home All hormones How often is an ecg performed on adults? How do you prepare for an ECG? When to do it

How often is an ecg performed on adults? How do you prepare for an ECG? When to do it

Used for practical purposes in the 70s of the 19th century by the Englishman A. Waller, the device that records the electrical activity of the heart continues to faithfully serve humanity to this day. Of course, over almost 150 years it has undergone numerous changes and improvements, but the principle of its operation, based on recordings of electrical impulses propagating in the heart muscle, remained the same.

Now almost every ambulance team is equipped with a portable, lightweight and mobile electrocardiograph, which allows you to quickly take an ECG, not waste precious minutes, diagnose and quickly transport the patient to the hospital. For large-focal myocardial infarction and other diseases that require emergency measures, minutes count, so an urgently taken electrocardiogram saves more than one life every day.

Deciphering an ECG for a cardiology team doctor is a common thing, and if it indicates the presence of acute cardiovascular pathology, then the team immediately turns on the siren and goes to the hospital, where, bypassing the emergency room, they will deliver the patient to the intensive care unit for emergency care. The diagnosis has already been made using an ECG and no time has been lost.

Patients want to know...

Yes, patients want to know what the strange teeth on the tape left by the recorder mean, so before going to the doctor, patients want to decipher the ECG themselves. However, everything is not so simple and in order to understand the “sophisticated” record, you need to know what the human “motor” is.

The heart of mammals, which includes humans, consists of 4 chambers: two atria, endowed with auxiliary functions and having relatively thin walls, and two ventricles, which bear the main load. The left and right parts of the heart are also different. Providing blood to the pulmonary circulation is less difficult for the right ventricle than pushing blood into the systemic circulation with the left. Therefore, the left ventricle is more developed, but also suffers more. However, regardless of the difference, both parts of the heart must work evenly and harmoniously.

The heart is heterogeneous in its structure and electrical activity, since contractile elements (myocardium) and non-contractile elements (nerves, vessels, valves, fatty tissue) differ from each other in varying degrees of electrical response.

Typically, patients, especially older ones, worry about whether there are signs of myocardial infarction on the ECG, which is quite understandable. However, to do this you need to learn more about the heart and the cardiogram. And we will try to provide this opportunity by talking about waves, intervals and leads and, of course, about some common heart diseases.

Heart Abilities

We first learn about the specific functions of the heart from school textbooks, so we imagine that the heart has:

Automatically, caused by the spontaneous generation of impulses, which then cause its excitation;
Excitability or the ability of the heart to activate under the influence of exciting impulses;
or the “ability” of the heart to ensure the conduction of impulses from the place of their origin to the contractile structures;
Contractility, that is, the ability of the heart muscle to contract and relax under the control of impulses;
Tonicity, in which the heart does not lose its shape in diastole and ensures continuous cyclic activity.

In general, the heart muscle in a calm state (static polarization) is electrically neutral, and biocurrents(electrical processes) are formed in it under the influence of exciting impulses.

Biocurrents in the heart can be recorded

Electrical processes in the heart are caused by the movement of sodium ions (Na+), which are initially located outside the myocardial cell, into it and the movement of potassium ions (K+), rushing from inside the cell to the outside. This movement creates the conditions for changes in transmembrane potentials throughout the entire cardiac cycle and repeated depolarizations(excitation, then contraction) and repolarizations(transition to the original state). All myocardial cells have electrical activity, but slow spontaneous depolarization is characteristic only of the cells of the conduction system, which is why they are capable of automatism.

Excitement spreading through conducting system, sequentially covers the parts of the heart. Starting in the sinoatrial (sinus) node (the wall of the right atrium), which has maximum automaticity, the impulse passes through the atrial muscles, the atrioventricular node, the bundle of His with its legs and is directed to the ventricles, stimulating parts of the conduction system even before the manifestation of its own automaticity .

Excitation that occurs on the outer surface of the myocardium leaves this part electronegative in relation to areas not affected by excitation. However, due to the fact that body tissues have electrical conductivity, biocurrents are projected onto the surface of the body and can be recorded and recorded on a moving tape in the form of a curve - an electrocardiogram. The ECG consists of waves that are repeated after each heartbeat, and through them shows the disorders that exist in the human heart.

