home Thyroid The electrical axis of the heart is located vertically. What problems will the electrical axis of the heart tell you about?

The electrical axis of the heart is located vertically. What problems will the electrical axis of the heart tell you about?

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

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

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

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

Effect of direction of ventricular depolarization

Can be confirmed in case of incomplete blockade of the anterior branch of the left ventricle, when the propagation of impulses along the upper left parts of the left ventricle is disrupted and the average electrical axis of the complex QRS deviated to the left (see section “Impaired intraventricular conduction”). On the contrary, with pancreatic hypertrophy it is deviated to the right.

How to recognize EOS deviation to the right and left

Axis deviation to the right

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

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

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

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

The myocardial conduction system is a powerful source of electrical impulses, which means that electrical changes occur in it first in the heart, preceding heart rate. If there are disturbances in this system, the electrical axis of the heart can significantly change its position, which will be discussed below.

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

The mass of the cardiac muscle of the left ventricle is normally much greater than the mass of the right ventricle. Thus, the electrical processes occurring in the left ventricle are overall stronger, and EOS will be directed specifically at it. If we project the position of the heart on the coordinate system, the left ventricle will be in the area +30 + 70 degrees. This will be the normal position of the axis. However, depending on individual anatomical features and body type EOS position healthy people ranges from 0 to +90 degrees:

So, vertical position EOS will be considered in the range from + 70 to +90 degrees. This position of the heart axis is found in tall, thin people - asthenics.
Horizontal position of the EOS It is more common in short, stocky people with a wide chest - hypersthenics, and its value ranges from 0 to + 30 degrees.

The structural features for each person are very individual; there are practically no pure asthenics or hypersthenics; more often they are intermediate body types, therefore the electrical axis can have an intermediate value (semi-horizontal and semi-vertical).

All five position options (normal, horizontal, semi-horizontal, vertical and semi-vertical) occur in healthy people and are not pathological.

So, in the conclusion of an ECG in an absolutely healthy person it can be said: “EOS is vertical, sinus rhythm, heart rate – 78 per minute,” which is a variant of the norm.

Rotations of the heart around the longitudinal axis help determine the position of the organ in space and, in some cases, are an additional parameter in diagnosing diseases.

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

When can the position of the EOS indicate heart disease?

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

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

EOS deviations to the left

Thus, deviation of the electrical axis of the heart to the left may indicate left ventricular hypertrophy (LVH), i.e. an increase in size, which is also not an independent disease, but may indicate an overload of the left ventricle. This condition often occurs with long-term arterial hypertension and is associated with significant vascular resistance to blood flow, as a result of which the left ventricle must contract with greater force, the mass of the ventricular muscles increases, which leads to its hypertrophy. Ischemic disease, chronic heart failure, and cardiomyopathies also cause left ventricular hypertrophy.

In addition, LVH develops when the valve apparatus of the left ventricle is damaged. This condition is caused by stenosis of the aortic mouth, in which the ejection of blood from the left ventricle is difficult, and aortic valve insufficiency, when part of the blood returns to the left ventricle, overloading it with volume.

These defects can be either congenital or acquired. The most common acquired heart defects are a consequence of rheumatic fever. Left ventricular hypertrophy is found in professional athletes. In this case, a consultation with a highly qualified sports doctor is necessary to decide on the possibility of continuing to play sports.

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

EOS deviations to the right

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

What to do if EOS displacement is found on the cardiogram?

None of the above diagnoses can be made on the basis of EOS displacement alone. The position of the axis serves only as an additional indicator in diagnosing a particular disease. When the heart axis is deviated beyond the limits normal values(from 0 to +90 degrees), consultation with a cardiologist and a number of studies are required.

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

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

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Normal values and causes of violation

The direction of this indicator depends on various physiological and anatomical factors. Average norm position +59 0 is considered. But normogram options fall in a wide range from +20 0 to +100 0.

In a healthy state, the electrical axis shifts to the left under the following conditions:

at the moment of deep exhalation;
when the body position changes to horizontal, the internal organs put pressure on the diaphragm;
with a high-standing diaphragm - observed in hypersthenics (short, strong people).

Shift indicator to the right in the absence of pathology is observed in such situations:

at the end of a deep breath;
when changing body position to vertical;
For asthenics (tall, thin people), the norm is the vertical position of the EOS.

Diagnosis using ECG

An electrocardiogram is the main tool for determining EOS. To detect changes in the location of the axis, use two equivalent ways. The first method is more often used by diagnosticians, the second method is more common among cardiologists and therapists.

Alpha angle offset detection

The value of the alpha angle directly shows the displacement of the EOS in one direction or another. To calculate this angle, find algebraic sum of Q, R and S waves in the first and third standard leads. To do this, measure the height of the teeth in millimeters, and when adding, take into account whether a particular tooth has a positive or negative value.

