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Explanation of analyzes

ECG transcript - norm, indicators, table

An electrocardiogram (ECG) is an instrumental diagnostic method that determines the pathological processes in the heart by recording cardiac electrical impulses. Graphic representation of the activity of the cardiac musculature under the electroimpulse effect, enables the cardiologist to detect the presence or development of cardiac pathologies in time.

The parameters of the ECG decoding help to determine with great certainty:

  1. Frequency and rhythm of cardiac contraction;
  2. In time to diagnose acute or chronic processes in the heart muscle;
  3. Disorders of the conduction system of the heart and its independent rhythmic contractions;
  4. To see hypertrophic changes in his departments;
  5. Identify the whole body of violations in the water-electrolyte balance and non-cardiac pathology (pulmonary heart).

Content

Indications for ECG

Indications for ECG

The need for an electrocardiographic examination is due to the manifestation of a certain symptomatology:

  • presence of synchronous or periodic noises in the heart;
  • syncopal symptoms (fainting, short-term loss of consciousness);
  • attacks of convulsive seizures;
  • paroxysmal arrhythmia;
  • manifestations of IHD (ischemia) or infarction;
  • the appearance of pain in the heart, shortness of breath, sudden weakness, cyanosis of the skin in patients with the presence of cardiac diseases.

ECG research is used to diagnose systemic diseases, monitor patients in anesthesia or before surgery. Before the clinical examination of patients over 45 years old.

ECG examination is mandatory for persons undergoing a medical commission (pilots, drivers, drivers, etc.) or associated with harmful production.

General principles of ECG analysis

The human body has a high electrical conductivity, which allows you to read from your surface the potential energy of the heart. This helps the electrodes supplied to various parts of the body. During the excitation of the heart muscle by electrical impulses, the voltage difference oscillates between certain points of the lead, which is recorded by electrodes located on the body - on the chest and extremities.

General principles of ECG analysis A certain movement and magnitude of stress in the period of systole and diastole (contraction and relaxation) of the heart muscle changes, the tension fluctuates, and this is fixed on the diagram paper tape by a line - denticles, convexity and concavity. Create the signals and form the vertices of triangular teeth electrodes placed on the extremities (standard leads).

Six leads located on the chest, display cardiac activity in a horizontal position - from V1 to V6.

On the limbs:

  • Lead (I) - displays the voltage level in the intermediate circuit of the electrodes placed on the left and right wrists (I = LR + OL).
  • (II) -fires on the tape electrical activity in the chain - the ankle of the left leg + wrist of the right hand).
  • Retraction (III) - characterizes the tension in the chain of fixed wrist electrodes of the left arm and ankle of the left leg (LR + LN).

If necessary, additional leads are installed, reinforced - "aVR", "aVF" and "aVL".

Decoding ECG of the cardiogram

ECG decoding

Decoding ECG diagram, photo

The general principles of decoding the cardiogram of the heart are based on the indications of the elements of the curve of cardiography on the diagram tape.

The teeth and protuberances in the diagram are denoted by capital letters of the Latin alphabet - "P", "Q", "R", "S", "T"

  1. Convexity (denticle or concavity) "P" displays the function of the atria (their excitation), and the whole complex, directed upwards of the tooth - "QRS", the greatest spread of the pulse in the cardiac ventricles.
  2. Convexity "T" characterizes the restoration of the potential energy of the myocardium (the middle layer of the heart muscle).
  3. Special attention is paid to the distance (segment) between the adjacent elevations - "P-Q" and "ST", reflecting the delay of electrical impulses between the cardiac ventricles and the atrium, while the "TP" segment is the relaxation of the cardiac muscle in the interval (diastole) .
  4. Intervals, on the cardiographic line, include elevations and segments. For example - "R-Q" or "Q-T".