How is an ECG taken?

Many people can probably answer this question. Doing an ECG, if necessary, will also not be difficult - there is an electrocardiograph in every clinic. ECG technique? It only seems at first glance that it is so familiar to everyone, but meanwhile, only medical workers who have undergone special training in taking an electrocardiogram know it. But we hardly need to go into details, since no one will allow us to do such work without preparation anyway.

Patients need to know how to properly prepare: that is, it is advisable not to overeat, not to smoke, not to drink alcoholic beverages and medications, not to get involved in heavy physical labor and not to drink coffee before the procedure, otherwise you can fool the ECG. It will certainly be provided, if nothing else.

So, a completely calm patient undresses to the waist, frees his legs and lies down on the couch, and the nurse will lubricate the necessary places (leads) with a special solution, apply electrodes from which wires of different colors go to the device, and take a cardiogram.

The doctor will decipher it later, but if you are interested, you can try to figure out your teeth and intervals yourself.

Teeth, leads, intervals

This section may not be of interest to everyone, in which case you can skip it, but for those who are trying to understand their ECG on their own, it may be useful.

The waves in the ECG are designated using Latin letters: P, Q, R, S, T, U, where each of them reflects the state of different parts of the heart:

P – atrial depolarization;
QRS wave complex – ventricular depolarization;
T – ventricular repolarization;
A weak U wave may indicate repolarization of the distal portions of the ventricular conduction system.

To record an ECG, 12 leads are usually used:

3 standard – I, II, III;
3 reinforced unipolar limb leads (according to Goldberger);
6 reinforced unipolar chest (according to Wilson).

In some cases (arrhythmias, abnormal location of the heart), there is a need to use additional unipolar chest and bipolar leads according to Neb (D, A, I).

When interpreting the ECG results, the duration of the intervals between its components is measured. This calculation is necessary to assess the rhythm frequency, where the shape and size of the teeth in different leads will be an indicator of the nature of the rhythm, the electrical phenomena occurring in the heart and (to some extent) the electrical activity of individual sections of the myocardium, that is, the electrocardiogram shows how our heart works at that time. or another period.

Video: lesson on ECG waves, segments and intervals

ECG analysis

A more rigorous interpretation of the ECG is made by analyzing and calculating the area of the teeth when using special leads (vector theory), however, in practice, they mainly make do with such an indicator as electrical axis direction, which is the total QRS vector. It is clear that everyone’s chest is structured differently and the heart does not have such a strict arrangement, the weight ratio of the ventricles and the conductivity inside them are also different for everyone, therefore, when deciphering, the horizontal or vertical direction of this vector is indicated.

Doctors carry out ECG analysis in a sequential order, determining the norm and violations:

Assess the heart rhythm and measure the heart rate (with a normal ECG - sinus rhythm, heart rate - from 60 to 80 beats per minute);
Intervals (QT, norm – 390-450 ms) are calculated, characterizing the duration of the contraction phase (systole) using a special formula (I often use Bazett’s formula). If this interval lengthens, then the doctor has the right to suspect. Hypercalcemia, on the contrary, leads to a shortening of the QT interval. The conductivity of the pulses reflected through the intervals is calculated using a computer program, which significantly increases the reliability of the results;
they begin to calculate from the isoline according to the height of the teeth (normally R is always higher than S) and if S exceeds R and the axis deviates to the right, then they think about disturbances in the activity of the right ventricle, if on the contrary - to the left, and the height of S is greater than R in II and III leads – left ventricular hypertrophy is suspected;
The QRS complex is studied, which is formed during the conduction of electrical impulses to the ventricular muscle and determines the activity of the latter (the norm is the absence of a pathological Q wave, the width of the complex is not more than 120 ms). If this interval shifts, then we speak of blockades (full or partial) of the bundle branches or conduction disturbances. Moreover, incomplete blockade of the right bundle branch is an electrocardiographic criterion of right ventricular hypertrophy, and incomplete blockade of the left bundle branch may indicate left ventricular hypertrophy;
They describe the ST segments, which reflect the period of restoration of the initial state of the heart muscle after its complete depolarization (normally located on the isoline) and the T wave, which characterizes the process of repolarization of both ventricles, which is directed upward, asymmetrical, its amplitude is lower than the wave in duration and is longer than the QRS complex.

