Determination of the position of the electrical axis of the heart using an ecg. How is an electrocardiogram taken? Deviation of the electrical axis of the heart to the right: what it depends on, what it threatens and what to do

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

Characteristics of the electrical position of the heart

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

Determination of EOS is possible due to the presence of a conducting system. It consists of areas of tissue, the components of which are atypical muscle fibers. Their distinctive feature consists of increased innervation, which is necessary to ensure synchronization of the heartbeat.

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

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

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

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

is a term that means electrical activity organ, that is, the total indicator of its average vector during depolarization. This is an indicator of the electrical processes of the heart.

This concept is used in cardiology and in functional diagnostics. Determination of the direction of EOS is carried out using an ECG.

In the direction of the axis, the doctor determines the bioelectrical changes that occur in the myocardium during contraction.

To determine the direction of the EOS, there is a coordinate system that is located throughout the chest.

With electrocardiography, the doctor can install the electrodes according to the coordinate system, and it will be clear where the axis angle is located, that is, the places where the electrical impulses are strongest.

Impulses travel along. It consists of atypical fibers that are located in certain areas of the organ.

This system begins in the sinus node. The impulse then passes to the atria and ventricles and to the bundle of His.

When any disturbances occur in the conduction system, the EOS changes its direction.

Axis location

In a healthy person, the left ventricle has a larger mass than the right.

This means that stronger electrical processes occur precisely in the left ventricle, and accordingly the electrical axis is directed there.

If we denote this in degrees, then the LV is in the region of 30-700 with a value of +. This is considered the standard, but it should be said that not everyone has this axis arrangement.

There may be a deviation greater than 0-900 with a value of +, since it is necessary to take into account the individual characteristics of each person’s body.

The doctor may make the following conclusion:

no deviations;
semi-vertical position;
semi-horizontal position.

All these conclusions are the norm.

As for individual characteristics, it is noted that in people who are tall and have a thin build, the EOS is in a semi-vertical position, and in people who are shorter and have a stocky build, the EOS is in a semi-horizontal position.

The pathological condition looks like a sharp deviation to the left or right.

Reasons for rejection

When the EOS deviates sharply to the left, this may mean that there are certain diseases, namely LV hypertrophy.

In this condition, the cavity stretches and increases in size. Sometimes this occurs due to overload, but it can also be a consequence of a disease.

Diseases that cause hypertrophy are:

In addition to hypertrophy, the main causes of axis deviation to the left are conduction disorders inside the ventricles and during blockades of various types.

Quite often, with such a deviation, blockade of the left leg of His, namely its anterior branch, is diagnosed.

As for the pathological deviation of the heart axis sharply to the right, this may mean that there is RV hypertrophy.

This pathology can be caused by the following diseases:

As well as diseases characteristic of LV hypertrophy:

cardiac ischemia;
chronic heart failure;
cardiomyopathy;
complete blockade left leg of His (posterior branch).

When the electrical axis of the heart is sharply deviated to the right in a newborn, this is considered normal.

We can conclude that the main cause of pathological displacement to the left or right is ventricular hypertrophy.

And the greater the degree of this pathology, the more EOS is rejected. A change in the axis is simply an ECG sign of some disease.

It is important to carry out timely identification of these indications and diseases.

Deviation of the heart axis does not cause any symptoms; symptoms manifest themselves from hypertrophy, which disrupts the hemodynamics of the heart. The main symptoms are headaches, chest pain, swelling of the limbs and face, suffocation and shortness of breath.

If cardiac symptoms occur, you should immediately undergo electrocardiography.

Determination of ECG signs

This is the position at which the axis is within the range of 70-900.

On the ECG this is expressed as tall R waves in the QRS complex. In this case, the R wave in lead III exceeds the wave in lead II. In lead I there is an RS complex, in which S has a greater depth than the height of R.

In this case, the position of the alpha angle is within the range of 0-500. The ECG shows that in standard lead I the QRS complex is expressed as R-type, and in lead III its form is S-type. The S wave has a depth greater than the height R.

With blockade of the posterior branch of the left leg of His, the alpha angle has a value greater than 900. On the ECG, the duration of the QRS complex may be slightly increased. There is a deep S wave (aVL, V6) and a high R wave (III, aVF).

