The main rhythm of the heart is sinus. Violation of sinus rhythm. Why should a person undergo an ECG test?

What does sinus rhythm mean on an ECG and how to decipher it? In the myocardium, through muscle contractions, an impulse is generated by the conduction system of the heart, namely the cells of the sinus and atrioventricular nodes, as well as Purkinje fibers.

The fact that sinus rhythm is normal on an ECG is indicated by its indicator of 60-90 pulses per minute (in a healthy person at rest). It must be taken into account that in a newborn child the SR frequency can vary from 60 to 150 pulses per minute; the adult physiological norm is established at the age of 6-7 years.

To understand what sinus rhythm is on an ECG and what it should be, consider normal indicators electrocardiograms:

• The P wave is normal should precede the QRS complex, and the distance between P and Q will be 0.12-0.2 seconds. After the QRS complex, the T wave can be traced.
• P wave shape in all leads is unchanged, and it will be negative in lead aVR and positive in standard lead II. In other leads, these P wave indicators depend on the electrical axis and may be different.
• In a healthy person, over 7 years old rhythm frequency is 60-90 pulses per minute.
• Vertical position of the EOS(electrical axis), as well as sinus rhythm on the ECG indicate the physiological norm of the parameters. The normal position of the myocardium in the chest is indicated by the vertical axis, which is a projection of the location. The organ can also be in a semi-vertical, semi-horizontal and horizontal projection; the rotation of the heart from the transverse axis can also be recorded. These indicators indicate individual characteristics.

It is known that such a sinus rhythm on the ECG indicates that the patient does not have cardiac pathologies. To obtain a reliable examination result, it is necessary to calm down before starting the diagnosis, eliminate excitement and nervousness, as well as physical activity.

For example, after climbing stairs you should rest. You should also not smoke for at least half an hour before the electrocardiogram.

Conclusion ECG sinus rhythm of an irregular nature may indicate both pathologies and physiological changes.

There are 3 options for deviation from the norm, in frequency and timing:

1. , which is evidenced by a regular acceleration of the rhythm. The cardiogram shows a shortened RR interval, heart rate (heart rate) exceeds 120 pulses per minute, in severe cases up to 220. These disorders manifest in the patient with the following symptoms: shortness of breath, lack of oxygen, rapid breathing, palpable chest palpitations, a feeling of anxiety and fear.
2. ABOUT sinus bradycardia indicates a decrease in sinus rhythm on the ECG below 60 pulses per minute and a pronounced prolongation of the P-P interval. The patient experiences dizziness and may lose consciousness. This condition may indicate a disorder of the vagus nerve, which requires pharmacotherapy, and if treatment is not effective, a need for a pacemaker arises.
3. Sinus arrhythmia expressed by irregular contraction of the myocardium. That such a sinus rhythm on an ECG indicates instability of the heart rhythm. At the same time, the heart rate either accelerates or slows down, as evidenced by the different durations of the P-P intervals.

Based on ECG data, the doctor can make a conclusion about the state of the cardiovascular system and, if there are abnormalities, make a diagnosis.

Instability of the heart muscle, slow or accelerated rhythm indicate the presence of weak sinoatrial node syndrome in the wall of the right atrium, which can lead to coronary heart disease or other serious disease.

How to decipher a cardiogram of the heart: sinus rhythm and what the ECG results indicate

After the diagnosis is completed, the cardiogram of the heart is deciphered, sinus rhythm and other parameters are described according to all the rules.

A specialist (cardiologist) compares the result with the norm and makes a conclusion:

• The normal heart rate falls in the range from 60 to 90 pulses per minute, in children under 6 years old up to 120, and in newborns up to 140.
• The state of excitation of the sinus node can be determined by the P wave, which is always located in front of the QRS waves.
• The PQ interval has the same duration (0.12-0.20 seconds) throughout the electrical cardiogram.
• The PP interval (the cycle of myocardial contraction before the start of the next contraction) should also be the same throughout the entire cardiogram.

ECG results, interpretation, sinus rhythm may indicate physiological arrhythmia caused by increased psycho-emotional or physical stress, as well as some external factors (sharp changes in weather conditions).

Functional bradycardia or tachycardia accompanied by both irregular sinus rhythm and changes in heart rate. If, after eliminating the above reasons, cardiac activity does not return to normal, a pathological process can be suspected.

As a result of deciphering the cardiogram of the heart, abnormal sinus rhythm may indicate:

• diseases of the cardiovascular system of an inflammatory and/or infectious nature;
• organic changes in the myocardium;
• congenital and acquired anomalies of heart valves;
• acute or chronic heart failure;
• congenital anomaly of the atrioventricular node;
• endocrine pathologies, including thyrotoxicosis;
• damage to the vagus nerve;
• anemia or chronic hypoxia.

Nonspecific changes in the myocardium, confirmed by deciphering the cardiogram of the heart, sinus rhythm and its deviations may also indicate bad habits such as smoking, drug use and large doses of alcohol, as well as an overdose of certain drugs, therapeutic regular use of medications such as cardiac glycosides.

ECG results, interpretation, sinus rhythm and its display on the cardiogram will help not only determine the presence of factors that lead to irregular cardiac fluctuations, but also choose the appropriate treatment tactics.

The choice of treatment for heart rhythm disturbances depends on what causes them, physiological or disease. If in the first case a change in regime helps and healthy image life, then in the second a thorough examination and treatment of the underlying disease is required.

In any case, without waiting for the results of an ECG decoding of sinus rhythm, it is necessary to give up drugs, nicotine, abuse of alcohol, coffee and tea, and observe normal mode sleep and rest, play sports, spend more time outdoors.

It is important to eat well, not to overuse spices or chocolate, and to provide the body with all the necessary nutrients. It is forbidden to self-prescribe medications, especially antiarrhythmics and sedatives.

Detection of severe sinus arrhythmia, which has developed against the background of pathology of the heart and blood vessels, requires careful analysis, a high-quality therapeutic complex, and, if necessary, surgical intervention.

The specifics of treatment depend on the type of pathological process and the severity of symptoms.

Decoding the cardiogram of the heart, sinus rhythm in most cases indicates the adaptive ability of the myocardium to living conditions and changes in the load on the body, but requires mandatory confirmation of the absence of ailments.

This is due to the fact that blockade of the conduction system of the heart can be dangerous not only to health, but also to human life. Therefore, you should look so carefully at all suspicious ECG results, transcripts, sinus rhythm and carefully study elements and segments with deviations from the norm.

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The role of sinus rhythm in the work of the heart

The heart is a kind of pump that moves blood through the vessels. Signals regulating the functioning of the organ come from the central nervous system to the sinus node. What it is? An organ located in the right atrium.

The control center generates the rhythm of the heart and transmits the impulse for muscle contraction from the atria to the ventricles. There the signal is delayed a little, the ventricles fill with blood during this time, and the accelerating impulse then spreads further throughout all the vessels.

Thus, blood under pressure created by the heart circulates throughout the body and delivers oxygen and nutrients to the organs. Failures in the contraction mechanism can lead to catastrophic consequences, which is why sinus rhythm means so much to the body.

Normal sinus rhythm for a healthy adult is considered to be 60–70 beats/min. The allowed value is 75 beats/min. The heart must work in a rhythmic manner. What does shortening the intervals between beats mean?

Tachycardia - main danger sinus rhythm, the heart accelerates uncontrollably.

Check heart rhythm indicators by drawing up a cardiogram. Frequent change A heart in sinus rhythm is also a bad sign.

The following abnormalities do not require treatment:

A signal about an increase in sinus rhythm enters the regulatory organ when adrenaline is released into the blood. Therefore, a rapid heartbeat is often observed in a state of stress, during heavy physical exertion.

It’s bad when there are constant disturbances in the functioning of the sinus node, which are called weakness syndrome of this organ and require treatment.