The decoding work is carried out only by a doctor, however, some ambulance paramedics perfectly recognize common pathologies, which is very important in emergency cases. But first, you still need to know the ECG norm.

This is what the cardiogram of a healthy person looks like, whose heart works rhythmically and correctly, but not everyone knows what this record means, which can change under various physiological conditions, such as pregnancy. In pregnant women, the heart takes a different position in the chest, so the electrical axis shifts. In addition, depending on the duration, the load on the heart is added. An ECG during pregnancy will reflect these changes.

The cardiogram indicators in children are also excellent; they will “grow” with the baby, and therefore will change according to age; only after 12 years, the child’s electrocardiogram begins to approach the ECG of an adult.

The most disappointing diagnosis: heart attack

The most serious diagnosis on the ECG, of course, is, in the recognition of which the cardiogram plays the main role, because it is she (the first!) that finds areas of necrosis, determines the localization and depth of the lesion, and can distinguish an acute infarction from the scars of the past.

The classic signs of myocardial infarction on the ECG are the registration of a deep Q wave (OS), segment elevationST, which deforms R, smoothing it, and the subsequent appearance of a negative pointed isosceles tooth T. This elevation of the ST segment visually resembles a cat’s back (“cat”). However, a distinction is made between myocardial infarction with and without the Q wave.

Video: signs of a heart attack on an ECG

When there's something wrong with your heart

Often in ECG conclusions you can find the expression: “”. As a rule, such a cardiogram is obtained by people whose hearts have had an additional load for a long time, for example, due to obesity. It is clear that the left ventricle has a hard time in such situations. Then the electrical axis deviates to the left, and S becomes greater than R.

hypertrophy of the left (left) and right (right) ventricles of the heart on the ECG

Video: cardiac hypertrophy on ECG

One of the presenters will answer your question.

In questions about interpreting the ECG, be sure to indicate the patient’s gender, age, clinical data, diagnoses and complaints.

More than a century has passed since scientists discovered the heart's ability to produce electrical impulses in small doses.

This discovery marked the beginning of the science of electrocardiology, of which electrocardiography is an integral part. This section studies the electric current that arises in the heart or affects it from the outside.

Electrocardiography is capable of recording electrical potentials that arise during relaxation and contraction of the myocardium in a certain time period.

These impulses spread throughout the body and reach the skin.

A special device - an electrocardiograph - records these potentials and produces the result in the form of a graphic image, called an electrocardiogram. It can be printed on paper or displayed on a monitor screen.

Electrocardiography can serve various purposes:

Assess the effectiveness of heart medications, pacemakers and other methods of therapy.
Identify and monitor the dynamics of the development of heart diseases such as arrhythmia, intracardiac conduction disorders (blockades) and metabolism necessary for the functioning of the heart (potassium, magnesium, calcium). Here you can determine myocardial damage, the physical condition of the organ, acute cardiac pathologies and non-cardiac diseases (for example, pulmonary embolism).

An ECG is a very simple procedure with virtually no contraindications. It is allowed to be done to women during pregnancy and even to newborns upon discharge from the hospital. In emergency cases, a cardiogram is taken by an ambulance paramedic in a special vehicle, at the patient’s home, and even on the street.

Most often, the procedure is carried out in district clinics, hospitals, specialized clinics, and sanatorium institutions. This takes no more than 10 minutes and causes absolutely no discomfort to the subject.

However, despite all the positive aspects, electrocardiography also has disadvantages. Here, the short duration of the procedure is most often noted.

The operating principle of any electrocardiograph is based on the propagation of cardiac impulses. They are able to move by reducing the polarization of the cell electrodes. At rest, the surfaces of all muscle cells of the heart have a positive charge.

At such a moment there is no potential difference and, accordingly, it is impossible to register the electric field.

Electrical impulses in the heart usually originate in the sinoatrial (sinus) node.

It is located near the superior vena cava in the right atrium. The node is a specialized cell with the ability to automatically produce electrical impulses. The latter spread from the sinoatrial node first to the right, then to the left atrium.

The result of the propagation of electrical signals through the atria and ventricles is their contraction. The result is the flow of blood to the lungs and into the circulatory system.

