ECG interpretation in adults. Normal table: sinus rhythm, the parameters in the MS GMZH, pathology

An electrocardiogram is one of the most popular and affordable ways to diagnose heart disease in adults and children. The essence of the EKG method around the electrical impulses that radiate the heart, as well as display them on a recording paper.

Decoding results allows you to set the heart activity and myocardial structure. Independently decipher cardiogram difficult, which is why it is important to consult a specialist cardiologist.

Why conduct research ECG

cardiogram on the direction given in the following cases:

1. Pain in the heart, the presence of shortness of breath while walking.
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2. If there are signs of arrhythmia, coronary artery disease, myocardial infarction.
3. Before carrying out a series of operations, not only in the heart, but also in other important organs.
4. In the presence of external diseases (ear, nose and throat), which give a complication of heart.
5. During the medical examination of pilots, athletes and drivers.
6. To register activity of the heart.
7. For the diagnosis of diseases with symptoms irregular heartbeat, dizziness, fainting.
8. To adjust the operation of pacemakers and implants.
9. Cardiogram recommend to do every year to men and women after 45 years.
10. During pregnancy.

Disadvantages ECG study

Status information is relevant only at the time of validation and may be unreliable. The result is influenced by many factors, making a controversial procedure. For more complex diagnostics of diseases, physicians prescribe daily monitoring.

Types of ECG tests

To perform a standard procedure used by the electrocardiograph. Such devices are widely used in cardiology hospital, as well as ambulances. With the help of suction cups electrodes are attached to the human body, in the future electric potentials coming through them.

The electrodes are usually called "derivations" in the amount of their set of 6 pieces. Leads attached to the extremities are considered essential and are designated-I, II, III and aVL, aVR, aVF. On the chest electrodes marked labeled V1-V6.

Each type of abduction has a specific task, so separate factors give different values. The doctor is necessary to connect all the information into one or decrypt cardiogram.

The graph is displayed on a special graph paper. For each lead has to his schedule. In the standard application set belt speed of 5 cm / c, it can be adjusted if necessary.

Holter

In contrast to the standard procedure, the duration of a few minutes, during Holter monitoring information is recorded during the day. Duration of the procedure due to the need to obtain a complete picture of the processes occurring in the heart. This procedure is able to take readings, not only during the human mind, but also during exercise.

Some diseases are difficult to detect during a routine ECG, since deviations can appear only during activity.

Other types of procedures

Funds are also specific procedures for obtaining the ECG:

1. Monitoring with exercise. This way it is easier to establish the pathology of the heart. treadmill used for such monitoring, it helps to give your body the required load. Apply the procedure in situations where the pathology manifested only during the accelerated heart.
2. Phonocardiography. It can be studied by this method not only the electrical parameters, but also the noise arising in the heart area. According to the method used in the diagnosis of heart disease.

When and who appoints the study

The sheet with the direction to the cardiogram is issued by the attending physician or cardiologist. If there are complaints or problems with the heart, should immediately go to the hospital for examination. This procedure allows you to check the condition of the heart, as well as to determine the presence of abnormalities.

With the help of the ECG can identify a number of specific pathologies:

• formation in cardiac expansion chamber;
• changes in the size of the heart muscle;
• development of necrosis in the tissues of myocardial infarction;
• ischemic injury to the myocardium wall.

How to prepare for the study

ECG (transcript in adults involves the exact procedure depends on the outcome of that treatment) is conducted after the explanation the doctor basic nuances of training, the results of the study were the most correct:

• a few days before the ECG should abandon the use of alcoholic beverages;
• on the day of the procedure, it is desirable not to smoke;
• The procedure is recommended to do on an empty stomach;
• abandon the physical activities the day before the ECG;
• avoid stress and overwork;
• cardiogram undesirable to use medications that affect heart function;
• You can not drink coffee and other caffeinated beverages before the test;
• junk food and caffeine adversely affect the functioning of the heart, teaching the heartbeat, which affects the ECG;
• before the ECG is not desirable to put on body fat lotions and oil gels. Components in cosmetics, may hinder the passage of pulses between the sensor and the body;
• choosing clothes, preference should be given ample jackets and pants that easily can be wrapped or removed;
• on the procedure, all metal jewelry must be removed.