The value of the sum of teeth from the first lead is found on the horizontal axis, and from the third - on the vertical axis. The intersection of the resulting lines determines the alpha angle.

Visual definition

A simpler and more visual way to determine EOS is comparison of R and S waves in the first and third standard leads. If absolute value If the R wave within one lead is greater than the size of the S wave, then they speak of an R-type ventricular complex. If on the contrary, then the ventricular complex is classified as S-type.

When the EOS deviates to the left, a picture of RI - SIII is observed, which means R-type of the ventricular complex in the first lead and S-type in the third. If the EOS is deviated to the right, then SI - RIII is determined on the electrocardiogram.

Establishing diagnosis

What does it mean if the electrical axis of the heart is deviated to the left? EOS displacement is not an independent disease. This is a sign of changes in the heart muscle or its conduction system that lead to the development of the disease. Deviation of the electrical axis to the left indicates the following violations:

an increase in the size of the left ventricle - hypertrophy (LVH);
malfunction of the left ventricular valves, which causes the ventricle to be overloaded with blood volume;
cardiac blockades, for example, blockade of the left bundle branch (on the ECG this looks like this, which you can learn about from another article);
disturbances in electrical conductivity inside the left ventricle.

Diseases that are accompanied by levogram

If a patient has an EOS deviation, then this may be a consequence of diseases such as:

coronary heart disease (CHD);
cardiopathy of various origins;
chronic heart failure (CHF) of the left ventricular type;
congenital heart defects;
myocardial infarction;
infectious lesion myocardium.

In addition to diseases, blockage of the conduction system of the heart can result from taking certain medications.

Additional Research

Detection on the cardiogram of EOS deviation in left side is not in itself the basis for the final conclusion of the doctor. In order to determine what specific changes occur in the heart muscle, additional instrumental studies are required.

Bicycle ergometry(electrocardiogram while walking on a treadmill or on an exercise bike). Test to detect ischemia of the heart muscle.
Ultrasound. Using ultrasound, the degree of ventricular hypertrophy and disturbances in their contractile function are assessed.
24-hour Holter ECG monitoring. The cardiogram is taken within 24 hours. Prescribed in cases of rhythm disturbance, which is accompanied by deviation of the EOS.
X-ray examination chest. With significant hypertrophy of myocardial tissue, an increase in the cardiac shadow in the image is observed.
Angiography coronary arteries(KAG). Allows you to determine the degree of damage to the coronary arteries with diagnosed ischemic disease.
Echocardioscopy. Allows targeted determination of the condition of the patient’s ventricles and atria.

Treatment

Deviation of the electrical axis of the heart to the left from the normal position is not in itself a disease. This is a sign determined using instrumental research, which allows you to identify disturbances in the functioning of the heart muscle.

Ischemia, heart failure and some cardiopathy are treated with medications. Additional maintaining a diet and healthy lifestyle leads to normalization of the patient's condition.

In severe cases it is required surgery , for example, with congenital or acquired heart defects. In case of severe disruption of the conduction system, it may be necessary to transplant a pacemaker, which will send signals directly to the myocardium and cause its contraction.

Most often, deviation is not a threatening symptom. But if the axis changes its position suddenly, reaches values of more than 90 0, this may indicate a blockade of the Hiss bundle branches and threatens cardiac arrest. Such a patient requires urgent hospitalization in the department intensive care. A sharp and pronounced deviation of the electrical axis of the heart to the left looks like this:

Detection of a displacement of the electrical axis of the heart is not a cause for concern. But If this symptom is detected, you should immediately consult a doctor for further examination. and identifying the cause of this condition. Annual planned electrocardiography allows for timely detection of cardiac dysfunction and immediate initiation of therapy.

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Axis location

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

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

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

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

The doctor may make the following conclusion:

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

All these conclusions are the norm.

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

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

Reasons for rejection

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

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

Diseases that cause hypertrophy are:

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

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

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

This pathology can be caused by the following diseases:

As well as diseases characteristic of LV hypertrophy:

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

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

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

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

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

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

If cardiac symptoms occur, you should immediately undergo electrocardiography.

Determination of ECG signs

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

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

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

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

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

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

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

Determination of these diseases begins with an ECG, and then methods such as echocardiography, radiography, and coronary angiography are prescribed. An ECG with stress and 24-hour Holter monitoring can also be performed.

The electrical axis of the heart is diagnostic criterion, which displays electrical activity organ.