Each element on the graphic image indicates certain processes occurring in the heart. Specifically, in terms of the indices of these elements (length, height, width), location relative to the isoline, features, according to different locations on the body of electrodes (leads), the doctor can identify affected areas of the myocardium, based on the indications of the dynamic aspects of cardiac muscle energy.

Decoding ECG - the norm in adults, the table

The analysis of the result of the ECG decoding is carried out according to the evaluation of the data in a certain sequence:

  • Determination of heart rate. With the same interval between the "R" teeth, the figures correspond to the norm.
  • The heart rate is calculated. This is defined simply - the ECG recording time is divided by the number of cells of the interval between the "R" teeth. With a good cardiogram of the heart, the frequency of contractions of the heart muscle should be within the limits not exceeding 90 beats / min. A healthy heart should have a sinus rhythm, it is determined mainly by the elevation "P", which reflects the excitation of the atria. On the wave motion, this rate is 0.25 mV with a duration of 100 ms.
  • The norm of the depth of the tooth "Q" should not be more than 0.25% of the oscillations of the "R" height and the width of 30 ms.
  • The latitude of the "R" oscillations of the elevation, with normal operation of the heart, can be displayed with a large range in the range of 0.5-2.5 mV. And the excitation activation time above the zone of the right heart chamber - V1-V2 is 30 ms. Above the zone of the left camera - V5 and V6 it corresponds to 50 ms.
  • According to the maximum length of the "S" tooth, its size is normal with the largest lead can not cross the 2.5 mV threshold.
  • The amplitude of the "T" oscillations of the elevation, representing the restorative cellular processes of the initial potential in the myocardium, should equal ⅔ of the vibration of the "R" wave. The normal interval (width) of the "T" of the elevation can vary (100-250) ms.
  • The normal value of the width of the ventricular excitation complex (QRS) is 100 ms. Measured by the start interval "Q" and the end of the "S" teeth. The normal amplitude of duration "R" and "S" of teeth is determined by electrical cardiac activity. The duration to the maximum should be within 2.6 mV.
ECG decoding in adults is the norm in the table
Index Value
QRS 0.06-0.1 s
P 0.07-0.11 s
Q 0.03 s
T 0.12-0.28 sec
PO 0.12-0.2 s
Heart rate 60-80 ud. minute

Decoding ECG in children, the norm indicators

The electrocardiogram in children, as practice shows, differs little from the norm in adult patients. But certain physiological age features can change some indicators. In particular - the heart rate. In young children, up to 3 years of age, they can range from 100 to 110 cuts / minute. But, already at pubertal age, it is equated to adult indicators (60-90).

Normally, when decoding ECG of the heart in children, the passage of electrical impulses along the heart (in the range of elevations P, QRS, T) varies 120-200 ms.

The ventricular excitation index (QRS) is determined by the width of the interval between the tooth "Q" and "S" and should not exceed the limits of 60-100 ms.

Particular attention is paid to the magnitude (excitation activity) of the right ventricle (V1-V2). In children, this figure is higher than in the left ventricle. With age, the indicators come back to normal.

  • Quite often on the ECG, babies show thickenings, splits or notches on the "R" hills. Such a symptom in a cardiogram of adults indicates a tachycardia and a bradycardia, and in children, it is quite an ordinary condition.

But there are indications and a bad cardiogram of the heart, which indicate the presence or progression of pathological processes in the heart. Much depends on the individual indicators of the child. In addition, the interruption or slowing of the normal heart rhythm manifests itself in children experiencing chest pain, dizziness, who have frequent signs of unstable blood pressure or impaired coordination.

If the ECG examination of a child is diagnosed with an excess of the heart rate more than 110 beats / min. Is an alarm signal, which speaks of the development of tachycardia.

It is necessary to immediately reduce the physical load in the child and protect him from nervous overexcitation. In children, this symptomatology may be temporary, but if not taken, tachycardia will develop into a permanent problem.

ECG example - ciliary tachycardia

Atrial tachycardia

Interesting

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