With blockade of the anterior branch of the left leg of His, the values will be from -300 or more. On ECG signs These are the late R wave (lead aVR). Leads V1 and V2 may have a small r wave. In this case, the QRS complex is not expanded, and the amplitude of its waves is not changed.

Blockade of the anterior and posterior branches of the left leg of His (complete block) - in this case, the electrical axis is sharply deviated to the left and can be located horizontally. On the ECG in the QRS complex (leads I, aVL, V5, V6), the R wave is widened and its apex is jagged. Near the high R wave there is a negative T wave.

It should be concluded that the electrical axis of the heart can be moderately deviated. If the deviation is sharp, then this may mean the presence serious illnesses cardiological nature.

During a routine examination, a person over 40 years of age should have a cardiogram done to identify heart pathologies. The location of the teeth allows us to determine the state of the organ during excitation.

Deviation of the electrical axis of the heart to the left indicates certain diseases and requires clarification of the diagnosis.

General information about pathology

The electrical activity of the body’s “motor” is recorded using an ECG. To imagine what the heart axis is, it is necessary to construct a coordinate scale and mark the directions in increments of 300. The semi-vertical position of the organ in the chest when superimposed on the coordinate system sets the electrical axis.

Vectors make an angle, so the direction of the EOS is measured in degrees from -180 to +1800. In a normal location, it should be in the range +30 - +69.

If, under the influence of any factors, a change in the position of the organ and the vector of signal transmission occurs, then they speak of its change in the coordinate system.

Normally, the heart has a sinus rhythm, the electrical impulse begins from the atrium and then moves to the ventricles. On an electrocardiogram, the normal position of the organ can be determined if the P wave is detected, indicating atrial contraction, the QRS complex, contraction of the ventricles and T, their repolarization.

The location of the terminals when taking an ECG is the direction of the electrical impulse of the heart. When removing the leads, 3 main and 3 auxiliary lines are determined, as well as chest indicators.

We can talk about the normal value of the axis if the R wave has highest value in the 2nd main lead, and the value is R1>R3.

If there is a shift in the electrical axis to the left, what does this mean? There are factors that cause the organ to preponderate to the left. A leftogram is observed if the axis position is from 0 to -900.

Reasons for rejection

The EOS is deviated to the left not only in cardiac pathologies. The reasons for the deviation are left ventricular hypertrophy, provoked by the following disorders:

heart failure;
hypertension with congestive manifestations;
heart disease;
left bundle branch block;
atrial fibrillation.

During the cardiac cycle, during the first contraction, blood is pushed into the atrium, the valve closes, then it is transferred to the ventricle, and with the next contraction all the blood must go into the vessels.

If the pumping function is impaired, when the organ is not able to contract with such force to push out all the fluid, part of it constantly remains inside the cavity. It gradually stretches.

This phenomenon is provoked by cardiomyopathy due to ischemic heart disease due to heart attack, myocarditis.

The second reason for residual fluid accumulation: the valve does not close completely, or there is stenosis, a narrowing of the lumen of the vessel. Then some of the blood returns back or cannot exit into the aorta in one cycle.

Heart disease can be congenital or acquired. In the first case, it is detected during examination of a newborn child, in the second, in an adult.

If the conduction of the left bundle branch is disrupted, the functioning of the left ventricle is disrupted, which is why it does not contract as it should. In this case, sinus rhythm is maintained, but the axis deviates.

At arterial hypertension Blood pressure on the vessels increases, which affects their condition. The more often blood pressure rises, the more likely decreased elasticity of blood vessels and expansion of the ventricle, which bears a large load.

At atrial fibrillation, in addition to changes in the electrical axis of the heart, there is a lack of atrial contraction, and ventricular complexes are formed at different intervals.

Symptoms and manifestations

The deviation itself does not manifest symptoms, but since the disorder is caused by certain reasons, signs appear when the process spreads significantly.

Hemodynamic disturbances occur, and there are accompanying symptoms.

If the patient has heart failure or a heart defect, this is manifested by the appearance of shortness of breath when walking or climbing stairs, blueness of the limbs and nasolabial triangle, shortness of breath and dizziness.

Atrial fibrillation is manifested by attacks during which there is not enough breathing, a feeling of palpitations, pain in the chest, and irregular pulses.