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

The direction of the electrical axis is calculated by the cardiologist during the interpretation of the ECG. To do this, he sums the values of the Q, R and S waves in lead 1, then finds the sum of the values of the Q, R and S waves in lead 3. Next, it takes the two obtained numbers and calculates the alpha angle using a special table. It's called the Diede table. This angle is the criterion by which it is determined whether the location of the electrical axis of the heart is normal.

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

To resolve this problem, consult a cardiologist.

The location of the electrical axis is normal

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

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

Norm of angle alpha EOS

The location of the anatomical and electrical axes depends to some extent on body type. Asthenics ( skinny people with tall stature and long limbs) the heart (and, accordingly, its axes) is located more vertically, and in hypersthenics (not tall people stocky build) - more horizontal.

Normal alpha angle depending on body type:

: everything you need to know about it

The electrical axis of the heart (EOS) is a clinical parameter that is used in cardiology and is reflected on the electrocardiogram. Allows you to evaluate the electrical processes that move the heart muscle and are responsible for its correct operation.

From the point of view of cardiologists, the chest is a three-dimensional coordinate system in which the heart is enclosed. Each contraction is accompanied by a number of bioelectrical changes, which determine the direction of the cardiac axis.

Normal values and causes of violation

The direction of this indicator depends on various physiological and anatomical factors. The average norm is considered to be +59 0. But the variants of the normogram fall into a wide range from +20 0 to +100 0.

In a state of health, the electrical axis shifts to the left under the following conditions:

at the moment of deep exhalation;
when the body position changes to horizontal, the internal organs put pressure on the diaphragm;
with a high-standing diaphragm - observed in hypersthenics (short, strong people).

A shift of the indicator to the right in the absence of pathology is observed in the following situations:

at the end of a deep breath;
when changing body position to vertical;
For asthenics (tall, thin people), the norm is the vertical position of the EOS.

Diagnosis using ECG

An electrocardiogram is the main tool for determining EOS. To identify changes in the location of the axis, two equivalent methods are used. The first method is more often used by diagnosticians, the second method is more common among cardiologists and therapists.

Alpha angle offset detection

The value of the alpha angle directly shows the displacement of the EOS in one direction or another. To calculate this angle, find the algebraic sum of the Q, R and S waves in the first and third standard leads. To do this, measure the height of the teeth in millimeters, and when adding, take into account whether a particular tooth has a positive or negative value.

The value of the sum of teeth from the first lead is found on the horizontal axis, and from the third - on the vertical axis. The intersection of the resulting lines determines the alpha angle.

Visual definition

A simpler and more visual way to determine EOS is to compare the R and S waves in the first and third standard leads. If the absolute value of the R wave within one lead is greater than the value of the S wave, then we speak of an R-type ventricular complex. If on the contrary, then the ventricular complex is classified as S-type.

When the EOS deviates to the left, a picture of RI - SIII is observed, which means the R-type of the ventricular complex in the first lead and the S-type in the third. If the EOS is deviated to the right, then SI - RIII is determined on the electrocardiogram.

Establishing diagnosis

What does it mean if the electrical axis of the heart is deviated to the left? EOS displacement is not an independent disease. This is a sign of changes in the heart muscle or its conduction system that lead to the development of the disease. Deviation of the electrical axis to the left indicates the following violations:

an increase in the size of the left ventricle - hypertrophy (LVH);
malfunction of the left ventricular valves, which causes the ventricle to be overloaded with blood volume;
cardiac blockades, for example, blockade of the left bundle branch (on the ECG this looks like this, which you can learn about from another article);
disturbances in electrical conductivity inside the left ventricle.

Diseases that are accompanied by levogram

If a patient has a deviation in EOS, this may be a consequence of diseases such as:

In addition to diseases, blockage of the conduction system of the heart can result from taking certain medications.

Additional Research

The detection of a deviation of the EOS to the left side on the cardiogram is not in itself the basis for the doctor’s final conclusion. In order to determine what specific changes occur in the heart muscle, additional instrumental studies are required.

Bicycle ergometry (electrocardiogram while walking on a treadmill or on an exercise bike). Test to detect ischemia of the heart muscle.
Ultrasound. Using ultrasound, the degree of ventricular hypertrophy and disturbances in their contractile function are assessed.
24-hour Holter ECG monitoring. The cardiogram is taken within 24 hours. Prescribed in cases of rhythm disturbance, which is accompanied by deviation of the EOS.
X-ray examination of the chest. With significant hypertrophy of myocardial tissue, an increase in the cardiac shadow in the image is observed.
Coronary artery angiography (CAG). Allows you to determine the degree of damage to the coronary arteries with diagnosed ischemic disease.
Echocardioscopy. Allows targeted determination of the condition of the patient’s ventricles and atria.