Causes of heart disorders and diseases

Factors contributing to sinus rhythm disturbance are:

Signs of a malfunction of the sinus node are fatigue, irritability, weakness, and dizziness.

Such signs are not characteristic; they are inherent in many diseases, so heart problems cannot always be detected in a timely manner.

As a result, the following diseases may develop:

1. Tachycardia, when the pulse rate is significantly higher than normal. Accelerated sinus rhythm can be with a heart rate of up to 220 beats/min. This means that the heart is under enormous strain and wears out faster. The person’s condition does not allow him to perform even simple everyday tasks. Blood cannot circulate properly throughout the body.
2. Bradycardia, which means the sinus rhythm of the heart decreases below 60 beats/min. Such indicators are dangerous due to fainting, weakness and dizziness. The quality of human life is significantly reduced, circulatory system does not fully fulfill its tasks. In some cases, this problem is solved by installing an artificial stimulator.
3. Arrhythmia is a diagnosis in which the heart rhythm is uneven, the frequency of impulses unexpectedly speeds up or slows down. This condition may indicate a serious deficiency in the nutrition of the heart muscle, which, in turn, can provoke the development of other serious illnesses, such as heart failure.

Any disturbances in the performance of the sinoatrial node lead to circulatory failure. There is often a risk of developing blood clots, which can lead to a stroke.

The brain suffers especially severely from lack of oxygen and nutrients. Other organs and systems also do not receive the necessary substances in full.

It is not difficult to identify disturbances in the functioning of the sinus node; diagnosis consists of drawing up an electrocardiogram. The test is available and often helps prevent serious consequences of changes in sinus rhythm, one of which is tachycardia.

What is sinus rhythm of the heart? The most important indicator of the body's functioning. A healthy heart is the basis for the health of the entire body.

It is necessary to closely monitor its condition and, if there are any signs of malfunction, seek medical help as quickly as possible.

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The human heart moves non-stop throughout an individual's life, and as it operates, electric fields are constantly generated. This was the impetus for the emergence of a special method for recording them called electrocardiography. Now, perhaps, it is no longer possible to do without this method; in any cardiology, you can conduct an examination and identify possible abnormalities.

So what is an ECG? As a result, we get a visual image of the jumps in the biopotentials of our heart; the whole process of this study is called electrocardiography. But this is what lies at the heart of the testimony ECG: sinus rhythm, not everyone knows, but in vain. After all, this is a clear warning about the presence of serious abnormalities in the functioning of the cardiac system.

The permissible rhythm is the frequency of beats per minute in the range from sixty to eighty. In this case, the interval between strikes should be between 0.12 and 0.22 seconds.

If in your doctor’s final answer you saw a diagnosis of unstable sinus rhythm, then this implies too low a heart rate, namely the presence of sinus bradycardia. This disease has a very detrimental effect on general state the body, since all organs do not receive enough oxygen for their functioning. Often the first symptoms for a person may be regular dizziness, unstable arterial pressure, sharp pain in the chest, heavy breathing.

If, on the contrary, the sinus rhythm is rapid, then most likely the patient suffers from tachycardia. This is the case if the number of strokes exceeds one hundred and ten.

Absolutely healthy people can also fall under the influence of this sore, the reason for this is severe physical exertion or emotional arousal.

In some cases sinus tachycardia may be temporary, and its manifestations will be influenced by other factors.

It is a mistake to think that sinus rhythm is disturbed only in adults; on the contrary, children very often succumb to the effects of this disease. Only the reasons in this case are completely different, often it is emotional, psychological and physical stress. Violation of a child’s sinus rhythm can manifest itself during birth, but also during adulthood.

Instability of sinus rhythm in humans is primarily associated with the presence of sinus arrhythmia. This disease occurs due to problems with the contraction of the heart. According to statistics, the majority of patients with respiratory sinus arrhythmia are among young people. The reasons for this are obvious - overuse alcohol, the dangers of smoking, congenital and acquired heart defects, heart failure, etc.

But, be that as it may, maintaining a healthy heart is quite possible. People of all ages suffer from irregular heart rhythms, and to be honest, this is a very common diagnosis. If you control your physical and emotional stress, and also completely get rid of bad habits, stop using harmful medications, you will definitely be able to achieve positive results ECG and thereby protect yourself from further spread and manifestation of this disease.

Remember that sinus arrhythmia does not require any special treatment; it will be enough to identify negative factors and remove them in a timely manner, then the health of your heart and the whole body will return to normal. Everything is in your hands, so when you detect the first signs of this disease You must immediately go for an ECG, there you can find out about the state of sinus rhythm and, based on the conclusion, further conclusions can be drawn.

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Basic ECG parameters

When deciphered, any cardiogram undergoes a thorough analysis, which includes an assessment of many factors and indicators. The search for pathological changes in the ECG is based on the assessment of the waves, intervals, spaces that make up the electrical circuit of the heart. Moreover, each tooth and interval characterize the process of functioning of a specific department and area of ​​the heart muscle.

It is the recording of the biopotentials of the heart that forms the cardiographic image on film.

Based on the ECG results, a specialist can draw conclusions about the presence of a particular pathology of the cardiovascular system, decide on the need for additional examination or prescribe appropriate treatment already at at this stage. In this case, it is important for a specialist to evaluate both each indicator separately and their totality as a whole.

That is why, starting from medical schools, future specialists are introduced to the general scheme for decoding the ECG, according to which all the main points of the cardiogram should be assessed and analyzed.

The first and main parameter in this list is the determination of heart rhythm. When determining the heart rhythm on a cardiogram, an important indicator is the position and shape of the P wave. Normally, it is located in front of the QRS complex, it is positive in standard leads, and its width does not exceed 0.2 cm. Then cardiologists will say that there is sinus rhythm.

This fact indicates that, from a physiological point of view, the sinoatrial node of the conduction system of the heart is the driver of the heart rhythm. It is this accumulation of neurons that normally sets the rate of contraction in all areas of the heart muscle.

Sinus rhythm abnormalities on ECG

Decoding the ECG when analyzing the rhythm does not end with the statement that its driver is the sinoatrial node. The very fact of the presence of sinus rhythm does not mean the absence of pathology in this ECG segment.

IN modern cardiology There are many forms of sinus rhythm disturbance.

Normally, in a healthy person, the main pacemaker generates from 60 to 80 contractions of the heart muscle per minute. In this case, the interval between contractions is 0.12-0.22 seconds.

Correct sinus rhythm is indicated by the presence of equal duration intervals between complexes on the ECG.

When the duration of intervals in some areas is less than 0.12 seconds, and in others more than 0.22 seconds, this indicates an abnormal sinus rhythm, or sinus arrhythmia.

Also in his conclusion, the cardiologist can indicate the stability or instability of the heart rhythm. This indicator is also determined by the length of the intercomplex intervals. In this case, there are two extreme variants of the pathology: sinus tachycardia and sinus bradycardia.

In the first case, there is too frequent (more than 100 times per minute) generation of contractions by the sinoatrial node. In the case of bradycardia, a small number of heart contractions per unit of time is observed. Clinicians consider the minimum limit of normal, taking into account physiological characteristics, to be 50 beats per minute.

At the same time, both variants of the pathology carry quite significant grounds for immediate rhythm correction, since they equally have a detrimental effect on the functioning of the heart.

If we talk about instability of sinus rhythm, or sinus arrhythmia, then this problem is identified by cardiologists as a separate group of heart diseases.

Classification of arrhythmia

They involve the allocation large quantity various types of arrhythmias.

The extreme development options are complete violation functions of the sinoatrial node with the formation of atrial fibrillation and flutter.

In such cases, the heart rate exceeds 250-500 beats per minute, the waves on the ECG are practically not tracked, and the formation of single sawtooth waves f on the isoline is noted.