Heart cardiogram: recording technique and scope of application

The recording of the potential difference between two points in the electrical field of the heart by an electrocardiograph is called a lead.

When recording a cardiac cardiogram, standard leads are recorded from two limbs by alternately connecting paired electrodes. Three standard positions form a triangular figure (Einthoven triangle).

A cardiac cardiogram is recorded when the patient is at rest. In some cases, the specialist records the ECG during inspiration, asking the patient to take a deep breath.

When analyzing ECG results, the cardiologist must have the necessary knowledge and skills to interpret the graphic image.

Electrocardiography is prescribed not only for existing or suspected heart disease. Your doctor may recommend an ECG as a preventative measure, as well as during a medical examination and annual physical examination.

If there are no suspicions of abnormalities, a cardiac cardiogram is done upon receipt of a medical book for employment. Children are given an ECG upon admission to kindergarten, and according to the new rules, they are required to provide it to the head of the sports section and the children involved in it. In addition, ECGs are often performed on pregnant women before giving birth. Patients with diabetes mellitus must be examined without fail, even in the absence of indications.

The referral for the study is given by the attending physician or cardiologist. Indications for an urgent procedure include pain in the heart, fainting, dizziness, hypertension, swelling of the legs, and weakness in the joints.

Electrocardiography: types of diagnostics

The first device capable of recording a high-quality ECG was a string galvanometer designed by V. Einthoven. Its basis was a very thin thread, which was in a magnetic field under a certain voltage. He created a new direction in the physiology of blood circulation - electrophysiology of the heart.

The first such equipment was very bulky and weighed 270 kg.

V. Einthoven identified the main waves, intervals and segments of the ECG, and also calculated their time intervals. He also proposed a system for placing electrodes on the surface of the patient’s body. These data are used by cardiologists to this day.

The jagged edges are the ups and downs of a graph.. In electrocardiography, a segment is a section of a straight line between two teeth. An electrocardiogram can show cardiac dysfunction in the early stages, as well as consider the possibilities for the development of serious pathologies.

However, an ECG does not always accurately determine the presence of a disease. For example, a disturbance in the rhythm of the heart (arrhythmia) during a study at rest may “lurk” and not manifest itself.

Therefore, the specialist chooses another examination method, there are several of them:

At rest- The standard method used most often. The patient lies on the couch in a relaxed state.
With load— during this procedure, the doctor will first take electrocardiograph readings, then ask the patient to perform a simple physical exercise (bending, squats), and then examine him again using the device. In addition, it is possible to use other methods - bicycle ergometry and treadmill test. In the first case, a bicycle ergometer is used (a device similar to an exercise bike with varying resistance of the pedals), in the second, a treadmill (a moving track). For each type of examination, electrodes connected to a computer are applied to the patient's body. The doctor monitors and analyzes the readings during the procedure.
Daily (Holter) monitoring- This method takes the longest time. When using it, adhesive electrodes are attached to the body of the subject. They are connected to a device that is attached to the belt or worn over the shoulder on a belt. It weighs no more than half a kilogram, so it does not cause any particular inconvenience.

The patient should keep a diary in which he indicates information about changes in physical activity, emotional overload, time of taking medications, sleep and wakefulness. Here he describes pain in the heart area and a feeling of discomfort that can arise during certain activities.

There are two options for Holter monitoring: full-scale and fragmented.

The first continues continuously for 1-3 days, as a result providing accurate and complete information about abnormalities in the functioning of the heart.

Fragmented monitoring may extend over a longer period. It is resorted to only when cardiac dysfunction occurs infrequently. Electrocardiography in this case is carried out using a special device.

To record deviations, the subject turns on the ECG recording button when pain occurs. The apparatus for such research is very miniature: it can be a pocket version or a device in the form of a wristwatch.

A sterile electrode is inserted into the subject's esophagus. This is usually done through the nasopharynx, less often through the mouth. The patient must make swallowing movements. But do not be alarmed - the transesophageal electrophysiological examination of the heart (TECFE) probe is thin and its insertion usually does not cause difficulties. At the same time, electrodes are attached to the chest to record an electrocardiogram.