Treatment

Deviation of the electrical axis of the heart to the left from the normal position is not in itself a disease. This is a sign determined using instrumental research, which allows us to identify disturbances in the functioning of the heart muscle.

Ischemia, heart failure and some cardiopathy are treated with medications. Additional adherence to diet and a healthy lifestyle leads to normalization of the patient’s condition.

In severe cases, surgical intervention is required, for example, with congenital or acquired heart defects. In case of severe disruption of the conduction system, it may be necessary to transplant a pacemaker, which will send signals directly to the myocardium and cause its contraction.

Most often, deviation is not a threatening symptom. But if the axis changes its position abruptly and reaches values of more than 90 0, then this may indicate a blockade of the Hiss bundle branches and threatens cardiac arrest. Such a patient requires urgent hospitalization in the intensive care unit. A sharp and pronounced deviation of the electrical axis of the heart to the left looks like this:

Detection of a displacement of the electrical axis of the heart is not a cause for concern. But if this symptom is detected, you should immediately consult a doctor for further examination and identify the cause of this condition. Annual planned electrocardiography allows for timely detection of cardiac dysfunction and immediate initiation of therapy.

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

Electrical axis of the heart (EOS) is a term used in cardiology and functional diagnostics, reflecting the electrical processes occurring in the heart.

The direction of the electrical axis of the heart shows the total magnitude of bioelectric changes occurring in the heart muscle with each contraction. The heart is a three-dimensional organ, and in order to calculate the direction of the EOS, cardiologists represent the chest as a coordinate system.

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

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

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

The myocardial conduction system is a powerful source of electrical impulses, which means that electrical changes that precede cardiac contraction occur in it first of all in the heart. If there are disturbances in this system, the electrical axis of the heart can significantly change its position, as will be discussed below.

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

The mass of the cardiac muscle of the left ventricle is normally much greater than the mass of the right ventricle. Thus, the electrical processes occurring in the left ventricle are overall stronger, and EOS will be directed specifically at it. If we project the position of the heart on the coordinate system, the left ventricle will be in the area +30 + 70 degrees. This will be the normal position of the axis. However, depending on the individual anatomical characteristics and physique, the position of the EOS in healthy people ranges from 0 to +90 degrees:

So, the vertical position will be considered EOS in the range from + 70 to +90 degrees. This position of the heart axis is found in tall, thin people - asthenics.
The horizontal position of the EOS is more common in short, stocky people with a wide chest - hypersthenics, and its value ranges from 0 to + 30 degrees.

All five position options (normal, horizontal, semi-horizontal, vertical and semi-vertical) occur in healthy people and are not pathological.

So, in the conclusion of an ECG in an absolutely healthy person it can be said: “EOS is vertical, sinus rhythm, heart rate - 78 per minute,” which is a variant of the norm.

Rotations of the heart around the longitudinal axis help determine the position of the organ in space and, in some cases, are an additional parameter in diagnosing diseases.

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

When can the position of the EOS indicate heart disease?

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

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

EOS deviations to the left

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

EOS deviations to the right

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

What to do if EOS displacement is found on the cardiogram?

None of the above diagnoses can be made on the basis of EOS displacement alone. The position of the axis serves only as an additional indicator in diagnosing a particular disease. If the deviation of the heart axis is outside the normal range (from 0 to +90 degrees), consultation with a cardiologist and a series of studies are necessary.

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

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

If the EOS is deviated to the left or right - what does this mean?

If the EOS is deviated to the left, what does this mean, you need to find out from your doctor. The conclusion is made after examining the patient and analyzing the clinical parameter.

Using the electrical axis of the heart, cardiologists evaluate the electrical processes that move the heart muscles. The direction of EOS depends on various anatomical and physiological factors. The average rate of the indicator is +590. Normally, the EOS value fluctuates within +200. +1000.

The patient is examined in a specialized room, which is shielded from various electrical noise. The patient takes a supine position with a pillow placed under his head. To take an ECG, electrodes are applied. Data is recorded during quiet breathing. At the same time, the device records the frequency and regularity of heartbeats, including the position of the EOS and other parameters.

In a healthy person, deviation of the electrical axis of the heart to the left is allowed when:

deep exhalation;
changing body position;
body features (hypersthenic).

The EOS shifts to the right in a healthy person when:

the end of a deep breath;
body features (asthenic).

The location of the EOS is determined by the mass of the 2 parts of the ventricle. The indicator under consideration is determined using 2 methods.

In the first case, the specialist identifies a displacement in the alpha angle. The value of the main indicator is calculated using a special table according to Diede.

In the second case, the specialist compares the R and S waves in leads 1 and 3. A sharp deviation of the EOS in any direction is not an independent pathology.

An electrical axis shifted to the left indicates the following problems:

left ventricular hypertrophy;
impaired functioning of the left ventricular valve;
cardiac blockade.