Arterial hypertension is manifested by a headache, mainly in the back of the head, heaviness in the chest, and at high levels - flashing spots before the eyes.

Diagnostics

Bringing together the symptoms of the disorder, functional diagnostics, and other methods help to establish the disorder:

Holter monitoring;
X-ray;
coronary angiography.

Thanks to these studies, it is possible to visually assess the organ and its parts, determine the size of the enlarged cavity, and establish the cause of the insufficiency.

Using electrocardiography with a load in the form of a bicycle track or an exercise bike, it is possible to determine at what point myocardial ischemia appears.

The doctor prescribes a daily test if he suspects that the patient has a rhythm disorder. To “catch” periods of arrhythmia, a person is fitted with a device for a day that records the contraction of the heart.

Angiocoronary angiography is a study of blood vessels that allows you to see their condition and circulatory disorders. The image allows you to determine the expansion of the shadow of the organ, which indicates hypertrophy.

When additional examination is required

Standard EOS indicators are approximately the same for everyone, but in a tall person the size of the heart and its position may be slightly different, although he will not be sick. Therefore, when initial examination if a violation is established, it is required additional methods research.

A change in the parameter normally also occurs in athletes.

Because they endure significant stress during constant training, their heart pumps large volumes of fluid, causing the cavities to stretch. They may show horizontal type deviations when the organ occupies a position from -15 to +30.

If during the study a person did deep breath or changed the position of the body, then even if normal, a healthy heart will deviate to the left.

Manifestations on the ECG

During the examination, an electrocardiogram can be used to determine the presence of a deviation to the left side. In the diagram, the R wave is largest in lead 1.

An additional sign is the location of the QRS complex below the isoline in column 3, that is, S predominates. If you pay attention to the leads from the arms and legs, then in AVF the ventricular complex will be the same as III.

What does a sharp deviation mean?

Since the angle of deviation from the norm can be different, the degrees of the process also differ. Changing degrees is a gradual process. The larger the cavity size grows, the more the indicator deviates from the norm. If the deviation is from -450 to -900 degrees relative to the norm, then they say that the organ is sharply shifted to the left.

In adults

A displacement of the axis of the heart in the chest may indicate a violation conducting an ECG, if a person wellness and no other health problems were identified.

Normally, it is observed in people who regularly engage in physical activity and in athletes.

The pronounced deviation is not accidental; it is a sign of pathology in adults. May occur congestion, accumulating over several years.

In children

During the neonatal period, a child experiences a sharp deviation of the axis to the right; this is the norm. If an adult has such a disorder, then he has signs of right ventricular hypertrophy.

In a child, this is due to the fact that the right parts of the heart have a large mass, predominant over the left. By the age of one year, the condition is normalized, and the organ should assume a vertical position in the chest. During this period, it can rotate around its axis in different directions.

Then the left ventricle gains mass and ceases to adhere to the chest. By the age of 6-7 years, the organ acquires a correct, semi-vertical position.

Is treatment necessary?

The heart axis is a criterion by which a health disorder can be determined, therefore, in case of deviation, therapy is aimed at combating the cause identified during diagnosis. If you eliminate it, you will be able to restore normal functioning of the heart.

These may be the following procedures:

installation of an artificial valve;
implantation of a pacemaker;
bypass;
prescription of antihypertensive and antiarrhythmic drugs.

The set of measures depends on the degree of health impairment present.

If the arrhythmia is periodic and can be eliminated with the help of drugs, then suitable remedy. If a threat to life appears, the issue of installing a pacemaker is decided.

Coronary bypass surgery is the cleaning of blood vessels from plaques and lipid plaque, which expands their lumen and eliminates ischemia.

In the case of congenital and acquired heart disease or CHF, it helps to establish normal cardiac cycle. If the pumping function of the heart is affected, then weak myocardial contractility will still be observed.

Possible consequences and complications

It is not the deviation of the heart position that is dangerous, but the reasons why it occurs. Complications of left ventricular hypertrophy:

heart failure;
angina pectoris;
heart failure.

All causes of organ dysfunction are interconnected. If a heart defect has led to dilatation of the left ventricle, then with the development of the pathological process one should expect rhythm disturbances. If the myocardium becomes so weak that contraction of the fibers does not lead to the release of blood further, then circulatory failure and cardiac arrest occur.