In cardiology, atrial fibrillation is also called atrial fibrillation.

In cases where the sinus rhythm driver loses its functions, the formation of non-sinus rhythms develops. In the clinical picture this is reflected in the form of various types of arrhythmias.

Thus, when analyzing sinus rhythm, three main pathological conditions are distinguished:

1. Sinus tachycardia - in this case, the correct sinus rhythm is observed, the contraction frequency is more than 110 per minute. Clinicians among the reasons sinus tachycardia highlight increased activity sympathetic division autonomic nervous system (this can be a variety of emotional or physical overload, decreased activity of the vagus nerve, damage to the sinoatrial node, various intoxications, infectious diseases or the effects of certain medications).
2. Sinus bradycardia is a variant in which there is a regular rhythm generated by the sinoatrial node, with a frequency of less than 50 beats per minute. The causes of bradycardia are opposite to the previous condition. These include an increase in the activity of the vagus nerve, a decrease in the influence of the sympathetic nervous system, different kinds hypoxia, extensive heart attacks myocardium, the influence of antiarrhythmics and cardiac glycosides, hypothyroidism, some infectious diseases.
3. Sinus arrhythmia - characterized by the fact that the rhythm is formed by the sinus driver, but the contraction frequency varies within limits exceeding 0.16 seconds. In this case, depending on the presence or absence of a clearly visible connection between heart rate intervals and the duration of respiratory cycles, we can talk about respiratory and non-respiratory sinus arrhythmia. The first, as a rule, characterizes the presence of an imbalance in the functioning of parts of the autonomic nervous system. The second variant of arrhythmia indicates an organic lesion of the pacemaker itself. It could be ischemic disease heart, various inflammatory changes in the myocardium, toxic effects of cardiac glycosides.

Clinical picture of sinus rhythm disorders

In conclusion, it is worth noting that the presence of correct sinus rhythm is accompanied by absolute well-being in a person’s health. While any deviations from the norm immediately make themselves felt in the form of certain clinical symptoms.

Most often in the initial stages clinical picture is latent or nonspecific.

Modern cardiology is increasingly faced with problems of sinus rhythm disturbances in children. From a clinical point of view, this category of patients is especially problematic in terms of early diagnosis. Often children either will not tell their parents about the symptoms that bother them, or cannot express their discomfort in words. In some cases, the lack of early diagnosis causes serious disturbances in the functioning of the heart in young patients.

In both children and adults, the first symptoms may be increased fatigue, shortness of breath, and difficulty with prolonged walking or physical activity. At the beginning of the disease, the patient may not attach importance to the alarming signs of emerging changes in the heart.

At the same time, it is the results of the ECG that can allow the specialist to identify existing disorders on early stages and correct them in time, thereby avoiding more serious problems in future. In pediatric cardiology, an ECG of heart rhythm makes it possible to eliminate existing problems in the early stages without the risk of developing cardiac pathology in the future.

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Electrocardiogram is a widely used method of objective diagnostics various pathologies of the human heart, which is used almost everywhere today. An electrocardiogram (ECG) is taken in a clinic, in an ambulance, or in a hospital department. ECG is a very important recording that reflects the condition of the heart. That is why the reflection of the most different options Cardiac pathology on the ECG is described by a separate science - electrocardiography. Electrocardiography also deals with the problems of correct ECG recording, decoding issues, interpretation of controversial and unclear points, etc.

Definition and essence of the method

An electrocardiogram is a recording of the heart, which is presented as a curved line on paper. The cardiogram line itself is not chaotic; it has certain intervals, teeth and segments that correspond to certain stages of the heart.

To understand the essence of an electrocardiogram, you need to know what exactly is recorded by a device called an electrocardiograph. The ECG records the electrical activity of the heart, which changes cyclically in accordance with the onset of diastole and systole. The electrical activity of the human heart may seem like fiction, but this unique biological phenomenon exists in reality. In reality, the heart contains so-called cells of the conduction system, which generate electrical impulses that are transmitted to the muscles of the organ. It is these electrical impulses that cause the myocardium to contract and relax with a certain rhythm and frequency.

The electrical impulse propagates through the cells of the conduction system of the heart strictly sequentially, causing contraction and relaxation of the corresponding sections - the ventricles and atria. The electrocardiogram reflects precisely the total electrical potential difference in the heart.

decryption?

An electrocardiogram can be taken in any clinic or multidisciplinary hospital. You can contact a private medical center where there is a specialist cardiologist or therapist. After recording the cardiogram, the tape with curves is examined by the doctor. It is he who analyzes the recording, deciphers it and writes a final report, which reflects all visible pathologies and functional deviations from the norm.

An electrocardiogram is recorded using a special device - an electrocardiograph, which can be multi-channel or single-channel. The speed of ECG recording depends on the modification and modernity of the device. Modern devices can be connected to a computer, which, with a special program, will analyze the recording and issue a final conclusion immediately after the procedure is completed.

Any cardiograph has special electrodes that are applied in a strictly defined order. There are four clothespins in red, yellow, green and black that are placed on both arms and both legs. If you go in a circle, then the clothespins are applied according to the rule “red-yellow-green-black”, from the right hand. It's easy to remember this sequence thanks to the student saying: "Every-Woman is an Eviler Trait." In addition to these electrodes, there are also chest electrodes, which are installed in the intercostal spaces.

As a result, the electrocardiogram consists of twelve waveforms, six of which are recorded from the chest electrodes, and are called chest leads. The remaining six leads are recorded from electrodes attached to the arms and legs, with three of them called standard and three more called enhanced. The chest leads are designated V1, V2, V3, V4, V5, V6, the standard ones are simply Roman numerals - I, II, III, and the reinforced leg leads - the letters aVL, aVR, aVF. Different leads of the cardiogram are necessary to create the most complete picture of the activity of the heart, since some pathologies are visible on the chest leads, others on the standard ones, and still others on the enhanced ones.

The person lies down on the couch, the doctor attaches the electrodes and turns on the device. While the ECG is being written, the person must be absolutely calm. We must not allow the appearance of any irritants that can distort the true picture of the work of the heart.

How to correctly perform an electrocardiogram followed by
transcript - video

The principle of decoding an ECG

Since the electrocardiogram reflects the processes of contraction and relaxation of the myocardium, it is possible to trace how these processes occur and identify existing pathological processes. Elements of the electrocardiogram are closely related and reflect the duration of the phases cardiac cycle– systole and diastole, that is, contraction and subsequent relaxation. Decoding the electrocardiogram is based on the study of the teeth, their position relative to each other, duration, and other parameters. The following elements of the electrocardiogram are studied for analysis:
1. Teeth.
2. Intervals.
3. Segments.

All sharp and smooth convexities and concavities on the ECG line are called teeth. Each tooth is designated by a letter Latin alphabet. The P wave reflects contraction of the atria, the QRS complex – contraction of the ventricles of the heart, the T wave – relaxation of the ventricles. Sometimes after the T wave on the electrocardiogram there is another U wave, but it has no clinical and diagnostic role.

An ECG segment is considered to be a segment enclosed between adjacent teeth. For diagnosing heart pathology, the P – Q and S – T segments are of great importance. The interval on the electrocardiogram is a complex that includes a tooth and an interval. The P–Q and Q–T intervals are of great importance for diagnosis.

Often in the doctor’s report you can see small letters, which also denote teeth, intervals and segments. Small letters are used if the prong is less than 5 mm long. In addition, several R waves may appear in the QRS complex, which are usually designated R’, R”, etc. Sometimes the R wave is simply missing. Then the entire complex is designated by only two letters - QS. All this has important diagnostic significance.