The electrode is inserted approximately 40 cm - where the heart is closest to the esophagus. After this, they begin to record a cardiogram, and the probe begins to send weak electrical signals to the heart, causing it to contract more often.

At the end of the study, the electrode is removed from the esophagus.

In electrocardiography, there are instrumental methods for studying the functioning of the heart muscle. These include, for example, phonocardiography. In this case, a special microphone records the sounds made when the heart muscle is excited and relaxed. As a rule, listening is carried out by an experienced specialist with good hearing, who is able to separate murmurs and heart sounds from pathological sounds.

The book by V.V. Murashko “Electrocardiography” contains other methods of conducting research. Its cost is low, but it will be very useful for those who want to master the basics of ECG.

How to do an ECG correctly: preparation and conduct of the procedure

For those who do not know how to do an ECG correctly, do not worry: conducting electrocardiography does not require special training. However, some nuances still exist. It is advisable to refrain from eating heavy food 2 hours before the procedure.

Also, do not be nervous, play sports, drink energy cocktails or alcohol, as well as strong coffee or tea. Before the examination, women do not need to apply lotion or cream to the body; they should remove any jewelry from the wrists and chest area: bracelets, rings, chains, etc.

The chest electrodes have a special suction cup that is attached to the body due to the vacuum created. The specialist taking the readings knows very well how to do an ECG correctly, so it is unlikely that he will be able to confuse the wires connecting the suction cups to the device.

Before starting work, the device must be warmed up (3-5 minutes is enough). After this, the position of the recorder pen is adjusted, giving a calibration signal by turning on a special button.

There are no contraindications for conducting an ECG - the study can be performed even on infants.

In this case, the procedure for collecting data from a child is similar to that carried out by adults. Only the result will be different - for example, babies have a higher heart rate.

Some children are afraid of all people in white coats, so they can be very nervous before the procedure. Before it starts, parents should relieve stress in their children - give them a favorite toy, show a funny picture or photo (you can do it on your phone). An older child can be told about the study in advance and shown in a playful way how to do an ECG correctly.

The examination procedure may be difficult for those with complex chest injuries, high obesity, or excessive chest hair - in this case, the electrodes will not adhere tightly to the skin and the examination result will be distorted. The presence of a pacemaker will also lead to incorrect results.

Transesophageal examination cannot be performed in the presence of tumors or other diseases of the esophagus. ECG with stress is contraindicated in acute infectious diseases, chronic heart failure, coronary heart disease, complex rhythm disturbances, and in the acute period of myocardial infarction. Also, you should not do this if there is an exacerbation of diseases of other body systems - urinary, respiratory, digestive.

Normal cardiogram of a healthy heart and what it looks like

In a healthy adult, a normal cardiogram (cardiogram of a healthy heart) is considered to be a curve with sinus rhythm.

The heart rate (HR) is 60-80 beats per minute, the EOS (electrical axis of the heart) is in the standard position.

PQ interval (period of the excitation wave passing through the atria and atrioventricular node to the ventricular myocardium) - 0.12-0.18 seconds. (up to 0.2).

No changes in rhythm or tone (arrhythmia, bradycardia, tachycardia) were detected.

Increased heart rate is possible in pregnant women or overly emotional individuals. In elderly patients, on the contrary, there is a slowing of the heart rate or morphological pathologies of the myocardium.

Only a specialist with a medical education can correctly decipher the cardiogram and describe the obtained ECG parameters.

Electrocardiography can accurately diagnose various diseases of the cardiovascular system - ischemia, abnormalities in the development of conduction pathways, cardiac aneurysm, extrasystole, angina pectoris and many others.

The most serious diagnosis with electrocardiography is myocardial infarction. It is here that you can first detect areas of damaged or dead tissue, determine the specific location (in which wall of the heart) and the depth of the lesion. An ECG easily distinguishes the acute phase of a heart attack from old scars and aneurysms.

In case of a heart attack, the ECG procedure is performed more than once. The first time this happens is during the first contact with the patient - at home, in an ambulance or in a hospital waiting room. If there are no changes in the graphic image, but if symptoms are present, the procedure is repeated after 6 hours - by this time the symptoms usually appear in full force.

After this, diagnostics are carried out daily, and during recovery - once every few days. Thus, over the entire period the patient is examined at least 10 times.