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

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

How is an electrocardiogram taken?

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

What influences the location of the EOS?

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

An impulse entering the heart cannot escape the myocardial conduction system. This is a complex structure with fine settings, sensitively responding to the slightest changes in the body. In case of any disturbances in the conduction system, the electrical axis of the heart can change its position, which will be immediately recorded on the electrocardiogram.

EOS location options

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

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

Normal location of the electrical axis of the heart

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

Pathological location of the electrical axis of the heart

A condition in which the electrical axis of the heart is deviated is not a diagnosis in itself. However, such changes in the electrocardiogram may indicate various violations in the work of the most important organ. TO major changes The following diseases affect the functioning of the conduction system:

Cardiac ischemia;

Chronic heart failure;

Cardiomyopathies of various origins;

Congenital defects.

Knowing about these pathologies, the cardiologist will be able to notice the problem in time and refer the patient to hospital treatment. In some cases, when EOS deviation is registered, the patient requires emergency care in intensive care.

Deviation of the electrical axis of the heart to the left

Most often, such changes in the ECG are observed with enlargement of the left ventricle. This usually occurs with the progression of heart failure, when the organ simply cannot fully perform its function. It is possible that such a condition may develop in arterial hypertension accompanied by pathology large vessels and increase In all these conditions, the left ventricle is forced to work hard. Its walls thicken, leading to inevitable disruption of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the left also occurs with narrowing of the aortic mouth. In this case, stenosis of the lumen of the valve located at the exit from the left ventricle occurs. This condition is accompanied by a disruption of normal blood flow. Part of it is retained in the cavity of the left ventricle, causing it to stretch and, as a result, thickening of its walls. All this causes a natural change in EOS as a result of improper conduction of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the right

This condition clearly indicates Similar changes develop in some diseases of the respiratory system (for example, bronchial asthma or Some congenital ones can also cause an enlargement of the right ventricle. First of all, it is worth noting pulmonary artery stenosis. In individual situations tricuspid valve insufficiency can also lead to a similar pathology.

Why is changing EOS dangerous?

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

With the development of this pathology, the EOS can be deviated both to the left and to the right, depending on the localization of the process. The blockade can be caused by myocardial infarction, infection of the heart muscle, as well as taking certain medications. A regular electrocardiogram allows you to quickly make a diagnosis, which means it allows the doctor to prescribe treatment taking into account all important factors. IN severe cases It may be necessary to install a pacemaker (pacemaker), which will send impulses directly to the heart muscle and thereby ensure normal functioning of the organ.

What to do if the EOS is changed?

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

To summarize, several important points should be highlighted:

The normal EOS value is considered to be the range from +30 to +70°.

Horizontal (from 0 to +30°) and vertical (from +70 to +90°) positions of the heart axis are acceptable values and do not indicate the development of any pathology.

Deviations of the EOS to the left or to the right may indicate various disorders in the conduction system of the heart and require consultation with a specialist.

A change in EOS detected on a cardiogram cannot be made as a diagnosis, but is a reason to visit a cardiologist.

Heart is amazing organ, ensuring the functioning of all systems of the human body. Any changes that occur in it inevitably affect the functioning of the whole organism. Regular examinations by a therapist and an ECG will allow timely detection of serious diseases and avoid the development of any complications in this area.

The definition of EOS is a diagnostic method that displays the electrical parameters of the heart. The value that determines the position of the electrical axis of the heart is a summarized indicator of the bioelectric processes that occur during heart contractions. In cardiac diagnostics, the direction of the EOS is important.

The heart is an organ with a three-dimensional structure and volume. Its position in medicine is represented and determined in a virtual coordinate grid. Atypical myocardial fibers intensively generate electrical impulses during their work. This is a complete system that conducts electrical signals. It is from there that electrical impulses originate, causing the movement of parts of the heart and determining the rhythm of its work. In a split second before contractions, electrical changes appear, forming the EOS value.

EOS parameters, sinus rhythm is shown by a cardiogram; indicators are taken by a diagnostic device with electrodes that are attached to the patient’s body. Each of them picks up bioelectrical signals emitted by myocardial segments. By projecting the electrodes onto a coordinate grid in three dimensions, the angle of the electrical axis is calculated and determined. It passes through the localization areas of the most active electrical processes.