ECG interpretation plan - general scheme for reading results

When deciphering an electrocardiogram, the following parameters reflecting the work of the heart must be established:

• position of the electrical axis of the heart;
• determining the correctness of the heart rhythm and conductivity of the electrical impulse (blockades, arrhythmias are identified);
• determining the regularity of contractions of the heart muscle;
• determination of heart rate;
• identifying the source of the electrical impulse (whether sinus rhythm is determined or not);
• analysis of the duration, depth and width of the atrial P wave and the P – Q interval;
• analysis of the duration, depth, width of the QRST ventricular wave complex;
• analysis of parameters of the RS – T segment and T wave;
• analysis of Q – T interval parameters.

Based on all the studied parameters, the doctor writes a final conclusion on the electrocardiogram. The conclusion may roughly look like this: “Sinus rhythm with heart rate 65. Normal position of the electrical axis of the heart. No pathology identified.” Or this: “Sinus tachycardia with heart rate 100. Single supraventricular extrasystole. Incomplete blockade of the right bundle branch. Moderate metabolic changes in the myocardium.”

In the conclusion on the electrocardiogram, the doctor must reflect the following parameters:

• sinus rhythm or not;
• rhythm regularity;
• heart rate (HR);
• position of the electrical axis of the heart.

If any of the 4 pathological syndromes are identified, then indicate which ones - rhythm disturbance, conduction, overload of the ventricles or atria, and damage to the structure of the heart muscle (infarction, scar, dystrophy).

Example of deciphering an electrocardiogram

At the very beginning of the electrocardiogram tape there should be a calibration signal, which looks like a large letter “P” 10 mm high. If this calibration signal is not present, then the electrocardiogram is uninformative. If the height of the calibration signal is below 5 mm in standard and enhanced leads, and below 8 mm in chest leads, then there is a low voltage of the electrocardiogram, which is a sign of a number of heart pathologies. For subsequent decoding and calculation of some parameters, you need to know what period of time fits into one cell of graph paper. At a belt speed of 25 mm/s, one cell 1 mm long is equal to 0.04 seconds, and at a speed of 50 mm/s – 0.02 seconds.

Checking the regularity of heart contractions

It is assessed by the intervals R - R. If the teeth are located at the same distance from each other throughout the entire recording, then the rhythm is regular. Otherwise it is called correct. Estimating the distance between the R - R teeth is very simple: the electrocardiogram is recorded on graph paper, which makes it easy to measure any gaps in millimeters.

Heart rate (HR) calculation

It is carried out using a simple arithmetic method: count the number of large squares on graph paper that are placed between two R waves. Then the heart rate is calculated using the formula, which is determined by the speed of the tape in the cardiograph:
1. The tape speed is 50 mm/s - then the heart rate is 600 divided by the number of squares.
2. The tape speed is 25 mm/s - then the heart rate is 300 divided by the number of squares.

For example, if 4.8 large squares fit between two R teeth, then the heart rate, at a belt speed of 50 mm/s, will be equal to 600/4.8 = 125 beats per minute.

If the heart rate is abnormal, then the maximum and minimum heart rate is determined, also taking as a basis the maximum and minimum distances between the R waves.

Identifying the source of the rhythm

The doctor studies the rhythm of heart contractions and finds out which node of nerve cells causes the cyclic processes of contraction and relaxation of the heart muscle. This is very important for identifying blockages.

Decoding ECG - rhythms

Normally, the pacemaker is the sinus node. And such a normal rhythm itself is called sinus - all other options are pathological. At various pathologies Any other node of the nerve cells of the conduction system of the heart can act as a pacemaker. In this case, the cyclic electrical impulses become confused and the heart rhythm is disrupted - an arrhythmia occurs.

In sinus rhythm on the electrocardiogram in lead II there is a P wave before each QRS complex, and it is always positive. In one lead, all P waves should have the same shape, length and width.

With atrial rhythm the P wave in leads II and III is negative, but is present before each QRS complex.

Atrioventricular rhythms are characterized by the absence of P waves on cardiograms, or the appearance of this wave after the QRS complex, and not before it, as is normal. With this type of rhythm, the heart rate is low, ranging from 40 to 60 beats per minute.

Ventricular rhythm characterized by an increase in the width of the QRS complex, which becomes large and quite frightening. The P waves and the QRS complex are completely unrelated to each other. That is, there is no strict correct normal sequence - the P wave, followed by the QRS complex. Ventricular rhythm is characterized by a decrease in heart rate - less than 40 beats per minute.

Detection of pathology of electrical impulse conduction through the structures of the heart

To do this, measure the duration of the P wave, the P–Q interval and the QRS complex. The duration of these parameters is calculated from the millimeter tape on which the cardiogram is recorded. First, count how many millimeters each tooth or interval occupies, after which the resulting value is multiplied by 0.02 at a recording speed of 50 mm/s, or by 0.04 at a recording speed of 25 mm/s.

The normal duration of the P wave is up to 0.1 seconds, the P – Q interval is 0.12-0.2 seconds, the QRS complex is 0.06-0.1 seconds.

Electrical axis of the heart

Denoted as the alpha angle. It can have a normal position, horizontal or vertical. Moreover, thin man The axis of the heart is more vertical relative to average values, and in overweight people it is more horizontal. The normal position of the electrical axis of the heart is 30–69 o, vertical – 70–90 o, horizontal – 0–29 o. The alpha angle, equal to 91 to ±180 o, reflects a sharp deviation of the electrical axis of the heart to the right. The alpha angle, equal to 0 to –90 o, reflects a sharp deviation of the electrical axis of the heart to the left.

The electrical axis of the heart can deviate under various pathological conditions. For example, hypertension leads to a deviation to the right; a conduction disorder (blockade) can shift it to the right or left.

Atrial P wave

The atrial P wave should be:

• positive in I, II, aVF and chest leads (2, 3,4, 5, 6);
• negative in aVR;
• biphasic (part of the tooth lies in the positive region, and part in the negative) in III, aVL, V1.

The normal duration of P is no more than 0.1 seconds, and the amplitude is 1.5 - 2.5 mm.

Pathological forms of the P wave may indicate the following pathologies:
1. Tall and sharp teeth in leads II, III, aVF appear with hypertrophy of the right atrium (“cor pulmonale”);
2. A P wave with two peaks and a large width in leads I, aVL, V5 and V6 indicates hypertrophy of the left atrium (for example, mitral valve disease).

P–Q interval

The P–Q interval has a normal duration of 0.12 to 0.2 seconds. An increase in the duration of the P–Q interval is a reflection of atrioventricular block. On the electrocardiogram, three degrees of atrioventricular block (AV) can be distinguished:

• I degree: simple lengthening of the P–Q interval while preserving all other complexes and waves.
• II degree: prolongation of the P–Q interval with partial loss of some QRS complexes.
• III degree: lack of connection between the P wave and QRS complexes. In this case, the atria work in their own rhythm, and the ventricles - in their own.

Ventricular QRST complex

The ventricular QRST complex consists of the QRS complex itself and the S – T segment. The normal duration of the QRST complex does not exceed 0.1 seconds, and its increase is detected with blockades of the Hiss bundle branches.

QRS complex consists of three waves, Q, R and S, respectively. The Q wave is visible on the cardiogram in all leads except 1, 2 and 3 chest leads. Normal tooth Q has an amplitude of up to 25% of that of the R wave. The duration of the Q wave is 0.03 seconds. The R wave is recorded in absolutely all leads. The S wave is also visible in all leads, but its amplitude decreases from the 1st thoracic to the 4th, and in the 5th and 6th it may be completely absent. The maximum amplitude of this tooth is 20 mm.

The S–T segment is very important from a diagnostic point of view. It is by this tooth that myocardial ischemia can be detected, that is, a lack of oxygen in the heart muscle. Usually this segment runs along the isoline, in the 1st, 2nd and 3rd chest leads; it can rise up by a maximum of 2 mm. And in the 4th, 5th and 6th chest leads, the S-T segment can shift below the isoline by a maximum of half a millimeter. It is the deviation of the segment from the isoline that reflects the presence of myocardial ischemia.

