ECG sign - no. If this symptom is one of the others in the presence of a disease in the human body, the disease, of course, must be treated. The tactics of treatment depends directly on the disease that caused changes in the direction of the cardiac axis. With hypertension, which led to an increase in the left ventricle, adequate selection is necessary. antihypertensive drugs. With arrhythmias - antiarrhythmic medicines, or, if there are indications, implantation of an artificial pacemaker. With diagnosed heart defects - surgical treatment according to indications.

Sinus bradycardia deviation of eos to the left

What is the electrical axis of the heart?

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. main organ is three-dimensional, and in order to correctly determine the direction of the EOS (which means the electrical axis of the heart), you need to imagine the human chest as a system with some coordinates that allow you to more accurately set the angle of displacement - this is what cardiologists do.

Features of the conductive system

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

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

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

Parameters in healthy people

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

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

What positions of the electric axis exist:

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

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

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

Since the features of the body composition are different for people, 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 axis of the heart can deviate from normal values ​​(semi-vertical state or semi-horizontal position).

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

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

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

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

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

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

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

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

• Pathological processes in the tricuspid valve.
• Stenosis and narrowing of the lumen of the pulmonary artery.
• Pulmonary hypertension. This violation often occurs against the background of other ailments, such as obstructive bronchitis, organ damage emphysema, 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 that a change in the electrical position of the heart is a consequence of ventricular hypertrophy. In itself, such a disorder is not considered a disease, it is a sign of another pathology.

Norms in children

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

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

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

Symptoms

A change in the direction of the electrical axis cannot cause discomfort in a person. Feeling unwell usually provokes hypertrophic damage to the myocardium, if they are accompanied by severe violations hemodynamics, and also lead to the development of heart failure, which is very dangerous and requires treatment.

• pain in the head and chest area;
• breathing problems, shortness of breath, choking;
• swelling of the tissues of the lower, upper limbs and areas of the face;
• 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 you experience these symptoms, you should immediately consult a doctor, as cardiac problems extremely dangerous.

Diagnosis and treatment

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

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

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

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

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

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

What is sinus rhythm on an ECG

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

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

What is sinus rhythm

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

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

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

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

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

What are the criteria for deciphering the result of the ECG

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

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

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

What sinus rhythm problems can be seen on an ECG

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

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

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

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

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

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

What can be said about the indicators of the norm

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

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

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

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

Because of what, ECG readings may deviate from the norm

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

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

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

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

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

Why should a person undergo an ECG study?

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

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

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

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

If the sinus rhythm is within the normal range, then take additional tests and do not need to be retested. Normal work of the heart, as well as pathological deviations, is always recorded by a cardiogram.

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