The above phenomena lead to incorrect functioning of the left ventricle. Any deviation of EOS indicates pathologies such as ischemia, CHF, congenital heart disease, and heart attack. Blockade of the conduction system of the main organ is associated with taking certain medications.

If a deviation of the electrical axis to the left is recorded on the cardiogram, additional instrumental examination patient. It is recommended to have an electrocardiogram while walking on a treadmill or exercise bike. Using ultrasound, the degree of ventricular hypertrophy is assessed.

If sinus rhythm is disturbed, EOS is rejected, daily Holter ECG monitoring is performed. Data is recorded throughout the day. If the myocardial tissue is significantly hypertrophied, a chest x-ray is performed. Using angiography of the coronary arteries, the degree of vascular damage during current ischemia is determined. Echocardioscopy allows you to determine the condition of the atria and ventricles of the heart.

Therapy for the phenomenon under consideration is aimed at eliminating the underlying disease. Some heart pathologies are treated medical supplies. Additionally, it is recommended to eat right and lead a healthy lifestyle.

In severe cases of the disease, it is necessary surgical intervention. If the conduction system is seriously impaired, a pacemaker transplant is performed. This device sends signals to the myocardium, causing it to contract.

Most often, the phenomenon in question does not threaten human life. But, if a sharp change in the position of the axis is diagnosed (value greater than +900), this can lead to cardiac arrest. Such a patient must be urgently hospitalized in intensive care. For warning similar condition annual scheduled examinations with a cardiologist are indicated.

Deviation of the axis to the right is not an independent pathology, but is a diagnostic symptom of a disorder in the functioning of the main organ. Most often, such a clinic indicates an abnormal enlargement of the right atrium or ventricle. After finding out the exact cause of the development of this anomaly, the doctor makes a diagnosis.

If necessary, the patient is prescribed additional diagnostics:

1. Ultrasound - provides information about changes in the anatomy of the main organ.
2. Chest X-ray - reveals myocardial hypertrophy.
3. Daily ECG - performed for concomitant rhythm disturbances.
4. ECG during exercise - helps to detect myocardial ischemia.
5. CAG - performed to diagnose lesions of the coronary artery.

Deviation of the axis to the right can be caused by the following pathologies:

1. Ischemia is an incurable pathology in which there is blockage of the coronary arteries. If left untreated, the disease can lead to myocardial infarction.
2. Acquired or congenital stenosis of the pulmonary artery - due to the narrowing of the vessel, the normal flow of blood from the right ventricle stops, which provokes an increase in blood pressure.
3. Atrial fibrillation - can provoke a cerebral stroke.
4. Chronic cor pulmonale- observed with impaired lung function, chest pathology. Under such conditions, hypertrophy may develop.
5. The presence of a hole in the septum between the atria, through which blood is ejected from left to right. This provokes the development of heart failure.
6. Valve stenosis - manifests itself as a narrowing of the opening between the left ventricle and the corresponding atrium, which impedes the diastolic movement of blood. This pathology is acquired.
7. Pulmonary embolism - provoked by blood clots that occur in large vessels. They then move through the system, clogging the artery and its branches.
8. Primary pulmonary hypertension, which is accompanied by high blood pressure caused by various reasons.

Axial tilt to the right is a consequence of tricyclic antidepressant poisoning. The somatotropic effect of these drugs is observed due to the presence of substances in them that affect the conduction system of the heart. If the ECG diagnosed an axis deviation in right side, a more in-depth diagnosis of the patient is required.

There is a direct relationship between the anatomical position of the main organ and the EOS of the QRS complex. This relationship is confirmed by the effect of breathing. When inhaling, the diaphragm lowers, the heart changes its position, which provokes a shift of the EOS to the right. In patients with pulmonary emphysema, the anatomical position of the main organ is observed. On the contrary, when you exhale, the diaphragm rises, the heart takes a horizontal position, shifting the axis to the left.

There is also a direct influence of the direction of ventricular depolarization on the EOS value. This phenomenon is confirmed when partial blockade LNPG. In this case, the impulses propagate along the upper left parts of the ventricle, which provokes an axis deviation to the left.

If the value of the parameter in question in a newborn baby is deviated from the norm to the right, there is no pathology.

Doctors do not consider this condition as right ventricular hypertrophy. This is explained by the fact that the deviation angle of +100 is a normal phenomenon observed in many newborn children. This is especially true for those who live in harsh climatic conditions and in the mountains.

But a deviation of the axis to the right in a baby may be associated with a blockade of the LBP. Therefore, when identifying the diagnostic symptom in question, full examination little patient.