T wave

The T wave is a reflection of the process of eventual relaxation in the cardiac muscle of the ventricles of the heart. Typically, when the amplitude of the R wave is large, the T wave will also be positive. A negative T wave is normally recorded only in lead aVR.

Q-T interval

The Q–T interval reflects the process of eventual contraction in the myocardium of the ventricles of the heart.

ECG interpretation - normal indicators

The transcript of the electrocardiogram is usually recorded by the doctor in conclusion. Typical example normal cardiogram heart looks like this:
1. PQ – 0.12 s.
2. QRS – 0.06 s.
3. QT – 0.31 s.
4. RR – 0.62 – 0.66 – 0.6.
5. Heart rate is 70 - 75 beats per minute.
6. sinus rhythm.
7. The electrical axis of the heart is located normally.

Normally, the rhythm should be only sinus, the heart rate of an adult is 60 - 90 beats per minute. The P wave is normally no more than 0.1 s, the P – Q interval is 0.12-0.2 seconds, the QRS complex is 0.06-0.1 seconds, Q – T is up to 0.4 s.

If the cardiogram is pathological, then it indicates specific syndromes and deviations from the norm (for example, partial blockade left Hiss bundle branch, myocardial ischemia, etc.). The doctor can also reflect specific violations and changes in the normal parameters of the waves, intervals and segments (for example, shortening of the P wave or Q-T interval, etc.).

Interpretation of ECG in children and pregnant women

In principle, children and pregnant women have normal heart electrocardiogram readings - the same as in healthy adults. However, there are certain physiological characteristics. For example, the heart rate of children is higher than that of an adult. Normal heart rate a child under 3 years of age is 100–110 beats per minute, 3–5 years old – 90–100 beats per minute. Then gradually the heart rate decreases, and adolescence is compared with that of an adult – 60 – 90 beats per minute.

In pregnant women, there may be a slight deviation of the electrical axis of the heart by later gestation due to compression by the growing uterus. In addition, sinus tachycardia often develops, that is, an increase in heart rate to 110 - 120 beats per minute, which is a functional condition and goes away on its own. An increase in heart rate is associated with a greater volume of circulating blood and increased workload. Due to increased workload on the heart, pregnant women may experience overload various departments organ. These phenomena are not a pathology - they are associated with pregnancy and will go away on their own after childbirth.

Decoding the electrocardiogram during a heart attack

Myocardial infarction is a sudden cessation of oxygen supply to the heart muscle cells, resulting in the development of necrosis of a tissue area that is in a state of hypoxia. The reason for the disruption of oxygen supply can be different - most often it is a blockage of a blood vessel, or its rupture. A heart attack affects only part of muscle tissue heart, and the volume of damage depends on the size blood vessel found to be clogged or ruptured. On an electrocardiogram, myocardial infarction has certain signs by which it can be diagnosed.

In the process of development of myocardial infarction, four stages are distinguished, which have different manifestations on ECG:

• acute;
• acute;
• subacute;
• cicatricial.

The most acute stage myocardial infarction can last for 3 hours - 3 days from the moment of circulatory disturbance. At this stage, the Q wave may be absent on the electrocardiogram. If it is present, then the R wave has a low amplitude or is completely absent. In this case, there is a characteristic QS wave, reflecting a transmural infarction. Second sign acute heart attack– this is an increase in the S-T segment by at least 4 mm above the isoline, with the formation of one large T wave.

Sometimes it is possible to detect the phase of myocardial ischemia preceding the acute phase, which is characterized by high T waves.

Acute stage A heart attack lasts 2–3 weeks. During this period, a wide and high-amplitude Q wave and a negative T wave are recorded on the ECG.

Subacute stage lasts up to 3 months. The ECG shows a very large negative T wave with a huge amplitude, which gradually normalizes. Sometimes a rise in the S-T segment is detected, which should have leveled off by this period. This is an alarming symptom, as it may indicate the formation of a cardiac aneurysm.

Scar stage heart attack is final, since connective tissue is formed at the damaged site, incapable of contraction. This scar is recorded on the ECG as a Q wave, which will remain for life. Often the T wave is smoothed, has a low amplitude, or is completely negative.

Interpretation of the most common ECGs

In conclusion, doctors write the result of the ECG interpretation, which is often incomprehensible because it consists of terms, syndromes and simply statements of pathophysiological processes. Let's consider the most common ECG conclusions, which are incomprehensible to a person without a medical education.

Ectopic rhythm means not sinus - which can be either a pathology or a norm. The norm is ectopic rhythm when there is a congenital malformation of the conduction system of the heart, but the person does not present any complaints and does not suffer from other cardiac pathologies. In other cases, an ectopic rhythm indicates the presence of blockades.

Changes in repolarization processes on the ECG reflects a violation of the process of relaxation of the heart muscle after contraction.

Sinus rhythm This is the normal heart rate of a healthy person.

Sinus or sinusoidal tachycardia means that a person has a correct and regular rhythm, but an increased heart rate - more than 90 beats per minute. In young people under 30 years of age, this is a variant of the norm.

Sinus bradycardia- this is a low heart rate - less than 60 beats per minute against the background of a normal, regular rhythm.

Nonspecific ST-T changes mean that there are minor deviations from the norm, but their cause may be completely unrelated to heart pathology. Must pass full examination. Such nonspecific ST-T changes can develop with an imbalance of potassium, sodium, chlorine, magnesium, or various ions endocrine disorders, often during menopause in women.

Biphasic R wave in combination with other signs of a heart attack indicates damage to the anterior wall of the myocardium. If no other signs of a heart attack are detected, then a biphasic R wave is not a sign of pathology.

QT prolongation may indicate hypoxia (lack of oxygen), rickets, or overexcitation of the child’s nervous system, which is a consequence of birth trauma.

Myocardial hypertrophy means that the muscular wall of the heart is thickened and works under enormous load. This can lead to the formation of:

• heart failure;
• arrhythmias.

Also, myocardial hypertrophy can be a consequence of previous heart attacks.

Moderate diffuse changes in the myocardium mean that tissue nutrition is impaired and cardiac muscle dystrophy has developed. This is a fixable condition: you need to see a doctor and undergo an adequate course of treatment, including normalizing your diet.

Deviation of the electrical axis of the heart (EOS) left or right is possible with hypertrophy of the left or right ventricle, respectively. EOS can deviate to the left in obese people, and to the right - in thin people, but in this case this is a variant of the norm.

Left type ECG– EOS deviation to the left.

NBPNG– an abbreviation for “incomplete right bundle branch block.” This condition can occur in newborns and is a normal variant. In rare cases, RBBB can cause arrhythmia, but generally does not lead to the development negative consequences. Block of the Hiss bundle branch is quite common in people, but if there are no complaints about the heart, then it is not at all dangerous.

BPVLNPG– an abbreviation meaning “blockade of the anterior branch of the left bundle branch.” Reflects a violation of the conduction of electrical impulses in the heart, and leads to the development of arrhythmias.

Small growth of the R wave in V1-V3 may be a sign of a heart attack interventricular septum. To accurately determine whether this is the case, it is necessary to do another ECG study.

CLC syndrome(Klein-Levy-Kritesco syndrome) is a congenital feature of the conduction system of the heart. May cause the development of arrhythmias. This syndrome does not require treatment, but it is necessary to be regularly examined by a cardiologist.

Low voltage ECG often recorded with pericarditis (a large amount of connective tissue in the heart that has replaced muscle tissue). In addition, this sign may be a reflection of exhaustion or myxedema.

Metabolic changes are a reflection of insufficient nutrition of the heart muscle. It is necessary to be examined by a cardiologist and undergo a course of treatment.