The patient must always remember that taking care of his health should only be entrusted to a specialist. This fully applies to the electrocardiography procedure. You should not neglect the doctor’s prescription and you should not try to decipher the ECG yourself, even if you are sure that the result will be a normal cardiogram.

A cardiogram of a healthy heart, like an ECG with abnormalities, can only be read correctly by a doctor.

Only a person with a medical education is capable of assessing the risk of a critical condition obtained from the examination, clinical symptoms and the results of the study. Otherwise, there is a possibility of underestimating the ECG, which can lead to fatal consequences.

The heart is the most important organ in the human body. It is often compared to a motor, which is not surprising, because the main one is the constant pumping of blood in the vessels of our body. The heart works 24 hours a day! But it happens that it cannot cope with its functions due to illness. Of course, it is necessary to monitor general health, including heart health, but in our time this is not always possible for everyone.

A little history about the appearance of the ECG

Back in the mid-19th century, doctors began to think about how to track work, identify deviations in time and prevent the terrible consequences of the functioning of a diseased heart. Already at that time, doctors discovered what was happening in the contracting heart muscle and began to conduct the first observations and studies on animals. Scientists from Europe began to work on creating a special device or a unique technique for monitoring and finally the world's first electrocardiograph was created. All this time, science has not stood still, so in the modern world they use this unique and already improved device, which produces so-called electrocardiography, also called ECG for short. This method of recording heart biocurrents will be discussed in the article.

ECG procedure

Today, this is an absolutely painless procedure that is accessible to everyone. An ECG can be done in almost any medical facility. Consult your family doctor and he will tell you in detail why this procedure is necessary, how to take an ECG and where it can be done in your city.

Short description

Let's look at the steps of how to take an ECG. The algorithm of actions is as follows:

Preparing the patient for future manipulation. Laying him down on the couch, the health care worker asks him to relax and not tense up. Remove all unnecessary items, if any, that may interfere with the cardiograph recording. Free the necessary areas of skin from clothing.
They begin to apply electrodes strictly in a certain sequence and order of application of electrodes.
Connect the device to work while observing all the rules.
Once the device is connected and ready to use, start recording.
A paper with a recorded electrocardiogram of the heart is removed.
The ECG result is handed over to the patient or doctor for subsequent interpretation.

Preparing for an ECG

Before you learn how to take an ECG, let's consider what steps you need to take to prepare the patient.

An ECG machine is available in every medical facility; it is located in a separate room with a couch for the convenience of the patient and medical staff. The room should be bright and cozy, with an air temperature of +22...+24 degrees Celsius. Since it is possible to correctly take an ECG only if the patient is completely calm, such an environment is very important for carrying out this manipulation.

The subject is placed on a medical couch. In a lying position, the body easily relaxes, which is important for future cardiograph recordings and for assessing the work of the heart itself. Before applying ECG electrodes, a cotton swab moistened with medical alcohol must be used to treat the desired areas of the patient’s arms and legs. Re-treatment of these areas is carried out with saline solution or a special medical gel intended for these purposes. The patient must remain calm during the cardiograph recording, breathe evenly, moderately, and not worry.

How to take an ECG correctly: applying electrodes

You need to know in what order the electrodes need to be applied. For the convenience of the personnel performing this manipulation, the inventors of the ECG device defined 4 colors for the electrodes: red, yellow, green and black. They are applied in exactly this order and in no other way, otherwise conducting an ECG will not be advisable. It is simply unacceptable to confuse them. Therefore, medical personnel who work with an ECG device undergo special training, then pass an exam and receive an admission or certificate that allows them to work specifically with this device. The health worker in the ECG room, according to his work instructions, must clearly know the location of the electrodes and correctly perform the sequence.

So, the electrodes for the arms and legs look like large clamps, but don’t worry, the clamp is placed on the limb absolutely painlessly, these clamps are of different colors and are applied to certain places on the body as follows:

Red - right wrist.
Yellow - left wrist.
Green - left leg.
Black - right leg.

Application of chest electrodes

Nowadays, chest electrodes come in different types, it all depends on the manufacturer. They are disposable and reusable. Disposable ones are more convenient to use and do not leave unpleasant traces of irritation on the skin after removal. But if there are no disposable ones, then reusable ones are used; they are similar in shape to hemispheres and tend to stick. This property is necessary for clear placement in exactly the right place with subsequent fixation for the right time.