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Deviation of the electrical axis of the heart to the left

Deviation of the electrical axis of the heart to the left - this conclusion from a specialist during decoding of the cardiogram can seriously frighten the patient. After all, a person far from medicine hardly knows what the electrical axis of the heart is, but the word “deviation” will alert anyone.

Let's figure out what this conclusion means, and whether it's worth sounding the alarm if your cardiogram shows a shift in the cardiac electrical axis.

1 Cardiac axis and ECG

Deviation of the electrical axis of the heart to the left

The human heart has the ability to contract. Electrical impulses sequentially cover the chambers of the heart, originating in the atrium sinus node. If you imagine the course of these pulses in the form of directed vectors, you will notice that they have a similar direction. By summing the directions of the vectors, one main vector can be obtained. This will be the electrical axis of the heart (EOS).

Doctors functional diagnostics EOS is often determined visually from a cardiogram, but it is more accurate to do this using special tables. If you look carefully at the QRS complex in leads I, II, III on the ECG, you can see that R II>RI>RIII, this means that the EOS on the cardiogram is normal.

If it is difficult for a doctor to visually determine the axis of the heart, he determines the alpha angle and calculates the EOS using special tables. Without delving into the course of measurements, we note that for a normal EOS angle alpha (RII>RIII), then the doctor’s conclusion will be as follows: deviation of the electrical axis of the heart to the left. EOS deviation is confirmed when the alpha angle is in the range from 00 to -900.

2 When does the heart axis “go to the left”?

Sharp deviation of the electrical axis of the heart to the left

The conclusions of a functional diagnostics doctor about the deviation of the cardiac axis to the left are not an independent diagnosis. But they always give reason to wonder why the heart axis “went to the left.” A slight shift of the EOS to -190, as well as its semi-vertical position, in some cases is not considered a pathology. This position of the axis can be observed in healthy, tall, thin people, in athletes with a trained heart, in children with an asthenic physique, and with a high position of the diaphragm dome.

If the cardiac axis is significantly deviated to the left, then this pathological condition indicates problems with the heart; the cause of such a displacement must be determined. After all this symptom sometimes it can be the first “bell” in case of pathology of the heart and blood vessels. According to some data, the deviation of the electrical axis of the heart to the left is sometimes called a slight deviation, and if the angle is from -450 to -900 they speak of a sharp deviation.

3 Pathological causes of EOS shift to the left

Pathological conditions in which there is a displacement of the cardiac axis to the left

As mentioned above, a slight deviation of the EOS to the left can be considered by doctors as a variant of the norm, if, after a more thorough examination, the doctor did not identify any diseases in the patient and the patient’s health is good. If the EOS is significantly deviated to the left, or the patient has health problems due to minor ECG changes, the following pathological conditions should be suspected, in which a shift to the left of the cardiac axis is most common:

4 Left ventricular hypertrophy

The deviation of the cardiac axis to the left with an enlargement of the left ventricle is quite understandable, because physiologically this chamber of the heart is already the most powerful in terms of mass. This means that the vector of the heart will “take over” the left ventricle. And the more it increases in size and grows, the more the EOS will “move to the left.” This pathology occurs when high blood pressure or arterial hypertension, when the chambers of the heart, unable to withstand the increased pressure and load, begin to compensatory gain weight - hypertrophy. Hypertrophy as one of the symptoms occurs in heart failure, atherosclerotic vascular changes, angina pectoris, cardiac asthma, and cardiomyopathies.

5 Conduction disorders

Left bundle branch block

Disturbances in the conduction system will lead to changes in the cardiac vector and deviation of the cardiac axis. This is most often observed with blockade of the left bundle branch, or with blockade of its anterior superior branch. There are other ECG signs that can help diagnose this type of arrhythmia. A Holter scan will also help in establishing a diagnosis. ECG monitoring.

6 Special forms of ventricular tachycardia

Some forms of ventricular tachycardia may also be the reason why EOS values are far from normal.

7 Heart defects

Heart defects, the ECG symptom of which can be the axis of the heart moving to the left, by their nature can be either congenital or acquired. Defects of any etiology, accompanied by overload of the left heart chambers, will be characterized by this ECG symptomatology.

Based on the reasons described above for EOS deviation, we can conclude that a shift to the left of the cardiac axis is not such a harmless ECG sign. It may indicate the presence in the patient’s body of sufficient serious problems. But at the same time, don't panic! If the patient is in good health, has a stable ECG for several years, and in the absence of confirmatory data on pathological changes in the heart and blood vessels after a thorough examination, a slight deviation of the cardiac axis to the left may be a variant of the norm! But the conclusion that this is the norm can be made by a doctor after a thorough examination of the patient, and in the absence of data on the pathology of the cardiovascular system. What examinations should a doctor prescribe when diagnosing a patient with a shift to the left of the heart axis?

8 A set of examinations to clarify the diagnosis

Taking a repeat cardiogram

Repeated ECG. It is imperative to take a repeat cardiogram, especially if EOS displacement is detected for the first time and previous ECGs were normal. It is possible that there was an error in the application of electrodes, which may show a distorted result, or a malfunction of the cardiograph. It is also always necessary, if possible, to compare a “fresh” ECG with a previous cardiogram to assess the dynamics of the patient’s condition and monitor changes in the work of the heart.
Ultrasound of the heart. The most informative way to tell about the condition of the heart, its chambers, cardiac ejection fraction, and the flow of blood through the cardiac cavities is with ultrasound or echocardiography. This method The examination can be supplemented, if necessary, with Doppler sonography.
Holter ECG. If the doctor suspects a patient has conduction disturbances or rhythm disturbances, then faithful assistant Holter ECG monitoring will help make the diagnosis. A daily recording of a cardiogram will allow the doctor to “catch” the arrhythmia and see in which part of the heart the conductivity is changed. To ensure that Holter data is not distorted, the patient should be given detailed instructions on how to behave during the study.

24-hour blood pressure monitoring

It should be understood that deviation to the left of the EOS is not a diagnosis, but an ECG sign, which can be either a variant of the norm or a symptom of numerous diseases. Only a doctor can make a conclusion about what information this symptom carries, after carrying out a set of diagnostic procedures.

9 Is it necessary to treat an axle tilted to the left?

Is treatment necessary?

As the only isolated ECG sign - no. If this symptom is one of the others in the presence of a disease in the human body, the disease certainly needs to be treated. Treatment tactics depend directly on the disease that caused changes in the direction of the cardiac axis. In case of hypertension, which has led to enlargement of the left ventricle, adequate selection is necessary antihypertensive drugs. For arrhythmias - antiarrhythmics medicines, or, if there are indications, implantation of an artificial pacemaker. For diagnosed heart defects - surgical treatment according to indications.

Sinus bradycardia deviation of EOS to the left

What is the electrical axis of the heart?

The medical concept of “electrical axis of the heart” is used by cardiologists to reflect the electrical processes occurring in this organ. The location of the electrical axis must be calculated to determine the total component of the bioelectrical changes that occur in the muscle tissue of the heart during its contractile activity. The main organ is three-dimensional, and in order to correctly determine the direction of the EOS (which means the electrical axis of the heart), you need to imagine the human chest as a system with some coordinates that allow you to more accurately determine the angle of displacement - this is what cardiologists do.

Features of the conduction system

The cardiac conduction system is a collection of sections of muscle tissue in the myocardium, which is an atypical type of fiber. These fibers have good innervation, which allows the organ to contract synchronously. The contractile activity of the heart begins in the sinus node; it is in this area that the electrical impulse originates. Therefore, doctors call the correct heart rate sinus.

Originating in the sinus node, the exciting signal is sent to the atrioventricular node, and then it travels along the His bundle. Such a bundle is located in the section that blocks the ventricles, where it is divided into two legs. The leg extending to the right leads to the right ventricle, and the other, rushing to the left, is divided into two branches - posterior and anterior. The anterior branch is accordingly located in the region of the anterior zones of the septum between the ventricles, in the anterolateral compartment of the wall of the left ventricle. The posterior branch of the left bundle branch is localized in two-thirds of the septal part separating the ventricles of the organ, the middle and lower, as well as the posterolateral and lower walls, located in the area of the left ventricle. Doctors say that the anterior branch is located slightly to the right of the posterior branch.

The conduction system is a powerful source that supplies electrical signals that cause the main part of the body to work normally, in the correct rhythm. Only doctors can calculate any violations in this area; they cannot do this on their own. Both an adult and a newborn baby can suffer from pathological processes of this nature in the cardiovascular system. If deviations occur in the conduction system of the organ, the axis of the heart may become confused. There are certain standards for the position of this indicator, according to which the doctor identifies the presence or absence of deviations.

Parameters in healthy people

How to determine the direction of the electrical axis of the heart? The weight of the muscle tissue of the left ventricle usually significantly exceeds that of the right ventricle. You can find out whether a given measurement is a horizontal or vertical vector using these standards. Since the mass of the organ is distributed unevenly, it means that electrical processes should occur more strongly in the left ventricle, and this shows that the EOS is directed specifically to this section.

Doctors project this data using a specially developed coordinate system, from which we can conclude that the electrical axis of the heart is in the region of +30 and also +70 degrees. However, every person, even a child, has individual body characteristics, its own anatomical characteristics. This shows that the slope of the EOS in healthy people can vary between 0-90 degrees. Based on such data, doctors have identified several areas of this indicator that are considered normal and do not interfere with the functioning of the organ.