Conduction slowdown means that the nerve impulse travels through the tissues of the heart more slowly than normal. By itself this state does not require special treatment - this may be a congenital feature of the conduction system of the heart. Regular monitoring by a cardiologist is recommended.

Blockade 2 and 3 degrees reflects a serious disturbance of cardiac conduction, which is manifested by arrhythmia. In this case, treatment is necessary.

Rotation of the heart by the right ventricle forward may be an indirect sign of the development of hypertrophy. In this case, it is necessary to find out its cause and undergo a course of treatment, or adjust your diet and lifestyle.

Price of an electrocardiogram with interpretation

The cost of an electrocardiogram with interpretation varies significantly, depending on the specific medical institution. Thus, in public hospitals and clinics minimum price for the procedure of taking an ECG and interpreting it by a doctor, it costs from 300 rubles. In this case, you will receive films with recorded curves and a doctor’s conclusion on them, which he will make himself, or using a computer program.

If you want to receive a thorough and detailed conclusion on the electrocardiogram, an explanation by the doctor of all parameters and changes, it is better to contact private clinic, which provides similar services. Here the doctor will be able not only to write a conclusion after deciphering the cardiogram, but also to calmly talk to you, taking his time to explain all the points of interest. However, the cost of such a cardiogram with interpretation in a private medical center ranges from 800 rubles to 3,600 rubles. You should not assume that bad specialists work in an ordinary clinic or hospital - it’s just that the doctor has government agency, as a rule, there is a very large amount of work, so he simply does not have time to talk with each patient in great detail.

When choosing a medical institution for taking a cardiogram with interpretation, first of all, pay attention to the qualifications of the doctor. It is better for this to be a specialist - a cardiologist or therapist with good experience. If a child needs a cardiogram, then it is better to contact specialists - pediatricians, since “adult” doctors do not always take into account the specifics and physiological characteristics of children.

Before use, you should consult a specialist.

An electrocardiogram is prescribed to a patient when the doctor suspects the development of a disease related to the cardiovascular system. With the help of such an examination, many factors can be identified: worsening of a previously detected pathology, the manifestation of new symptoms.

The procedure is mandatory before every surgical operation, regardless of the damaged organs and the expected disease. The results of the electrocardiogram have certain marks of normal activity of the heart muscle. Cardiogram of the heart, sinus rhythm, what is it?

Normal indicators

The sinus ECG rhythm indicates the absence of any abnormalities in the functioning of the heart muscle in the patient’s body. These are certain oscillations, when they appear, electronic impulses are first formed in the sinus node, and only then diverge to their final destinations - to the ventricular and precardiac sections of the organ. In general, this whole process makes a person’s heart beat, saturating the limbs with blood.

The cardiogram displays correct result, if the patient who was prescribed the examination does not need to worry or be nervous about any issues. He shouldn't be afraid, it's better to relax and not think about anything.

What does sinus heart rhythm mean? When a cardiologist puts a certain mark on the cardiogram, he shows that the P peak in the entire QRS complex is constant, the main beat interval is 65–85 beats in 60 seconds, and the displayed distances P-P, R-R are similar. As a result, it becomes clear that the survey methodology great value focuses on localizing the driver's rhythm in the sinus center. For a reliable analysis, the following factors are checked:

• The P points should precede the QRS complexes;
• The P values ​​of the openings must be identical to each other and located in similar divisions;
• In the 2nd opening, point P should be in the positive spectrum.

When all the data ECG signs The sinus beat is found in full, this means that the excitatory impulses are correctly distributed in order from top to bottom. If they were not detected, the rhythm cannot be assessed as sinus.

This fact will indicate that the source is located in the second-order sections: the ventricles, atrium or atrioventricular node.

Interpretation of the cardiogram - vertical position of the ECG rhythm. It means that the central axis and stroke move according to the accepted norm. As a result, this method determines the closest position of the heart muscle in the patient’s chest.

IN special cases the organ is located in planes - horizontal and semi-horizontal, as well as half vertical. It is worth noting that the heart can move in different directions relative to the axis: forward and backward, to the sides. This fact is not proof of the development of pathology, it only indicates the individual characteristics of the patient’s body structure.

Deviations from the norm

Unfortunately, not all people have good health. Often, during diagnosis, various deviations and disorders are revealed. ECG indicator negative character, usually speaks of blockades in the heart or arrhythmia.

The blockage is usually caused by abnormal, unusual transmission of electrical impulses from the CNS (central nervous system) to the heart muscle itself. For example, an overestimated number of pulse beats indicates that with the usual systematics, as well as the standard sequence of organ compression, the oscillations are slightly accelerated and increased.

When talking about deviations in beat, it is usually caused by any differences between the sequence, frequency and regularity of beats. The size of the differences between the distances of points on the ECG reflects the irregularity of sinus rhythm. As a rule, this indicates a weak node.

To identify the development of heart rhythm pathology, a Holter examination is prescribed, and a medication test is also performed. This method is used to determine how stable the regulation of the autonomic system is and whether it has gone astray.

Signs of sinus rhythm disturbances on the ECG

Weakness syndrome (SSWS) is damage to the exciter impulses, which can be detected using electrocardiographic examination and clinical methods.

It is important to know what the normal ECG examination looks like in order to diagnose the presence of arrhythmia in a patient.

It was already indicated above that the disease is characterized by P waves located in the positive zone and similar in size. They must also be at the same distance from each other (approximately from 0.1 to 0.2 seconds), and must be in front of the QRS indicator.

The main thing is that the frequency of heart muscle beats within one minute does not exceed 90–100 contractions. To calculate the desired mark, you need to divide 60 by the length of the armhole R-R, displayed on the second scale.

Another method is to multiply the QRS mark obtained over a 3-second interval (approximately 15 centimeters on the tape) by 20. An ECG examination of sinus rhythm may show the following abnormalities:

Causes of heart rate surges

TO most known reasons disorders of the heart include:

1. Excessive alcohol consumption;
2. Cardiac muscle disorders - defects, acquired or congenital;
3. Tobacco smoking;
4. Long-term use of antiarrhythmic medications, glucosides;
5. Protrusion of the mitral valve, complete or partial;
6. Vivid heart failure;
7. A strong surge in the production of thyroid hormones.

Some factors that influence an increase in heart rate can eliminate rhythm deviations during respiratory function.

The human heart is peculiar trigger mechanism for the productive functioning of the whole organism. Thanks to the impulses of this organ, which are issued on a regular basis, blood is able to circulate throughout the body, saturating the body with vitality. important substances. If the heart is normal, then the whole body works as productively as possible, but sometimes you still have to face certain health problems.

If a person comes for an examination to a doctor and the specialist suspects that something is wrong with his heart, he will send the patient for an ECG. Sinus rhythm on an ECG is a very important indicator and clearly provides data on the real state of the human heart muscle. What exactly can be determined by looking at the cardiogram is worth considering in more detail.

What is sinus rhythm

According to medical staff, sinus rhythm of the cardiogram is the norm for the human body. If there are equal spaces between the teeth shown on the cardiogram, and the height of these columns is also the same, then there are no deviations in the functioning of the main organ.

This means that sinus rhythm on the cardiogram is as follows:

• graphical representation of human pulse fluctuations;
• a set of teeth of different lengths, between which there are different intervals, showing the specific rhythm of heart impulses;
• schematic representation of the work of the heart muscle;
• an indicator of the presence or absence of abnormalities in the functioning of the heart and its individual valves.

Normal sinus rhythm is only present when the heart rate is at least 60 and no more than 80 beats per minute. This is the rhythm that is considered normal for the human body. and on the cardiogram it is displayed as teeth of the same size, located at the same distance from each other.