Modern medicine allows you to easily and safely explore the work of the heart. To do this, in the case of sickness or to prevent a person refers to a cardiologist for a referral to the analysis.

ECG is performed in a specially equipped room in which is placed an electrocardiograph. Modern devices are equipped with thermal transfer element, replaces the conventional ink setting. With the help of the thermal effect on the paper appears ECG curve.

The cardiograph latest models, the result is not immediately printed on paper, but remains on the screen. Using the software, the device itself decrypts performance and saves data to disk or a flash drive.

Einthoven developed a device for the first time in 1903. Since cardiograph got a lot of changes and improvements, but the operating principle remains the same. device features a multichannel device allows to display immediately results from multiple leads.

The 3-channel decoding apparatus first passes standard leads (I, II, III), then separating aVL, aVR, aVF extending from the extremities, and at the end of the pectoral.

Venues for ECG is usually placed away from electromagnetic fields and X-ray irradiation. In the treatment room, the patient lie down on a flat couch. Must be removed clothes to the laundry, or open space for attaching the electrodes.

The electrodes are made in the shape of a pear on suckers. Depending on the number of channels in cardiography, wire colors may be white or colored.

In multichannel marking devices operate as follows:

1. V1-carried red;
2. V2-wire yellow;
3. V3-conductive green;
4. V4-wire brown;
5. V5-conductive black;
6. V6-wire blue.

Before starting the procedure, the physician should check the quality of the adjacent electrodes to the body. Skin should be clean and free of sweat and secretions oily film. Part of the bottom electrode is applied to the lower leg and foot. For mounting on a limb, the suction cup are in the form of plates. Their goal-registration standard leads.

Each fixture has a certain color, which helps to avoid confusion in the study. Red wire is attached to the right wrist, yellow, to the left, in an area where actively palpable pulse at the bottom left limb clings green electrode, and the right-black.

In the study of ECG, right foot does not take part in the readings. Therefore, the electrode to it cling to the ground.

On the cardiogram output gear diagram of a cycle which is responsible for the condition of the heart muscle at impact and during the holidays. Such a scheme is called a heart-cycle for each lead is usually observed to 5 cycles. These indications are standard for conventional ECG, but in the case of symptoms of myocardial infarction or other heart disease, these cycles can be several times more.

After printing the ECG, the person is freed from the suction cups. The resulting paper signed and left for analysis. In specific cases, a cardiogram is prescribed after exercise. To obtain correct results, the readings are taken before and after exercise.

ECG norms

ECG (transcript in adults includes a set of indicators with a valid interval) is performed according to the values ​​that indicate a healthy state of the cardiac system.

Metric	Range of permissible values
P	0,05-0,12 with
T	0,14-0,27 with
Q	with 0.04-0.06
QRS	0,07-0,3 with
HR	63-85 beats / min
PQ	0,11-0,19 with

Contraindications

In most cases, the procedure is performed for all, including for small children. Abandon the ECG is necessary only in case of violation of the skin in places of attachment of electrodes. It should be remembered that the emergency hospitalization cardiogram removed in any case.

Which may affect the ECG result

The reliability of the data affected by such indicators:

• improper attachment of the device to the human body, in some cases, the wiring can move away in the process of obtaining the ECG;
• in the presence of residues on the skin lotion, soap tools and other components which leave a protective film;
• transfer of high stress on the eve of the procedure;

  

• reception on the eve of antidepressants, nootropics and sedatives;
• when experiencing fear or medical procedures;
• if a person is in a hurry to the hospital, resulting in a significantly accelerated heartbeat.

Before going on the treatment table, a person must spend 10-15 minutes in a relaxed atmosphere. It is important that people are not worried about his heart rate was within the prescribed limits.