Concept and specifics

There are several options for the location of the electrical axis of the heart; it changes its position under certain conditions.

This does not always indicate disorders and diseases. U healthy body, depending on the anatomy and body composition, the EOS deviates from 0 to +90 degrees (+30...+90 is considered the norm, with normal sinus rhythm).

The vertical position of the EOS is observed when it is within the range from +70 to +90 degrees. This is typical for people of thin build and tall stature (asthenics).

Intermediate types of body composition are often observed. Accordingly, the position of the electrical axis of the heart changes, for example, it becomes semi-vertical. Such displacements are not a pathology; they are inherent in people with normal body functions.

An example of wording in the conclusion of an ECG may sound like this: “EOS is vertical, sinus rhythm, heart rate - 77 per minute.” - this is considered normal. It should be noted that the term “rotation of the EOS around its axis,” which may be noted in the electrocardiogram, does not indicate any pathologies. In itself, such a deviation is not regarded as a diagnosis.

There is a group of ailments that are characterized by vertical EOS:

ischemia;
cardiomyopathy of different nature, especially in the dilated form;
chronic heart failure;
congenital anomalies.

Sinus rhythm in these pathologies is impaired.

Left and right position

When the electrical axis is shifted to the left side, the left ventricle and its myocardium are hypertrophied (LVH). This is the most common specificity of the deviation. This pathology acts as an additional symptom, rather than independently, and indicates an overload of the ventricle and a change in the process of its work.

These problems appear with prolonged arterial hypertension.

The disorder is accompanied by a significant load on the vessels delivering blood to the organ, so contractions of the ventricle occur with excessive force, its muscles increase and hypertrophy. The same is observed with ischemia, cardiomyopathy, etc.

The left location of the electrical axis and LVH is also observed in cases of disorders valve system, while the sinus rhythm of contractions is also disrupted. The pathology is based on the following processes:

aortic stenosis, when the exit of blood from the ventricle is difficult;
weakness of the aortic valve, when some of the blood flows back into the ventricle and overloads it.

The designated disorders are acquired or congenital. Often the cause of the former is rheumatism. Changes in ventricular volume are also observed in people who are professionally involved in sports. It is highly recommended that they consult a doctor to determine whether physical activity will cause irreparable harm to their health.

Deviation to the left is also detected when conduction inside the ventricle is impaired, during blockade disorders in the heart.

Hypertrophic processes of the right ventricle (RVH) accompany the right deviation of the EOS. Right part The heart is responsible for sending blood to the lungs, where it is supplied with oxygen. HPG is characteristic of pathologies respiratory system: asthma, chronic obstructive processes in the lungs. If the disease lasts for a long time, this causes hypertrophic changes in the ventricle.

Other causes of pathology are the same as for left deviation: ischemia, abnormal rhythm, heart failure in chronic form, cardiomyopathy and blockade.

Consequences of displacement and their specificity

The displacement of the EOS is detected on the cardiogram. Consultation with a cardiologist and additional research are required when the deviation goes beyond the norm, which is set in the range from 0 to +90 degrees.

The processes and factors involved in the displacement of the heart axis, accompanied by severe clinical symptoms, require additional examinations without fail. Special attention attention should be paid to circumstances when, with previously existing stable indicators of axis deviation, a change in the ECG suddenly occurs or sinus rhythm is disturbed. This is one of the symptoms of blockade.

The EOS deviation itself does not need therapeutic measures, it is classified as a cardiac parameter that requires, first of all, to determine the cause of its occurrence. Only a cardiologist decides whether treatment is necessary in each individual case.

VERTICAL POSITION OF EOS

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rhythm: isthmus of the right atrium (“-”З.Р in avR, avL, V-2)

Heart rate: 75-76 (on inspiration up to 72)

EOS position: vertical

Conclusion: rhythm from the right atrial appendage, normosystole. Features of conduction according to right leg p. Gisa.

What does this diagnosis mean? Do I need to see a cardiologist?

The ECG diagnosed (I write as it is written on the certificate):

EOS vertical. Sinus rhythm, right. Left ventricular overload. Incomplete blockade of the right side of Gis.