If the sinus rhythm of the heart cardiogram deviates from the norm, the medical specialist will prescribe a number of additional studies to the patient, including tests

It is clearly worth remembering that the results of a cardiogram can be one hundred percent accurate only if the person is completely calm. Stressful situations and nervous tension contribute to the fact that the heart muscle begins to emit impulses faster, which means that it will definitely not be possible to obtain a reliable result about the state of a person’s health.

What criteria are used to decipher the ECG result?

It is performed by doctors according to a special scheme. Medical specialists have a clear understanding of which marks on the cardiogram are normal and which are abnormal. The ECG conclusion will be issued only after calculating the results, which were displayed in schematic form. A doctor, when examining a patient’s cardiogram in order to correctly and accurately decipher it, will pay special attention to a number of such indicators:

• the height of the bars displaying the rhythm of heart impulses;
• the distance between the teeth on the cardiogram;
• how sharply the indicators of the schematic image fluctuate;
• what specific distance is observed between the bars displaying the pulses.

A doctor who knows what each of these schematic marks means carefully studies them and can clearly determine what kind of diagnosis needs to be made. Cardiograms of children and adults are deciphered according to the same principle, but normal indicators for people of different age categories cannot be the same.

What sinus rhythm problems can be seen on an ECG?

Electrocardiogram readings can indicate obvious signs problems in the functioning of the heart muscles. With the help of this study, you can notice whether there is weakness of the sinus node, and what kind of health problems this causes. By looking at the cardiogram readings of a particular patient, a medical specialist can decipher the presence of problems of the following nature:

• sinus tachycardia on the ECG, indicating an excess of the contraction rhythm, which is considered normal;
• sinus arrhythmia on the ECG, indicating that the interval between contractions of the heart muscles is too long;
• sinus bradycardia on the ECG, indicating that the heart beats less than 60 times in one minute;
• the presence of too small an interval between the teeth of the cardiogram, which means disturbances in the functioning of the sinus node.

An ECG can easily determine the presence of sinus tachycardia, arrhythmia or bradycardia

Sinus bradycardia is a common abnormality, especially when it comes to the health of a child. This diagnosis can be explained by many factors, among which may be physiological defects or simply a factor of chronic fatigue.

Deviation of the EOS to the left also indicates that the work of a vital organ is not working properly. Having identified such deviations, the doctor will send the patient for additional examination and ask him to undergo a number of necessary tests.

If a vertical position of the EOS is observed, this means that the heart has a normal location and is in its place, there are no serious physiological abnormalities. This situation is an indicator of the norm, which is also indicated in the conclusion of the doctor who deciphered the cardiogram.

If a horizontal position of the EOS is observed, then this cannot immediately be considered a pathological condition. Such axis indicators are observed in people who have short stature, but rather broad shoulders. If the axis deviates to the left or right, and this is very noticeable, then such indicators may indicate pathological condition organ, enlargement of the left or right ventricles. Axial displacement may indicate that certain valves are affected. If the axis shifts to the left, then the person most likely has heart failure. If a person suffers from ischemia, then the axis shifts in right side. Such a deviation may also indicate abnormalities in the development of the heart muscle.

What can we say about normal indicators?

On an ECG, sinus rhythm is always and without fail compared with certain normal values. Only knowing these indicators completely will the doctor be able to understand the patient’s cardiogram and give the correct conclusion.

Normal indicators for children and adults are completely different factors. If we consider the norms for different age categories, they will be something like this:

• in children from birth to the first year of life, the direction of the axis is vertical, the heart beats with a heart rate of 60 to 150 beats per minute;
• children from one year to six years have a mainly vertical axis, but it can also be horizontal, without indicating deviations from the norm. Heart rate from 95 to 128;
• children from seven years of age and adolescents should have a normal or vertical axis position on the cardiogram, the heart should contract from 65 to 90 beats per minute;
• adults should have a normal axis direction on the cardiogram, the heart contracts at a frequency of 60 to 90 times per minute.

Normal heart rate in children is higher than in adults

The above indicators fall under the category of the established norm, but if they are slightly different, this does not always become a sign of the presence of some serious pathologies in the body.

Why ECG readings may deviate from the norm

Irregular heart rhythm can be provoked not only by serious pathological abnormalities, but also by factors more familiar to a person’s daily life.

If the result of the electrocardiogram does not always correspond to the norm, this means that this state of the body could be provoked by the following factors:

• the person regularly drinks alcoholic beverages;
• the patient is quite long time smokes cigarettes on a regular basis;
• a person is regularly exposed to various types of stressful situations;
• the patient often uses antiarrhythmic drugs;
• a person has problems with the functioning of the thyroid gland.

Of course, an accelerated heart rate or too slow may indicate problems of a more serious nature. If the results of the cardiogram are not normal, this may indicate acute heart failure, valve displacement, or congenital heart defects.

If the sinus rhythm is within the established norm, then the person should not worry, and the doctor will be able to make sure that his patient is healthy.

The sinus node regularly emits impulses that cause the heart muscles to contract correctly and carry the necessary signals throughout the body. If these impulses are given irregularly, which can be clearly recorded by a cardiogram, then the doctor will have every reason to assume that the person has health problems. After studying the heart rate, the doctor will determine the exact cause of all deviations and will be able to offer the patient competent treatment.

Why should a person undergo an ECG test?

The sinus rhythm, which is displayed on the ECG, clearly indicates whether there are deviations in the functioning of the heart and in which directions the problem is observed. Not only adults, but also children need to undergo such research regularly. The results of a completed cardiogram will help a person obtain the following information:

• does he have any congenital pathologies or diseases;
• What pathologies in the body cause heart problems;
• could a person’s way of life become the cause of disturbances in the functioning of the main organ;
• whether the heart is in the correct position and whether its valves are working correctly.

Normal sinus rhythm on an ECG is displayed as waves of the same size and shape, and the distance between them is also the same. If any deviations from this norm are observed, then the person will have to be further examined.

Any irregularities in the cardiogram sheet can also be observed due to the fact that at the time of the procedure the person was very agitated. If the patient does notice something like this, then he should calm down and go through the procedure again in order to definitely get a reliable result.

The sinus rhythm on the cardiogram must coincide with the established norm, and only in this case can a person be considered healthy. If impulses from the heart to other systems diverge too quickly or slowly, then this does not bode well. This means that doctors will have to further clarify the cause of the problem and engage in comprehensive treatment. If an uneven rhythm is observed on a teenager’s cardiogram, then this cannot be considered a pathological deviation, because such a condition may be associated with hormonal changes and physiological maturation of the body.

Doing a cardiogram regularly and checking the rhythm of impulses is necessary for those who already have heart problems or work in certain fields

If the sinus rhythm is within normal limits, then you will not have to undergo additional tests or repeat studies. Normal heart function, as well as pathological abnormalities, are always recorded by a cardiogram.

The sinus rhythm on the ECG should be smooth and clear, without any intermittent lines or too long or short intervals. If the presented indicators are normal, then we can safely say that the person is completely healthy. Deviations in the cardiogram are a reason for doctors to perform additional studies and prescribe tests. Only after additional examinations can we understand the exact cause of the deviations and begin treatment. A normal sinus rhythm is reflected by a clear and evenly spaced cardiogram. Additional attention will have to be paid to the location of the axis, regarding the parameters of which medical standards have also been established.

Cardiologist

Higher education:

Cardiologist

Kabardino-Balkarian State University named after. HM. Berbekova, Faculty of Medicine (KBSU)

Level of education – Specialist

Additional education:

"Cardiology"

State educational institution "Institute for Advanced Medical Studies" of the Ministry of Health and Social Development of Chuvashia

Physiological processes in the body are determined not only by internal biochemistry - they are also influenced external factors. Changes in body temperature, breathing rate and heart rate - natural reaction on external environment, load, psycho-emotional state. Cardiac activity directly depends on the momentary state of a person.