A medical professional, who already knows how to take an ECG, sits on the couch to the right of the patient in order to correctly apply the electrodes. It is necessary, as already mentioned, to pre-treat the patient’s chest skin with alcohol, then with saline solution or medical gel. Each chest electrode is marked. To make it clearer how to take an ECG, a diagram of the application of electrodes is presented below.

Let's begin applying electrodes to the chest:

First, we find the patient’s 4th rib and place the first electrode under the rib, which has the number 1 on it. In order for the electrode to successfully position itself in the required place, you need to use its suction property.
We also place the 2nd electrode under the 4th rib, only on the left side.
Then we proceed to applying not the 3rd, but the 4th electrode at once. It is placed under the 5th rib.
Electrode number 3 must be placed between the 2nd and 4th ribs.
The 5th electrode is installed on the 5th rib.
We place the 6th electrode at the same level as the 5th, but a couple of centimeters closer to the couch.

Before turning on the device for recording an ECG, we once again check the correctness and reliability of the applied electrodes. Only after this can you turn on the electrocardiograph. Before this, you need to set the paper speed and configure other indicators. During recording, the patient must be in a state of complete rest! At the end of the operation of the device, you can remove the paper with the cardiograph record and release the patient.

We take ECGs for children

Since there are no age restrictions for performing an ECG, ECGs can also be taken for children. This procedure is done in the same way as for adults, starting at any age, including (as a rule, at such an early age, an ECG is done solely to eliminate suspicion of heart disease).

The only difference between how to take an ECG for an adult and a child is that a child needs a special approach, everything needs to be explained and shown to him, and reassured if necessary. The electrodes on the child’s body are fixed in the same places as on adults, and must correspond to the child’s age. You have already learned how to apply ECG electrodes to the body. In order not to upset the little patient, it is important to ensure that the child does not move during the procedure, support him in every possible way and explain everything that is happening.

Very often, when prescribing pediatricians, they recommend additional tests, with physical activity or with the prescription of a particular drug. These tests are carried out in order to promptly identify abnormalities in the functioning of the child’s heart, correctly diagnose a particular heart disease, prescribe treatment in a timely manner, or dispel the fears of parents and doctors.

How to take an ECG. Scheme

In order to correctly read the recording on the paper tape that the ECG machine gives us at the end of the procedure, of course, it is necessary to have a medical education. The record must be carefully studied by a general practitioner or cardiologist in order to promptly and accurately diagnose the patient. So, what can an incomprehensible curved line, consisting of teeth, individual segments at intervals, tell us? Let's try to figure this out.

The recording will analyze how regular the heart contractions are, identifying the heart rate, the source of excitation, the conductive ability of the heart muscle, the determination of the heart in relation to the axes, and the condition of the so-called cardiac waves in medicine.

Immediately after reading the cardiogram, an experienced doctor will be able to make a diagnosis and prescribe treatment or give the necessary recommendations, which will significantly speed up the recovery process or protect against serious complications, and most importantly, a timely ECG can save a person’s life.

It is necessary to take into account that the cardiogram of an adult differs from the cardiogram of a child or a pregnant woman.

Is ECG taken for pregnant women?

In what cases is a pregnant woman prescribed a heart electrocardiogram? If at the next appointment with an obstetrician-gynecologist the patient complains of chest pain, shortness of breath, large fluctuations in blood pressure control, headaches, fainting, dizziness, then most likely an experienced doctor will prescribe this procedure in order to promptly reject bad suspicions and avoid unpleasant consequences for the health of the expectant mother and her baby. There are no contraindications for undergoing an ECG during pregnancy.

Some recommendations before the planned ECG procedure

Before taking an ECG, the patient must be instructed about what conditions need to be met the day before and on the day of removal.