Please tell me how serious this is. They ordered an ultrasound of the heart, I will do it only on 9.11. then just see a cardiologist (I’m worried). I am 30 years old, I work out in the gym with weights. Before that, judo. Can I study?

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 is a section 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. Left leg The bundle of His is divided into two branches, anterior and posterior. The anterior branch is located in the anterior sections 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:

Cardiac ischemia.
Cardiomyopathies of various origins (especially dilated cardiomyopathy).
Chronic heart failure.
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. increasing it in size, which is also not independent disease, but may indicate left ventricular overload. 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, insufficiency aortic valve, when some 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 with a long course causes 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. When the heart axis is deviated beyond the limits normal values(from 0 to +90 degrees), consultation with a cardiologist and a number of studies are required.

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 leading 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.

Sinus arrhythmia vertical position eos what is it

Sinus (sinusoidal) cardiac arrhythmia

Heart rhythm disturbances quite often serve as a manifestation various diseases, but in some cases is 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);
activation of the sympathetic nervous system under the influence of intake medicines 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;
hormone deficiency thyroid gland;
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 this case, cardiac arrhythmia serves as a compensatory response of the body to an 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 side 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 eliminate the influence of the respiratory cycle on 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, cardiac arrhythmias go away on their own after the cause that caused them is eliminated, that is specific treatment not required. However, severe sinus arrhythmia can lead to disruption of the blood supply to vital important organs. Therefore, they can be used to treat it therapeutic methods and cardiac pacing.

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, sedatives, including those of natural origin, are used for treatment.

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 physiological processes And increased activity nervous system. Only a significant deviation from the normal heart rate can manifest as serious hemodynamic disturbances. Used to treat these conditions medicinal methods or electrocardiostimulation. Preventive actions do not differ from generally accepted ones and are aimed at maintaining a healthy lifestyle.

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 a common consequence their impact. 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. Similar reflex reaction checked during electrocardiography, placing the patient on a couch, on top of which a cold oilcloth is laid. Because of its impact, the child instinctively holds his breath. In the presence of this form of arrhythmia, the heart rate will decrease slightly.

Arises respiratory view disruption of the heart rhythm due to 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 physical activity;
active growth phase (6-10 years).

The severity of the failure depends on the cause of its occurrence. Often arrhythmia is provoked by the inability of the autonomic department to keep up with the active growth of the child. Over the years this problem eliminates itself.

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 the conduction system, the heart rate (HR) jumps. The organic form develops 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. He has chronic course and develops due to tonsillitis. The disease is accompanied by high fever, 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 a sinus type of malfunction occurs, but sometimes more develops. dangerous forms(atrial fibrillation, His bundle block). The main pathological process is accompanied by pain in the chest area, high fever, swelling lower limbs, 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 medication.
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 when receiving physical activity because of 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. On this nuance Various factors influence:

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;
chest x-ray and cervical region 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 by 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 stop the negative influence of the factor causing the 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, prescribed the following drugs 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 didn't help fix it 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 of an artificial pacemaker (pacemaker, defibrillator).

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

acupuncture;
medicinal baths
laser or magnetic therapy.

ethnoscience

Facilities traditional medicine prepared from plants with healing properties and have minimum quantity contraindications. Before using them, you should consult your doctor to avoid undesirable consequences. The most popular recipes are:

300 g dried apricots, 130 g raisins and walnuts It is necessary to grind thoroughly and mix 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. Similar tea with sedative effect It is advisable to drink 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 pronounced calming 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 is a good tonic 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 general health child. They can be found below:

Create the right diet, saturating it with herbs, vegetables, fruits and berries. It is recommended to cook by steaming or boiling. Eating 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 spend more time in the 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 occur, side effects and other problems - you need to 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 people tall people asthenic physique, and to the horizontal - in strong stocky persons 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 in case of ECG decoding 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 normal operation with all my 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) of the 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, pulmonary 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 reason for deviation according to ECG axis heart left or right, a cardiologist or therapist may prescribe additional research methods:

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 their impairment contractile function. This method is especially important for examining a newborn child for congenital heart pathology.
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.
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.
Chest X-ray - with severe myocardial hypertrophy, an expansion of the cardiac shadow is characteristic.
Coronary angiography (CAG) - performed to clarify the nature of lesions of the coronary arteries during coronary disease A.

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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