Sports, physical work, stress make the heart beat faster, as the muscles and nerve tissues more oxygen is required. At rest, the heart returns to its normal rhythm. Irregular heart rhythm can also be a response. When should you be concerned and contact a cardiologist?

What is sinus rhythm

Sinus heart rhythm means normal heart function. The electrical impulses that cause the heart to contract and pump blood evenly come from the right place - the sinus node, located in the upper part of the right atrium. Pulses are generated at regular intervals. The heart rate (HR) for a healthy adult at rest is 60–90 beats per minute. This is called regular sinus rhythm.

Deviations from the genetically determined mode of cardiac activity are called arrhythmias. Rhythm disturbances occur in different areas cardiac muscle - in the atria, ventricles and septa. If the cause is a malfunction of the sinoatrial node, then the arrhythmia is called sinus.

This is what sinus rhythm looks like on an ECG

Sinus tachycardia

Sinus tachycardia is an increase in heart rate to 100 beats per minute or more. In this case, the interval between contractions remains the same. During and immediately after physical or nervous stress, this condition is considered normal. At rest, the heartbeat returns to normal. If your heart rate starts to increase without visible reasons, this indicates pathology.

Sinus bradycardia

A slow, uniform heartbeat occurs in physically trained people. With each beat, the heart pumps a volume of blood sufficient to fully supply the body with oxygen and nutrients. Therefore, a heart rate of 59–50 beats is the norm for them. The cause of pathological slow heartbeat is certain diseases that affect the functioning of the sinus node.

The condition when the frequency of contractions remains normal (increased or decreased), but the intervals between them differ, is called sinus arrhythmia. The reason for its appearance in children and adolescents is uneven growth and development of organs or respiratory arrhythmia. Sinus arrhythmia as an isolated disease is more common in older people.

Sinus arrhythmia - view on ECG

Changes in the sinus rhythm of the heart sometimes do not manifest significant symptoms. But they are clearly visible on the ECG. Electrocardiography shows the parameters of the heart muscle - the uniformity and frequency of contractions, conductivity muscle fibers, the work of cells generating an impulse.

To do this, the doctor evaluates the teeth, intervals and segments on the displayed graph. What matters is their presence or absence, sequence, height, location and direction. Each parameter has a numerical value. Teeth are areas located above or below the isoline. They show moments of excitation and relaxation of the myocardium of different parts of the heart:

• P - wave, reflecting contraction and relaxation of the atria;
• Q, S - waves showing excitation of the septum between the ventricles;
• R - ventricular excitation parameter;
• T – the process of their relaxation.

The P–Q interval is the time it takes for an impulse to travel from the atrium to the ventricles. The QRS segment is the ventricular complex (reflects the excitation of the ventricles), T–P is the period of diastole (relaxation of the heart muscle). Heart rate is determined by R-R intervals - their number in 3 seconds is multiplied by 20. Normally, this figure ranges from 60 to 90 contractions. If sinus rhythm is disturbed, the following changes are observed on the ECG:

ECG indicators	Norm	Tachycardia	Bradycardia
Heart rate	60–90	100 and above	Less than 59	- normal - tachycardia - bradycardia
P waves and QRS complexes		Correct alternation in all cycles	Correct alternation in all cycles	Correct alternation in all cycles
P waves	1.5–2.5 mm	Amplitude increased	Amplitude reduced	Norm
P-Q interval	0.12–0.2 s	Shortened	Increased	Minor interval changes
R-R intervals	Uniform, 0.15 s	Uniform	Uniform	Changes abruptly, lasting more than 0.15 s

Sinus arrhythmia - physiological and pathological

Irregular sinus rhythm can be physiological and pathological. The cause of physiological arrhythmia is often the breathing process, which is inextricably linked with the work of the heart. When you inhale, it beats faster, and when you exhale, it slows down.

This irregular rhythm in some people is a feature of the body and occurs constantly. Physiological sinus arrhythmia does not interfere with blood circulation and does not affect cardiac activity in any way. Respiratory arrhythmia manifests itself:

• when overworked or in moments of stress;
• in childhood and adolescence;
• with vegetative-vascular dystonia;
• after severe infectious diseases.

Pathological sinus arrhythmia has cardiac and extracardiac causes. Cardiac - diseases or heart defects. Extracardiac origin is associated with other pathologies that disrupt the functioning of the heart - hypertension, viral infections, diseases of the lungs and thyroid gland. In older people, heart rhythm is affected age-related changes. Bad habits, lack of potassium and magnesium, obesity - this is also possible reasons sinus arrhythmia.

Symptoms

Interruptions in the heart sometimes cause panic attacks. They worsen existing symptoms:

• shortness of breath;
• inability to take a full breath;
• weakness;
• dizziness.

During an attack, the feet and hands become cold, the person feels blood pulsating in the temples, pain may appear in the heart area with a return to the left hand. One of indirect signs pathological sinus arrhythmia - mood swings and irritability.

Features of sinus arrhythmia in children

A child's heart rate is significantly different from an adult's. In newborns, the normal heart rate is between 120 and 170 beats per minute. With age, the heart rate decreases and adolescence reaches adult values.

Doctors distinguish three types of arrhythmia - mild, moderate and severe. In moderate form, it occurs in children under 5 years of age and in adolescents. Severe bradyarrhythmia occurs after rheumatism or in children involved in sports.

The main causes of arrhythmias are birth defects heart, endocrine pathologies, metabolic disorders (lack of microelements and impaired water-electrolyte metabolism). In some children, arrhythmia appears during periods of rapid growth - at 5–7 and at 9 years. In adolescence, it is caused by vegetative-vascular dystonia.

Each type of arrhythmia is characterized by certain threshold values ​​of heart rate. Severe bradycardia in children under one year of age, this is a pulse of less than 100 beats. In children from 2 to 7 years old, it is diagnosed with a heart rate of less than 75, from 8 to 18 years old - with a heart rate of less than 62 beats per minute. Severe tachycardia occurs when normal pulse values ​​are exceeded by 40–60 beats.

Common symptoms for all types of sinus arrhythmias in children:

• fast fatiguability;
• intolerance to stuffiness;
• restless behavior (typical of children under one year old);
• poor appetite;
• pale skin;
• When counting the pulse, interruptions are heard (uneven rhythm).

Older children complain about headache and morning dizziness. If these symptoms are observed continuously, the child should be examined by a cardiologist.

How to treat arrhythmia in a child

First of all, it is necessary to organize the child’s life in such a way as to minimize the risk of further development of the disease and complications. It is necessary to protect him from any conflicts in the family and reduce his time in front of the TV or computer. Daily long walks, balanced nutrition and physical activity will benefit your health.

Sinus arrhythmia in children is not treated with special medications. Usually it is symptomatic, and the efforts of doctors are aimed at correcting the underlying disease.

Treatment

Not all types of sinus arrhythmia need to be treated. Doctors distinguish two types - cyclic arrhythmia associated with breathing and non-cyclic or pathological. Cyclic arrhythmia is not treated, considering it physiological. In case of pathological arrhythmia, diagnostics are carried out to determine the cause of the rhythm disturbance. The choice of treatment depends on the type of pathology detected and the cause of its occurrence.

If heart failure is caused by chronic stress, the doctor prescribes sedatives. They improve sleep, relieve irritability and increased excitability. At nervous disorders tranquilizers are used.

If the heart rhythm disturbance is organic and associated with changes in the heart muscle, antiarrhythmic drugs are prescribed. In addition to medications, the doctor gives recommendations:

• make changes to your diet - give up junk food, strong tea and coffee, sweets and alcohol;
• normalize weight (for obesity);
• use traditional medicine.

A patient with sinus bradyarrhythmia less than 40 beats per minute requires implantation of a pacemaker. Often arrhythmia is symptomatic, that is, it is a consequence of another disease. After it is cured, cardiac activity returns to normal, and the risk of complications tends to zero.