The day before, it is recommended to avoid nervous tension, and the duration of sleep should be at least 8 hours.
On the day of delivery, you need a small breakfast of food that is easily digestible; a prerequisite is not to overeat.
Eliminate foods that affect heart function for 1 day, such as strong coffee or tea, spicy seasonings, alcoholic drinks, and smoking.
Do not apply creams and lotions to the skin of the arms, legs, chest, the action of fatty acids can subsequently worsen the conductivity of the medical gel on the skin before applying the electrodes.
Absolute calm is necessary before taking an ECG and during the procedure itself.
Be sure to avoid physical activity on the day of the procedure.
Before the procedure itself, you need to sit quietly for about 15-20 minutes, breathing calmly and evenly.

If the subject has severe shortness of breath, then he needs to undergo an ECG not lying down, but sitting, since it is in this position of the body that the device will be able to clearly record cardiac arrhythmia.

Of course, there are conditions in which it is absolutely impossible to perform an ECG, namely:

In acute myocardial infarction.
Unstable angina.
Heart failure.
Some types of arrhythmia of unknown etiology.
Severe forms of aortic stenosis.
PE syndrome (pulmonary embolism).
Dissection of aortic aneurysm.
Acute inflammatory diseases of the heart muscle and pericardial muscles.
Severe infectious diseases.
Severe mental illness.

ECG with mirror arrangement of internal organs

The mirror arrangement of the internal organs implies their arrangement in a different order, when the heart is not on the left, but on the right. The same applies to other organs. This is a fairly rare phenomenon, but nevertheless it occurs. When a patient with a mirror arrangement of internal organs is prescribed to undergo an ECG, he must warn the nurse who will perform this procedure about his peculiarity. In this case, young specialists working with people with mirror arrangement of internal organs have a question: how to take an ECG? On the right (the removal algorithm is basically the same), the electrodes are placed on the body in the same order as in ordinary patients they would be placed on the left.

Take care of your health and the health of your loved ones!

Domestic and foreign doctors claim that an electrocardiogram as such, the procedure itself, is harmless to the human body. Its harm lies only in the non-systemic use of an ECG - an unscheduled examination using this device can contribute to the incorrect diagnosis of the patient.

When is it better not to undergo this examination?

Candidate of Medical Sciences A.V. Rodionov believes that there are many situations when an ECG is not necessary, it is unnecessary. This is especially true for children and young people - each growing organism has a lot of individual developmental characteristics, and if a competent attending physician has not prescribed an electrocardiogram, you should not engage in amateur activities.
Rodionov assures that a healthy person does not need an ECG - undergoing this procedure as unnecessary is harmful in terms of possible subsequent incorrect interpretation of the results: a physician with low qualifications can “consider” a “serious pathology” on the heartbeat gradation tape, which will then have to be “seriously treated.”
Anton Vladimirovich is convinced that for a professional physician, a banal measurement of pressure and familiarization with the results of banal tests is enough to decide whether a patient should have an ECG or not.

Is a cardiogram in itself dangerous?

Cardiologist Rakesh K. Pai, MD, says an electrocardiogram "may show heart problems that would make an exercise ECG unsafe." In fact, Pai’s colleagues in this sense are more in favor of professional suitability - Domenico Corrado, Cristina Basso, Antonio Pellecchia and Gaetano Tiene, authors of the collection “Sports and Cardiovascular Diseases,” are seriously concerned about the problem of adequate interpretation and timely diagnosis of heart disease using ECG. This book provides many examples where misdiagnosis by unqualified physicians of the consequences of injuries contributed to the false interpretation of ECG results, which, in turn, then harmed the health of athletes.

To find out everything, you need to behave correctly

As confirmed by a doctor of the highest category, Zakir Anvarovich Khannanov, an ECG is prescribed by a doctor if the patient himself complains of pain in the heart or problems in the functioning of the cardiovascular system were identified as a result of a medical examination. So that the electrocardiogram does not “go wrong” and ultimately harm the patient himself, doctors do not advise unnecessarily physically loading the body before the ECG: the heart should work as usual before the examination, without extremes.
According to therapist Z. A. Khannanov, the “harm” from an ECG lies primarily in improper preparation of the patient for this procedure. Before undergoing an electrocardiogram, you should not smoke, drink coffee or strong tea (caffeine will in any case affect the results of the examination). It is advisable not to eat anything for 2 hours before the ECG. It is better not to use oil-fat creams applied to the body after a shower before taking an electrocardiogram: the electrodes have difficulty contacting the “oiled” skin, which complicates the process of obtaining an ECG.