Decoding results

ECG (decoding occurs in adults, taking into account three indicators: reductions interval segment factors and the amount of teeth) indicates a risk of developing an arrhythmia.

heart sinus rhythm

This factor is responsible for the systematic movement of both atria, which are active under the influence of sinus action. It can be used to study how cardiac departments operate correctly displays the correct operation of the tension and relaxation of the heart muscle.

Highest teeth in the diagram are responsible for the state of rhythm. Normally the spacing between the vertices should be standard or not vary by more than 10%. Otherwise an arrhythmia.

HR

The heart rate is referred to in a simple understanding, like pulse, move find ECG study. To do this, take the speed of the ECG, and the size of the interval between the high peaks.

Typically, the process speed is 25, 50 and 100 mm / s. The frequency is determined by multiplying the recording length for the segment length.

conductivity

This factor indicates the status of the pulse transmission. In the normal state, pulses are transmitted with the same sequence.

The teeth on the ECG sections are decoded as follows:

1. Shows P- process atrium working. It can be used in the reaction quality atrial pulses passing. The correct interpretation of the wave height not more than 2.4-2.7 mm, the apex has a rounded tip and a cycle length of less than 0.1-0.3 seconds. In some pathologies end tooth has a sharp end, which shows the expansion part of the myocardium.
2. Q, S-informed a partition condition in the cardiac system. Normally the Q-value is negative, lasting up to 0.03 s. S denotes the end of ventricular excitation. This negative index, the depth should not exceed 2 mm.
3. R-feature ventricle in an excited state.
4. T-state ventricles alone. Normally, the height factor T must be part of a third prong R. The top of a smooth shape, the length of 0,15-2,3 with. The higher the value, the more likely the presence of autonomic disorders of the heart.
5. interval RQ It indicates the duration of the pulse.
6. QRST-time for which the reduced area of ​​the ventricle.
7. ST-time transition ventricular stimulation.
8. TP-duration diastole cardiac region.

What heart disease can be determined by ECG

ECG (transcript in adults may indicate a number of pathologies) indicates the dangerous diseases that require urgent intervention.

1. Tachycardia. The disease, which is characterized by an increase in heart rate, regardless of the human condition. Availability pathologies characterized by decreasing the distance between the intervals, and the RS-T shift.
2. Angina. The ECG noticeable surges in T wave amplitude also varies factors S-T.
3. Arrhythmia - characterized by impaired activity of the heart rate and pulse shaping. In this case, changing the distance between the R-R interval, and varies interval P-Q and Q-T.
4. Bradycardia. During this disease the patient has a pulse slows. With a reduced set of ECG rhythm, and significant gaps are seen between the segments. The amplitude of the teeth becomes uneven.
5. Myocardial infarction. In this case, there is no ECG wave R. S-T segment is above the isoline and the T-value is negative.
6. Arrythmia. It is characterized by a change in heart rate. The ECG was isolated strain in the teeth image QRS, as well as offline factor P.

What if the detected abnormality

It is not always the first received ECG reflects the true picture of the patient's heart. That is why after the results, it is recommended to pass a second test. Part of heart disease are not detected during routine examination and require more precise analyzes.

After receiving the bad results should be reconsidered some of the subtleties:

1. The time of day when the ECG was performed. Under the rules of procedure is performed in the morning, on an empty stomach.
2. Emotional condition. If a person is under stress or worry about it should know the doctor, so that the ECG results did not change for the worse.
3. It should be recalled, was whether the meal before the first ECG. This innocuous factors can greatly affect the readings, especially if the patient has consumed alcohol, fatty foods or coffee.
4. In some cases, during the procedure may extend over the electrodes, which dramatically affects the transcript.

Problems with the heart rhythm may be present in the lives of healthy people, which is the norm. Therefore, when a negative result should not be just discouraged, because as the heart organ sensitive and it takes a lot of study time.

Given these factors, it is necessary to revise a past procedure. In any case, the presence of symptoms or complaints, patient returned for re ECG. Deciphering ECG in adults is a difficult and laborious task. From a specialist is needed the correct concept of angles and components. It should be remembered that the indications and the result can be affected by different values.

Registration of the article: Mila Friedan

Video decoding of ECG

How to decipher an electrocardiogram: