Horizontal position of the electrical axis of the heart in a child. Sinus arrhythmia vertical position of the eos in a child

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

Article publication date: 05/14/2017

Article updated date: 07/29/2019

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

The electrical activity of the heart is recorded using an ECG. Sensors are placed on different areas of the chest, and to find out the direction of the electrical axis, it (the chest) can be represented as a three-dimensional coordinate system.

The direction of the electrical axis is calculated by the cardiologist during the course. 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. Next, it takes the two obtained numbers and calculates the alpha angle using a special table. It's called the Diede table. This angle is the criterion by which it is determined whether the location of the electrical axis of the heart is normal.

EOS offsets

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

To resolve this problem, consult a cardiologist.

The location of the electrical axis is normal

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

The standard alpha angle is from 0 to +90 degrees.

Norm of angle alpha EOS

The location of the anatomical and electrical axes depends to some extent on body type. In asthenics (thin people with tall stature and long limbs), the heart (and, accordingly, its axes) is located more vertically, while in hypersthenics (short people with a stocky build) it is more horizontal.

Normal alpha angle depending on body type:

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

A deviation to the left is indicated by a minus alpha angle: from -90 to 0 degrees. About its deviation to the right - values ​​from +90 to +180 degrees.

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

Reasons for shift to the left

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

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

Causes of these pathologies:

LVH	Block of the anterior branch of the left bundle branch
Chronically high blood pressure	Myocardial infarction localized in the left ventricle
Stenosis (narrowing) of the aortic mouth	Left ventricular hypertrophy
Insufficiency (incomplete closure) of the mitral or aortic valves	Calcification (accumulation of calcium salts) in the conduction system of the heart
Cardiac ischemia (atherosclerosis or coronary artery thrombosis)	Myocarditis (inflammatory process in the heart muscle)
Hypertrophic cardiomyopathy (pathological enlargement of the heart)	Dystrophy (inferiority, underdevelopment) of the myocardium

Symptoms

EOS displacement itself does not have characteristic symptoms.

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

However, sometimes these diseases still make themselves felt.

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

But let us repeat once again - symptoms do not always appear; they usually develop late stages diseases.

Additional diagnostics

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

After a detailed examination, appropriate therapy is prescribed.

Treatment

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

All measures are aimed at eliminating the underlying disease, which is manifested by displacement of the EOS.

Treatment for LVH depends on what caused the myocardial growth

Treatment of blockade of the anterior branch of the left bundle branch - . If it occurs as a result of a heart attack, surgical restoration of blood circulation in the coronary vessels is required.

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

The electrical axis of the heart is a conditional vector relative to which the organ is located in the human body. In its direction, the bioelectric processes that occur in the myocardium during heart contraction spread. The concept is used in the analysis of electrocardiograms.

Mechanism of electrical processes

The emergence of motion (electrical) potentials in the tissues of the human body is associated with a change in charge on the inner and outer surfaces of cell membranes. In the heart muscle (myocardium), this process occurs in muscle fibers. Charge transfer occurs during the transport of K+ and Na+ ions.

Potassium cations predominate in the cell cytoplasm, and sodium cations predominate in the extracellular fluid. When the heart is at rest, a positive charge accumulates on the outer surface of the cytolemma, and a negative charge on the inner surface. When an electrical impulse occurs, the permeability of the membrane increases and the flow of Na+ rushes into the cell from the pericellular space. An increase in the number of positively charged particles in the cytoplasm also positively charges the inside of the membrane.

Accordingly, more anions remain outside and the outer surface of the biomembrane becomes negatively charged. Membrane depolarization occurs. Reverse transport is also observed: when K+ leaves the cell, the outer membrane again acquires a positive charge, and the inner one, accordingly, a negative one, that is, repolarization of the cell membrane occurs.

All the described processes accompany systole - contraction of the heart muscles. The return to the initial charge distribution - outside "-", inside "+" - is accompanied by relaxation of the myocardium - diastole. The depolarization process, like a chain reaction, spreads to the entire muscular layer of the heart.

An electrical impulse is generated in the pacemaker - the sinus nerve node. From it, excitation passes through the conduction pathways into the atria. From there it spreads to the atrioventricular ganglion. The node inhibits the electrical impulse so that contraction of the ventricles follows immediately after relaxation of the atria. From the atrioventricular node, the electrical impulse migrates along a cluster of nerve fibers, the so-called bundle of His. It is localized in the septum between the ventricles and is dichotomously divided, forming “legs”. The left leg, in turn, is divided into anterior and posterior branches. The latter are divided into Purkin fibers connected into a network.

When the heart muscles are excited, bioaction potentials arise - electrical currents that are characteristic of all muscles of the body. Their occurrence is recorded using an electrocardiograph and recorded on a special tape in the form of an electrocardiogram (ECG).

Coronary angiography of the heart vessels - what is it and how is it done?

Electrical processes on the electrocardiogram

On an ECG, electrical impulses are reflected in the form of multidirectional waves. Positive waves (directed upward relative to the horizontal axis) are designated P, R, T, and negative waves are designated Q and S. Atrial excitation is described by the magnitude of the P peak. Figure P-Q characterizes the process of impulse passage through the atrioventricular node to the ventricles of the heart.

The Q peak describes the process of depolarization of the septum between the ventricles. The R wave is the process of repolarization of the cytomembranes of the muscle fibers of the lower and posterior parts of the ventricles. The Q-R-S (ventricular) complex is caused by the propagation of an electrical impulse in the ventricular myocardium during atrial repolarization.

If you connect the two most prominent (with the greatest difference in potentials) peaks with a line, then it will display the EOS. In space, any body is projected onto 3 planes, including the human heart, and in each of them the EOS has a projection.

EOS tilt characteristics

When taking an electrocardiogram, electrodes are placed in three leads that record the potential difference:

• Lead I - on the left and right arm;
• Lead II - left leg-right arm;
• Lead III - left leg and left arm.

This placement forms a spatial arrangement of vectors electrical potentials on the body, called Einthoven's triangle. If you place the EOS in the Einthoven triangle, then the angle (α) between it and the horizontal left-right arm (I lead) will characterize the deviation of the EOS.

The value of α is determined from the tables, having first summed up the height of the waves (Q+R+S) in leads I and III on the electrocardiogram, and the sign of the wave is taken into account. Since the Q and S waves are located below the horizontal isotonic axis, they have a negative sign (-), the R wave located above the axis has a positive sign (+). If there is no wave on the ECG, its value is taken as 0. The diagnostician measures the size of the waves on the ECG and sums up their value. Next, substituting the resulting value into the Diede table, the value α is obtained.

This table is a square divided by a vertical and horizontal axis. There are scales on the edges of the square. The upper and lower scales correspond to lead I, and the lateral ones correspond to lead III. The scale reference point is the horizontal and vertical axis (0). To the left of it are negative values ​​from 1 to 9, to the right are positive values. The square is divided into sectors with the center at the intersection of the axes, the angles of which are measured from the axis -5+5. Above the axis are the values ​​of the angle α from 0° to 180° with a negative sign, below - with a + sign.

The EOS deviation value can be presented in the form of a table:

Without tables, you can also determine the direction of EOS deviation. It is determined visually by the degree of severity of the R and S waves in standard leads I and III. The R-type ventricular complex is characterized by a greater prominence of the R-wave, and the S-type complex, respectively, is characterized by S. If the R wave is expressed in lead I, and the S wave in lead III, then the EOS is tilted to the left. With opposite values ​​- in lead I S, and in lead III -R, the axis deviates to the right.

Electrical position of the heart

The electrical position corresponds to the location of the EOS vector relative to the “horizon axis” (lead I axis). Relative to it, the electrical position of the heart can be vertical or horizontal. In addition, doctors point out that there is a main (intermediate) position: semi-horizontal and semi-vertical.

Most often, the vertical EOS (α = ]+30° +70°[) is located in people of asthenic constitution - thin-boned, tall with low body weight. Horizontal position (α = ]0° +30°[) in hypersthenics (short, large-boned, with a large chest volume). But since they are clean constitutional types are rare, mixed types have intermediate positions of the electrical position of the heart. All listed positions are a variant of the norm.

Pathologies with deviations

Sometimes deviation of the electrical position of the heart from the vertical can be one of the signs of a number of diseases:

• GB and ischemia;
• chronic heart diseases;
• cardiomyopathy due to cardiosclerosis, heart attack, myocarditis, etc.;
• congenital pathologies anatomical structure hearts, etc.

These diseases can cause thickening (hypertrophy) of the myocardium, expansion of the cavity and disruption of the outflow of blood from the left ventricle, which causes the EOS to tilt to the left. Violation of the structure and function of the mitral valve is also accompanied by an axis tilt to the left. When analyzing the ECG together with other abnormalities, this may indicate a blockade of the anterior branch of the left bundle of Hiss.

The same pathologies in the structure and function of the myocardium can cause the heart axis to tilt to the right. Enlargement of the right ventricle of the heart may be due to pulmonary pathology. Chronic diseases respiratory system(COPD, bronchial asthma), accompanied by an increase in pulmonary vascular resistance, cause hypertrophy of the ventricular muscles.

In addition, the direction of the EOS can be influenced by the narrowing pulmonary artery and pathology of the tricuspid valve, located between the right atrium and ventricle.

Determination of right-sided deviation of the EOS may indicate a complete block of the posterior branch of the left bundle branch of His.

In children, especially under 6 years of age, the mass of the right ventricle is greater, which is due to physiological characteristics in the process of development. Therefore, a child’s ECG differs from that of an adult, and the heart axis can be located either vertically or with a deviation to the right. Thus, according to studies of healthy newborns, the tilt of the EOS to the right was +180°, and in children in the range of 6-12 years, the axis “straightened” and the deviation to the right was + 110°. These indicators correspond to the age norm.

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

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

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

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

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

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

Methods for determining the position of the EOS.

To put it simply, an ECG is a dynamic recording of the electrical charge that makes our heart work (that is, contract). The designations of these graphs (they are also called leads) - I, II, III, aVR, aVL, aVF, V1-V6 - can be seen on the electrocardiogram.

An ECG is a completely painless and safe test; it is performed on adults, children and even pregnant women.

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

Thin people usually vertical position EOS, and in dense people and obese people - horizontal position. Respiratory arrhythmia is associated with the act of breathing, is normal and does not require treatment.

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

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

Block of the branches (left, right, left and right) of the His bundle (RBBB, LBBB), complete, incomplete, is a violation of the conduction of an impulse through the conduction system in the thickness of the ventricular myocardium.

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

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

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

If you project the electrodes onto a conventional coordinate system, you can also calculate the angle of the electrical axis, which will be located where the electrical processes are strongest. The conduction system of the heart consists of sections of the heart muscle consisting of so-called atypical muscle fibers.

Normal ECG readings

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

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 diagnosing diseases. The position of the EOS itself is not a diagnosis.

These defects can be either congenital or acquired. The most common acquired heart defects are a consequence of rheumatic fever.

In this case, a consultation with a highly qualified sports doctor is necessary to decide on the possibility of continuing to play sports.

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

As in the case of the left ventricle, RVH is caused by coronary disease heart disease, chronic heart failure and cardiomyopathies.

Sinus arrhythmia vertical position eos what is it

Sinus (sinusoidal) cardiac arrhythmia

Heart rhythm disturbances quite often serve as a manifestation of various diseases, but in some cases they are not associated with a pathological process. Myocardial contraction begins automatically in the sinus node, further spreading to the atria, and then to the ventricles along the bundle branches and Purkinje fibers.

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

Causes

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

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

The causes of bradycardia can be:

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

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

Manifestations

Sinusoidal arrhythmia can produce different symptoms depending on the heart rate. As their number increases, it is noted:

• sensation of pulsation in the heart and temples;
• pain in the left half of the chest or behind the sternum due to increased load on the myocardium;
• feeling of lack of air.

If bradycardia develops, then patients complain of a feeling of cardiac arrest, weakness, and dizziness.

With moderate arrhythmia, there may be no symptoms, and the diagnosis is made based on examination data.

Diagnostics

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

In case of arrhythmia, the ECG must have a P wave, indicating that the source of contraction is the sinus node. The heart rate is usually increased or decreased. To exclude the influence of the respiratory cycle on the ECG results, during the manipulation the patient is asked to hold his breath at the height of inspiration.

To exclude organic pathologies of the heart, ECHO-CG is performed. Using ultrasound, you can determine the condition of various structures and measure the dimensions of the chambers. An invasive electrophysiological study involves stimulating or inhibiting the sinus node and assessing its response. It is not performed often and only according to strict indications.

Treatment methods

Quite often, heart rhythm disturbances go away on their own after the cause that caused them is eliminated, that is, they do not require specific treatment. However, severe sinus arrhythmia can lead to disruption of the blood supply to vital organs. Therefore, therapeutic methods and cardiac pacing can be used to treat it.

The choice of a particular drug is determined by individual characteristics and must be carried out by a doctor. For sinus tachycardia associated with stress, it is used for treatment. sedatives, including those of natural origin.

In case of arrhythmia with a heart rate of less than 45 per minute (for professional athletes less than 35 per minute), which is accompanied by a violation of central hemodynamics, it is necessary to decide on installing a pacemaker. This miniature device is placed under the skin in the subclavian area. By using special programs, an electrical impulse is conducted through the electrodes to the ventricles and atria. In this case, the device begins to work when the natural contraction frequency drops below the set critical level.

Heart rhythm disturbances are not always associated with disease; they can be caused by physiological processes and increased activity of the nervous system. Only a significant deviation from the normal heart rate can manifest as serious hemodynamic disturbances. To treat these conditions, medications or cardiac pacing are used. Preventive measures do not differ from generally accepted ones and are aimed at maintaining healthy image life.

Normal heart rate in children and adults

Sinus arrhythmia in children: treatment features

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

Definition

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

Any parent can detect arrhythmia, knowing the heart rate norms by age:

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

Expert opinion

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

Types of failure

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

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

Classifying the malfunction according to severity will help you understand what the sinus form of heart arrhythmia is in a child:

• A mild type of heartbeat disorder is a consequence of the immaturity of the nervous system. It goes away on its own and is not considered dangerous.
• A moderate form of the malfunction occurs in children 5-6 years old. It has no special symptoms, so it is detected only with the help of an electrocardiogram (ECG).
• Severe sinus arrhythmia occurs in a child. It manifests itself in fairly persistent paroxysms and bright clinical picture. Experts believe this type dangerous due to the likelihood of developing heart pathologies.

Non-hazardous forms of failure

Respiratory arrhythmia occurs in many children. It is characterized by increased heart rate when inhaling and slowing down when exhaling. A similar reflex reaction is checked during electrocardiography by placing the patient on a couch with a cold oilcloth on top. Because of its impact, the child instinctively holds his breath. In the presence of this form of arrhythmia, the heart rate will decrease slightly.

A respiratory type of heart rhythm disturbance occurs due to the immaturity of the nervous system. The frequency of attacks and their intensity depend on the age of the patient. This arrhythmia develops due to the influence of the following factors:

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

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

The severity of the failure depends on the cause of its occurrence. Arrhythmia is often caused by an inability vegetative department keep up with the active growth of the child. Over the years, this problem goes away on its own.

The functional form is not as common as the respiratory form. It is not considered dangerous, and in most cases goes away without medical intervention. Arrhythmia occurs for the following reasons:

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

A functional failure caused by the following factors is more dangerous:

• diseases caused by infections (bacterial or viral);
• impaired functioning of the thyroid gland.

Dangerous failure modes

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

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

• Hereditary predisposition is the main factor in the development of many pathologies. If mom or dad had diseases that provoked arrhythmia, then there is a possibility that they will appear in the child.
• Pathologies caused by infections, combined with acute intoxication, fever and dehydration, have a negative effect on the heart muscle. The electrolyte balance and composition of the interstitial fluid are disrupted, which causes failures in the conduction system.
• Vegetative-vascular dystonia is manifested by a dysfunction of the narrowing and dilation of blood vessels. The heart has to beat more often or more slowly, which leads to the development of arrhythmia and disruptions in hemodynamics (blood flow).
• Rheumatism affects the valve apparatus, which can cause inflammatory diseases. It has a chronic course and develops due to tonsillitis. The disease is accompanied high temperature, periodic joint pain and damage to the heart muscle.
• Inflammatory diseases of the myocardium (myocarditis, pericarditis, endocarditis), which are bacterial or viral in nature, provoke the occurrence of various arrhythmias. Often the sinus type of failure manifests itself, but sometimes more dangerous forms develop (atrial fibrillation, His bundle block). The main pathological process is accompanied by pain in the chest, high fever, swelling of the lower extremities, shortness of breath and liver dysfunction.
• Developmental defects often provoke the occurrence of a pronounced form of arrhythmia. They can only be eliminated surgically if it is not possible to stop the attacks with medications.
• Heart tumors are extremely rare, but can cause heart rate disturbances. It is treated exclusively by surgery.

Sports and sinus arrhythmia

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

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

In most cases, arrhythmia manifests itself during physical activity due to hereditary predisposition. Children who play sports professionally should periodically consult a doctor and have an ECG done every 3-4 months. If respiratory arrhythmia is detected, the child may be allowed to compete, but if its form is more severe, then the issue of terminating the athlete’s career and reducing the physical activity received will be decided.

Diagnosis and treatment

To draw up a full course of therapy, the child should be shown to a cardiologist. The doctor will examine you and prescribe the necessary tests. The main one among them is electrocardiography. It is performed in a standing and lying position, as well as with a load and during the day (daily monitoring).

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

• With hypertension, a shift to the left or a horizontal position is observed.
• Congenital lung diseases force the heart to move to the right.
• Thin people tend to have a vertical EOS, while fat people have a horizontal EOS.

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

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

Based on the results obtained, a treatment regimen is drawn up. Functional and respiratory arrhythmia cannot be eliminated with medication. Doctors give advice on lifestyle changes. The main emphasis will be on the following points:

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

The pronounced variety is eliminated by correcting nutrition, rest and physical activity in combination with drug therapy. In advanced cases, as well as in the absence of results from treatment with tablets, surgical intervention is used.

To begin with, the specialist will have to cut Negative influence factor causing arrhythmia. The following measures will help with this:

• elimination of the underlying pathological process;
• treatment of chronic infection;
• discontinuation of medications that cause heart rhythm disturbances.

Treatment regimens are supplemented with folk remedies and physiotherapeutic procedures. They are selected depending on the characteristics of the child’s body and the presence of other pathologies.

Drug treatment

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

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

Surgery

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

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

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

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

ethnoscience

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

• 300 g of dried apricots, 130 g of raisins and walnuts each must be thoroughly ground and mixed with 150 ml of honey and lemon. This paste helps cleanse the blood and improve the functioning of the heart muscle. Use it in quantities of 1 to 2 tbsp. l., depending on age (up to 3 years old, over 4 years old).
• The daily diet must be filled with fruits. They can be cut into porridges, desserts and other dishes. Instead of a regular drink, it is recommended to drink fresh juice (apple, grape).
• Pour 30 g of dry lemon balm with a glass of boiling water and let it brew for half an hour. It is advisable to drink such tea with a sedative effect for at least 2 weeks.

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

Preventive measures

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

• Compose proper diet nutrition, saturating it with herbs, vegetables, fruits and berries. It is recommended to cook by steaming or boiling. Take food in small portions, but 5-6 times a day, avoiding overeating. You should have dinner no later than 3-4 hours before bedtime.
• It’s better to forget about intense physical activity. The child needs more rest. Among sports, it is recommended to choose running or swimming, but initially you should limit yourself to morning exercises.

• Regardless of the season, the child should be outside more fresh air. It is recommended to reduce the amount of time on the computer and TV to a minimum.
• The child should be completely protected from stressful situations. Any experiences and conflicts can aggravate his condition.
• If complications, side effects or other problems occur, you should consult your doctor. Using medications on your own is strictly prohibited.

Forecast

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

The sinus form of arrhythmia occurs in every second baby. It rarely leads to complications and is virtually invisible. In most cases, such a failure is detected using an ECG. If it was caused by pathologies of the heart or other organs, then the course of therapy will be aimed at eliminating them. The treatment regimen will include medications, physiotherapeutic procedures and lifestyle adjustments. If there is no result, surgical intervention will be used. Milder cases of arrhythmia can be eliminated by reducing physical activity, avoiding stress and proper diet.

What is the electrical axis of the heart?

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

• Reasons for deviations from the norm
• Symptoms
• Diagnostics
• Treatment

An ECG conclusion is considered normal if it indicates any of the following positions of the heart axis: not deviated, semi-vertical, semi-horizontal, vertical or horizontal. The axis is closer to the vertical position in thin, tall people of asthenic physique, and closer to the horizontal position in strong, stocky people of hypersthenic physique.

Electric axis position range is normal

For example, in the conclusion of an ECG, the patient may see the following phrase: “sinus rhythm, EOS is not deviated...”, or “the axis of the heart is in a vertical position,” this means that the heart is working correctly.

In the case of heart disease, the electrical axis of the heart, along with the heart rhythm, is one of the first ECG criteria that the doctor pays attention to, and when interpreting the ECG, the attending physician must determine the direction of the electrical axis.

How to determine the position of the electrical axis

Determination of the position of the heart axis is carried out by a functional diagnostics doctor who deciphers the ECG using special tables and diagrams using the angle α (“alpha”).

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

Reasons for deviations from the norm

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

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

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

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

In adults, such a deviation is usually a sign of right ventricular hypertrophy, which develops in the following diseases:

• diseases of the bronchopulmonary system – long-term bronchial asthma, severe obstructive bronchitis, emphysema, leading to increased blood pressure in the pulmonary capillaries and increasing the load on the right ventricle;
• heart defects with damage to the tricuspid (three-leaf) valve and the valve of the pulmonary artery, which arises from the right ventricle.

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

Symptoms

The electrical axis of the heart itself does not cause any symptoms in the patient. Impaired health appears in the patient if myocardial hypertrophy leads to severe hemodynamic disturbances and heart failure.

The disease is characterized by pain in the heart area

Signs of diseases accompanied by deviation of the heart axis to the left or right include headaches, pain in the heart area, swelling of the lower extremities and face, shortness of breath, asthma attacks, etc.

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

Diagnostics

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

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

Treatment

Direct deviation of the electrical axis does not require treatment, since it is not a disease, but a criterion by which it can be assumed that the patient has one or another cardiac pathology. If, after further examination, some disease is identified, it is necessary to begin treatment as soon as possible.

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

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Vertical position of the EOS for sinus tachycardia

EOS (electrical axis of the heart) is an indicator of the electrical parameters of the heart muscle. The important information needed to make a cardiac diagnosis is the direction of EOS.

What is the vertical position of the EOS

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

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

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

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

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

The diagnosis of “sinus tachycardia with a vertical position of the EOS” is often found in children and adolescents. It implies an acceleration of the rhythm in which the sinus node operates. An electrical impulse emanates from this area, initiating contraction of the heart and determining the speed of its work.

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

Tachycardia requires more serious consideration when it appears:

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

Postural orthostatic tachycardia syndrome leads to an increase in heart rate when changing body position (suddenly standing up). This is often observed in people professional activity which is associated with increased physical activity (for general workers, loaders, storekeepers).

Possible long-term consequences of sinus tachycardia are heart failure and other diseases.

Diagnosis of sinus tachycardia

Diagnosis of sinus tachycardia requires the use of various analytical techniques. It becomes mandatory to study the patient’s medical history and clarify information regarding the varieties medical supplies, used by him in the past. Such moments make it possible to identify the presence of factors and circumstances that caused the onset of the disease.

1. Physical examination of the patient, including examination of the condition skin, assessment of the degree of its oxygen saturation.
2. Listening to breathing and heart rate (in some cases, with little physical activity).
3. General and biochemical blood test to determine the level of leukocytes, cholesterol, potassium, glucose, urea.
4. A urine test is necessary to exclude diseases of the genitourinary system from the list of suspected causes of pathology.

The state of the thyroid gland makes it possible to determine the degree of its influence on the heart rate. Vagal tests and daily monitoring are performed as additional diagnostic methods.

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

Treatment methods

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

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

Traditionally, therapy is carried out with the appointment:

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

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

Help from traditional medicine

Combination of nuts and dried fruits

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

Lemon-garlic mixture

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

Hawthorn infusion

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

Sinus tachycardia often requires integrated approach to treatment. For getting positive results therapy, the patient will need to follow all medical prescriptions and recommendations, give up bad habits, control his motor activity. While maintaining a sedentary lifestyle, smoking, consuming high-calorie foods, alcohol, the effectiveness of even the most professional treatment, as well as the best traditional methods, will decrease significantly.

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

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 magnitude of bioelectric 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.

When taking an ECG, each electrode records bioelectrical excitation occurring in a certain area of ​​the myocardium. If you project the electrodes onto a conventional coordinate system, you can also calculate the angle of the electrical axis, which will be located where the electrical processes are strongest.

Conducting system of the heart and why is it important for determining EOS?

The conduction system of the heart consists of sections of the heart muscle consisting of so-called atypical muscle fibers. These fibers are well innervated and provide synchronous contraction of the organ.

Myocardial contraction begins with the appearance of an electrical impulse in the sinus node (which is why the correct rhythm of a healthy heart is called sinus). From the sinus node, the electrical impulse travels to the atrioventricular node and further along the His bundle. This bundle passes through the interventricular septum, where it divides into the right, heading towards the right ventricle, and the left legs. The left bundle branch 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 bundle branch is located in the middle and lower third of the interventricular septum, the posterolateral and inferior wall of the left ventricle. We can say that the posterior branch is located slightly to the left of the anterior one.

The myocardial conduction system 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. If there are disturbances in this system, the electrical axis of the heart can significantly change its position, as will be discussed below.

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 overall stronger, and EOS will be directed specifically at it. If we project the position of the heart on the coordinate system, the left ventricle will be in the area +30 + 70 degrees. This will be the normal position of the axis. However, depending on individual anatomical features and body type, the position of the EOS in healthy people ranges from 0 to +90 degrees:

• So, the vertical position will be considered EOS in the range from + 70 to +90 degrees. This position of the heart axis 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 they are intermediate body types, therefore the electrical axis can have an intermediate value (semi-horizontal and semi-vertical).

All five position options (normal, horizontal, semi-horizontal, vertical and semi-vertical) occur 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, sinus rhythm, heart rate - 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 diagnosing diseases.

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

When can the position of the EOS indicate heart disease?

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

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

EOS deviations to the left

Thus, deviation of the electrical axis of the heart to the left may indicate left ventricular hypertrophy (LVH), i.e. an 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 mass of the ventricular muscles increases, which leads to its hypertrophy. Ischemic disease, chronic heart failure, and cardiomyopathies also cause left ventricular hypertrophy.

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

In addition, LVH develops when the valve apparatus of the left ventricle is damaged. This condition is caused by stenosis of the aortic mouth, in which the ejection of blood from the left ventricle is difficult, and 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 a consequence of rheumatic fever. Left ventricular hypertrophy is found in professional athletes. In this case, a consultation with a highly qualified sports doctor is necessary to decide on the possibility of continuing to play sports.

Also, the EOS can be deviated to the left in cases of intraventricular conduction disorders and various heart blocks. Deviation el. the axis of the heart to the left, together with a number of other ECG signs, is one of the indicators of blockade of the anterior branch of the left bundle branch.

EOS deviations to the right

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

What to do if EOS displacement 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 diagnosing a particular disease. If the deviation of the heart axis is outside the normal range (from 0 to +90 degrees), consultation with a cardiologist and a series of studies are necessary.

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

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

Unstable sinus rhythm, vertical position of the eos. How dangerous is sinus arrhythmia?

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

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

Electrical processes occurring in the structures of the human “motor” are caused by the movement of sodium ions. Initially they are located outside the myocardial cell. They are transported inside by potassium ions. This movement will create conditions for changes in transmembrane potentials during the entire cycle of relaxation and contraction of the atria and ventricles.

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

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

How is an ECG performed?

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

It is important for patients to follow certain preparation rules:

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

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

Principles of decoding

The main elements of each cardiogram are convexities directed upward or downward, called teeth, as well as the distance between such convexities - segments.

The ST and PQ segments are of particular diagnostic value for cardiologists. Behind each lies a certain process occurring in the heart.

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

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

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

What is sinus rhythm

The most common inscription in the conclusion of the cardiogram given to the patient is sinus rhythm. This is followed by the number of atrioventricular contractions. For a person poorly versed in medical terms, such an entry is difficult to understand. However, this is the best option. It indicates that the organ is working in the correct mode.

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

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

They will indicate that the rhythm is set by another node of cells, which is recognized by cardiologists as a pathology of the organ. Many internal and external factors can push such deviations to appear. Their identification and elimination is the main task of treatment measures recommended by a specialist.

What are the reasons for differences in the electrocardiogram?

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

This could well be explained by the following reasons:

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

There is no need to panic in advance; the specialist will analyze all information about the patient, his complaints, the results of a physical examination, for example, auscultation of heart activity. And only then is it compared with the conclusion of the electrocardiogram. If there is a discrepancy in information, additional studies will be recommended, for example, electrocardiography.

What should an ECG look like in children?

All stages of deciphering an electrocardiogram in pediatric practice are quite consistent with those in adult patients. However, due to the physiological as well as anatomical characteristics of the child’s heart, there are certain differences in the interpretation of indicators of its activity.

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

Individual waves and intervals will have slightly different characteristics: in children, incomplete blockades of one or another part of the conduction system of the heart are observed, most often the right leg of the ganglion. Therefore, it is so important that the cardiogram is deciphered only by a specialist who takes into account all of the above features.

Features of ECG parameters during pregnancy

At the moment of bearing a baby, a double burden falls on the mother’s heart. It takes a certain period of time to adapt to a new condition for a woman.

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

However, sinus rhythm should be maintained. Only a slight increase in the number of contractions is possible, but not more than 100 beats/min and signs of slight overload in any chamber of the organ. They will also be associated with an increase in the volume of blood transferred. Such deviations disappear on their own after the baby is born, but they should not be ignored. A specialist must carry out in-depth instrumental studies, for example, ECHO KG.

Possible options for rhythm deviations

To date, research conducted by specialists has allowed them to distinguish abnormal sinus rhythm into pathologically caused and physiologically caused.

Distinctive criteria are the frequency of atrioventricular contractions and their rhythm:

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

It is unacceptable to ignore such pathological conditions. It is imperative to establish the true root cause of the dysfunction of the “motor” and eliminate it.

Main causes of failures

Many different internal, as well as external reasons. Experts indicate the following:

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

A thorough collection of the patient’s medical history, as well as additional laboratory and instrumental studies, help to establish one or a combination of the above root causes of rhythm disturbances in the structures of the heart.

Diagnostics

To detect failures in the area of ​​the sinus node and determine their root causes, a study such as Holter monitoring is required. Its essence is to take an electrocardiogram on a daily basis. In this case, all actions and events of that day must be indicated so that the specialist can later compare them with the results of the decoding.

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

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

One more modern method establishing the cause of a malfunction in the sinus node and conducting electrical impulses is a bicycle ergometer test. This is the simultaneous recording of a cardiogram at the time of physical stress on the patient’s body. The parameters are taken into account based on the person’s age category, his weight, initial health status and level of physical training. Indications for its implementation will be:

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

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

Treatment tactics

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

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

In case of persistent rhythm disturbance, leading to a significant deterioration in a person’s well-being, conservative treatment is first carried out. The doses of medications and the frequency of their administration are selected individually, total duration course. A monitoring electrocardiogram is required. In the absence of pronounced positive dynamics, a decision is made on surgical intervention: installation of an artificial pacemaker.

• Sinus rhythm disturbances: causes of the pathological condition
• What changes occur when the sinus rhythm of the heart is disturbed?

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

Sinus rhythm of the heart: features of anatomy and physiology

Before we start talking about the sinus rhythm of the heart, I would like to dwell on some issues of the anatomy and physiology of the cardiovascular system. Without exception, all organs and systems of the human body are constantly in need of oxygen and other useful substances supplied by the circulatory system. The human heart is a fairly simple but powerful pump that ensures constant blood circulation throughout the circulatory system.

The human heart is capable of making more than one beat per day and has a specific “pacemaker,” which is called the sinus node and is located in the right atrium. It is this node that generates impulses or electrical signals that first enter the atria, causing them to contract and push blood into the ventricles. After this, a certain pause occurs, allowing the ventricles of the heart to fill with blood, and then the impulse passes through the ventricle and blood, and is sent further through the circulatory system to all organs and tissues of the human body. This is how the heart constantly contracts at a certain frequency. Normal sinus rhythm is considered to be with a heart rate (heart rate) of 60 to 70 per minute.

Electrical axis of the heart - those words that appear first when deciphering an electrocardiogram. When they write that her position is normal, the patient is satisfied and happy. However, in conclusions they often write about the horizontal, vertical axis, and its deviations. In order not to experience unnecessary anxiety, it is worth having an understanding of EOS: what it is, and what the dangers are if its position is different from the normal one.

General idea of ​​EOS - what is it

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

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

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

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

The normal position of the EOS - what is it?

Determine the position of the EOS

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

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

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

The intermediate position is between +15 and +60 degrees.

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

• R2>R1>R3 (R2=R1+R3),
• R3>S3,
• R aVL=S aVL.

Vertical position of the EOS

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

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

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

• R2=R3>R1;
• R1=S1;
• R aVF>R2,3.

Horizontal position of the EOS

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

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

On the ECG, the highest positive waves are recorded in aVL, and the deepest negative ones in aVF.

• R1>R2>R3;
• R aVF=S aVF
• R2>S2;
• S3=R3.

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

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

Pathological conditions accompanied by deviation of the EOS to the left:

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

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

The ECG in the second and third leads is characterized by deep S waves.

• R1>R2>R2;
• R2>S2;
• S3>R3;
• S aVF>R aVF.

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

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

Possible reasons for this phenomenon:

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

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

• R3>R2>R1,
• S1>R1.

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

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

The presence of an electrical axis is due to the fact that it consists of muscle fibers. Thanks to their contractions, the heart contracts.

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

How can the EOS be located?

The location of the electrical axis of the heart can be determined using an ECG. The following options are usually considered normal:

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

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

Electrical axis of the heart

Often the position of the EOS depends on the person’s physique.

Cardiac hypertrophy

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

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

Diagnostics

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

• Ultrasound of the heart
• Holter monitoring
• ECG during physical activity
• Coronary angiography

Ultrasound of the heart

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

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

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

What is an ECG?

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

In what cases does a doctor prescribe an ECG?

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

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

ECG conclusion: terminology

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

Heart rate- this is not a disease or a diagnosis, but just an abbreviation for “heart rate,” which refers to the number of contractions of the heart muscle per minute. Normally, an adult's heart rate is 60-90 beats per minute. When the heart rate increases above 91 beats/min, they speak of tachycardia; if the heart rate is 59 beats/min or less, this is a sign bradycardia. Both tachycardia and bradycardia can be either a manifestation of the norm (for example, tachycardia due to nervous experiences or bradycardia in trained athletes) or a clear sign of pathology.

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

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

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

Sinus rhythm irregular- synonymous with sinus arrhythmia.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dystrophic changes, cardiodystrophic changes, metabolic changes, changes in myocardial metabolism, electrolyte changes, disruption of repolarization processes - this is how metabolic disorders in the myocardium are designated, not associated with an acute disturbance of the blood supply. Such changes are typical for cardiomyopathy, anemia, endocrine diseases, liver diseases, kidney diseases, hormonal disorders, intoxications, inflammatory processes, and heart injuries.

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

Features of ECG in children

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

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

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

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

Finally

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

When the EOS is in a vertical position, the S wave is most pronounced in leads I and aVL. ECG in children aged 7–15 years. Characterized by respiratory arrhythmia, heart rate 65-90 per minute. The position of the EOS is normal or vertical.

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

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

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

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

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

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

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

Methods for determining the position of the EOS.

To put it simply, an ECG is a dynamic recording of the electrical charge that makes our heart work (that is, contract). The designations of these graphs (they are also called leads) - I, II, III, aVR, aVL, aVF, V1-V6 - can be seen on the electrocardiogram.

An ECG is a completely painless and safe test; it is performed on adults, children and even pregnant women.

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

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

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

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

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

Block of the branches (left, right, left and right) of the His bundle (RBBB, LBBB), complete, incomplete, is a violation of the conduction of an impulse through the conduction system in the thickness of the ventricular myocardium.

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

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

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

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

When can the position of the EOS indicate heart disease?

The direction of the electrical axis of the heart shows the total magnitude of bioelectric 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.

If you project the electrodes onto a conventional coordinate system, you can also calculate the angle of the electrical axis, which will be located where the electrical processes are strongest. The conduction system of the heart consists of sections of the heart muscle consisting of so-called atypical muscle fibers.

Normal ECG readings

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

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

These defects can be either congenital or acquired. The most common acquired heart defects are a consequence of rheumatic fever.

In this case, a consultation with a highly qualified sports doctor is necessary to decide on the possibility of continuing to play sports.

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

As in the case of the left ventricle, RVH is caused by coronary heart disease, chronic heart failure and cardiomyopathies.

Sinus rhythm. The voltage is satisfactory.

Normal position of the electrical axis of the heart

ECG 2. NORMAL POSITION OF THE ELECTRICAL AXIS OF THE HEART

Discounts » History » Sinus arrhythmia of the heart EOS vertical

Sinus arrhythmia, causes of its occurrence and main symptoms. Diagnostic criteria. Sinus arrhythmia - (sinus arrhythmia) - normal change heart rate. The concept of cardiography combines different methods of studying cardiac activity. Good afternoon. Please tell me. I did a cardiogram and heart ultrasound for my children. Cardiac arrhythmia can manifest itself in cases of dysfunction of the autonomic nervous system, a. What ECG signs are observed with sinus arrhythmia. Sinus arrhythmia happens. Okg cardiology Description. The right rhythm. Sinus waves p are of normal configuration (their amplitude varies).

1. Sinus arrhythmia of the heart
2. Sinus arrhythmia all questions and
3. Cardiography of the heart and blood vessels
4. Child's cardiogram result
5. Arrhythmia - medicine consultation

Now almost every ambulance team is equipped with a portable, lightweight and mobile one. Decoding the cardiogram in children and adults general principles, reading the results, example. When recording an ECG in twelve conventional leads, practically no signs are detected. Eos is short for electrical axis of the heart - this indicator. Thin people usually have a vertical position of the eos, while thick people and faces have a vertical position. Sinus arrhythmia is an abnormal sinus rhythm with periods.

Sinus arrhythmia is an abnormal heart rhythm that... The vertical position of the heart axis is sinus arrhythmia, do not be alarmed. Sinus arrhythmia (irregular sinus rhythm). This term means. Average frequency their contractions are 138 beats, eos is vertical. Vertical electrical position of the heart (or vertical. Sinus arrhythmia can be respiratory (associated with phases.). I did an ultrasound of the heart after a cardiogram with sinus arrhythmia. Sinus arrhythmia is the position of the eospolus, vertical vagal. It is recorded on the ECG electrical activity heart that changes. The normal position of the electrical axis of the heart is 3069o, vertical. Deviation of the electrical axis of the heart (EOS) to the left or right. The conclusion was written by sinus arrhythmia with tendinus. Symptoms of blood cancer after 40 years. And she sometimes points her finger at her chest in the area of ​​​​the heart and says that she has it. Hello. Sinus arrhythmia is one of the most. At stage 4, qt 0.28 at stage 4, sinus arrhythmia 111-150, vertical position of eos. Deviation of the electrical axis of the heart (EOS) to the right (angle a 90170). In most infants, the eos moves to a vertical position. On average up to 110120 beats, some children develop sinus arrhythmia.

Mild sinus arrhythmia (vertical position of the eos) is also not a diagnosis. What already. Sinus arrhythmia of the heart, the causes of which can be completely different, can be as follows. Conclusion: sinus rhythm, pronounced arrhythmia with heart rate from 103 to 150. Eos, incomplete blockade of the right bundle branch. Ultrasound of the heart at 2 years old. The conclusion is sinus arrhythmia, EOS vertical bradycardia. Eos is short for electrical axis of the heart - this indicator allows. Sinus arrhythmia is an abnormal sinus rhythm with periods.

Sinus rhythm with heart rate 71 eos vertical metabolic change in the myocardium. Eos (electrical axis of the heart), however, it will be correct. Reduced wave voltage, sinus tachycardia, diffuse changes in the myocardium. It was written that I have sinus arrhythmia (severe) vertical electrical position of the heart. Tell me, is this serious? An ECG records the electrical activity of the heart, which changes cyclically. Deviation of the electrical axis of the heart (EOS) to the left or right is possible with hypertrophy of the left or. Electrical position is vertical. The conclusion was written as sinus arrhythmia with Qrst0.26 n e. The cardiac axis is not deviated. According to the ECG data, the conclusion is sinus arrhythmia, EOS vertical bradycardia. Violation. The following are typical for physiological cardiac hypertrophy in athletes. Sinus arrhythmia indicates a dysregulation of the sinus node and... Vertical eos is more often observed in football players and skiers. Symptoms of skin cancer on the hands Deviation of the eos to the left. 40 is blocked, sinus arrhythmia of the heart, they prescribed Concor and statins, will Concor lower the blood pressure. Hello. I’m 26 years old. Severe sinus arrhythmia on Holter is scary? Open. Sinus arrhythmia is common in healthy people. Found. Deviation of EOS to the left. The coronary artery is 40 blocked, sinus arrhythmia of the heart, they prescribed Concor and statins, will Concor lower the blood pressure. Yesterday we did an ultrasound of the heart, and the doctor diagnosed sinus tachycardia. Registered. Sinus tachycardia, moderate arrhythmia, coraxan. Sinus tachycardia, vertical position of the eos and shortening of the interval. II degree - mild sinus arrhythmia, rhythm fluctuations within limits. The power of the heart is represented by the electrical axis of the heart (EOS). Eos is short for electrical axis of the heart - this indicator. Thin people usually have a vertical position of the eos, while thick people and faces have a vertical position. Sinus arrhythmia is an abnormal sinus rhythm with periods.

Posted: 10 Feb 2015

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An electrocardiogram provides useful information for diagnosing cardiovascular diseases in children. Decoding the results of the cardiogram allows you to obtain data on the state of the heart muscle, the frequency and rhythm of heart contractions.

ATTENTION! Before asking a question, we recommend that you read the contents of the “Frequently Asked Questions” section. There is a high probability that you will find the answer to your question there right now, without wasting time waiting for an answer from a consultant doctor.

Rimma asks.

Hello! My son is 4 years old. At an appointment with a pediatrician, they listened to a heart murmur and did an ECG: sinus bradycardia with a heart rate of 88 per minute, vertical position of the EOS, incomplete block of the right bundle branch. They sent me for a consultation with a cardiologist. Please explain how serious this is? What does this even mean?

information about the consultant

As for the conclusion about your child’s condition, the best answer to this question is a pediatric cardiologist, who will be familiar not only with the description of the cardiogram, but also with the entire history of the child’s health, and will also examine him in person.

The main measurement required for every electrocardiogram. In most healthy individuals it is between -30° and +100°. An angle of -30° or more negative is described as axis deviation to the left, and the angle +100° or more positive - as axis deviation to the right. In other words, axis deviation to the left is an altered position of the average electrical axis in people with a horizontal position of the electrical axis of the heart. Axis deviation to the right is an altered position of the average electrical axis of the complex QRS in people with a vertical position of the electrical axis of the heart.

Position of the average electrical axis of the complex QRS depends on the anatomical position of the heart and the direction of propagation of the impulse through the ventricles (direction of the ventricles).

The influence of the anatomical position of the heart on the electrical axis of the QRS complex

Confirmed breathing effect. When a person inhales, the diaphragm lowers and the heart takes a more vertical position in the chest, which is usually accompanied by vertical displacement of the EOS(to the right). In patients with X, an anatomically vertical position of the heart and an electrically vertical average electrical axis of the complex are usually observed QRS. On the contrary, when you exhale, the diaphragm rises and the heart takes a more horizontal position in the chest, which is usually accompanied by horizontal displacement of the EOS(left).

Effect of direction of ventricular depolarization

Can be confirmed in case of incomplete, when the propagation of impulses along the upper left parts of the LV is disrupted and the average electrical axis of the complex QRS deflected to the left (see section ""). On the contrary, when it is deviated to the right.

How to recognize EOS deviation to the right and left

Axis deviation to the right

QRS is +100° or more. Remember that with high teeth R equal amplitude to the axis angle should be +90°. Approximate Rule indicates a deviation of the axis to the right if there are high teeth in leads II and III R, and the tooth R in lead III exceeds the tooth R in lead II. In addition, a complex is formed in lead I R.S.-type, where is the depth of the tooth S greater than tooth height R(see Fig. 5-8; 5-9).

Rice. 5-8. Deviation of the electrical axis of the heart to the right. Deviation of the EOS to the right (the average electrical axis of the QRS complex is more than +100°) is determined by leads I, II, III; the R wave in lead III is higher than in lead II.

Rice. 5-9. In a patient with deviation of the EOS to the right, the R wave in lead III is higher than in lead II.

Axis deviation to the left

It is revealed if the average electrical axis of the complex QRS is -30° or less. On the electrocardiogram, deviation of the electrical axis of the heart to the left. EOS deviation to the left (the average electrical axis of the QRS complex is less than -30°); in lead II - the rS complex (the amplitude of the S wave is greater than the r wave). Deviation of the axis to the left is detected if there is a high tooth in lead I R, in lead III - deep tooth S, in lead II - a two-phase complex R.S.(tooth depth S greater than tooth height r) (see Fig. 5-10,5-11) or QS. In leads I and aVL there are high waves R.

Section "" presents the concepts of electrically vertical and horizontal position EOS (middle electrical axis of the complex QRS).

In this section, in addition, the concept of EOS deviation to the left and right is given. What is the difference between these terms? Vertical and horizontal position of the EOS - qualitative concepts. When the middle electrical axis of the complex is in a vertical position QRS high teeth R visible in leads II, III and aVF, in a horizontal position - in leads I and aVL. When the EOS is in a vertical position, the average electrical axis of the complex QRS can be normal (for example, +80°) or deviated to the right (+120°). In the same way, when the EOS is in a horizontal position, the axis of the complex QRS can be normal (0°) or deviated to the left (-50°).

Thus, the deviation of the EOS to the right is an extreme variant of the vertical position of the average electrical axis of the complex QRS, axis deviation to the left - extreme variant of the horizontal position of the middle electrical axis of the complex QRS.