What positions of the electrical axis exist:

semi-vertical electrical position of the heart;
vertically directed electrical position of the heart;
horizontal state of the EOS;
vertical placement of the electrical axis.

It should be noted that all five positions can occur in a person who has good health. Finding the reason for such features is quite easy; human physiology explains everything.

The horizontal axis of the heart is more often detected in people with a stocky figure and short stature; it is also usually present in these individuals wide sizes sternum. This type of appearance is called hypersthenic, and the EOS direction indicator varies from 0 to +30 degrees. The horizontal position of the electrical cardiac axis is often the norm.
The range of the vertical position of this indicator varies between 70 and 90 degrees. This EOS vector is detected in a person of asthenic figure type, with a thin body structure and tall stature.

Since the body structure of people is different, it is extremely rare to meet a pure hypersthenic or a very skinny individual; usually such types of structure are considered intermediate, and the direction of the heart axis can deviate from normal values (semi-vertical state or semi-horizontal position).

In what cases are we talking about pathology, the causes of violations

Sometimes the direction of the indicator can indicate the presence of a disease in the body. If, as a result of the diagnosis, deviations of the electrical axis of the heart to the left are detected, it means that the person has certain ailments, especially hypertrophic changes in the left ventricle. Often such a violation becomes a consequence of pathological processes, as a result of which the cavity of this section stretches and increases in size.

What diseases cause hypertrophy and a sharp tilt of the EOS to the left:

Ischemic damage to the main organ.
Arterial hypertension, especially with regular pressure surges to high tonometer values.
Cardiomyopathy. The disease is characterized by an increase in the weight of the muscle tissue of the heart and the expansion of all its cavities. This disease often appears after anemia, myocardial infarction, myocarditis or cardiosclerosis.
Chronic heart failure.
Disturbances in the aortic valve, its insufficiency or stenosis. Pathological process This variety may be acquired or congenital in nature. Such diseases cause disruption of blood flow in the cavities of the organ, which leads to overload of the left ventricle.
People involved in sports activities professionally also often exhibit these disorders.

In addition to hypertrophic changes, deviation of the heart axis sharply to the left may indicate problems with the conductive properties of the inner part of the ventricles, which usually arise with various blockades. What it is and what it threatens will be explained by the attending physician.

A blockade found in the left bundle branch is often diagnosed, which also refers to a pathology that shifts the EOS to the left.

The opposite condition also has its own reasons for its occurrence. Deviation of the electrical axis of the heart to the other side, the right, indicates hypertrophy of the right ventricle. There are certain diseases that provoke such a disorder.

What diseases lead to a tilt of the EOS to the right:

Pathological processes in the triscupid valve.
Stenosis and narrowing of the lumen of the pulmonary artery.
Pulmonary hypertension. This disorder often occurs against the background of other ailments, such as obstructive bronchitis, organ damage by emphysema, and bronchial asthma.

In addition, diseases that lead to a shift in the direction of the axis to the left can also cause the EOS to be tilted to the right.

Based on this, doctors conclude: a change in the electrical position of the heart is a consequence of ventricular hypertrophy. In itself, such a disorder is not considered a disease; it is a sign of another pathology.

Norms for children

First of all, it is necessary to note the position of the EOS during the mother's pregnancy. Pregnancy changes the direction of this indicator, as serious changes occur in the body. The rapidly enlarging uterus puts pressure on the diaphragm, which leads to a displacement of all internal organs and changes the position of the axis, as a result of which its direction can become semi-vertical, semi-horizontal or otherwise, depending on its initial state.

As for children, this indicator changes with age. In newborn babies, a significant deviation of the EOS to the right side is usually detected, which is absolutely normal. TO adolescence this angle is already established. Such changes are associated with a difference in the weight ratio and electrical activity of both ventricles of the organ, as well as with a change in the position of the heart in the chest area.

A teenager already has a certain angle of EOS, which normally remains throughout his life.

Symptoms

Changing the direction of the electrical axis cannot cause unpleasant sensations in humans. Disorders of well-being usually provoke hypertrophic damage to the myocardium if they are accompanied by severe hemodynamic disturbances, and also lead to the development of heart failure, which is very dangerous and requires treatment.

pain in the head and chest area;
breathing problems, shortness of breath, suffocation;
swelling of the lower tissues, upper limbs and facial areas;
weakness, lethargy;
arrhythmia, tachycardia;
disturbance of consciousness.

Determining the causes of such disorders is an important part of all therapy. The prognosis of the disease depends on the correctness of the diagnosis. If such symptoms occur, you should immediately consult a doctor, as cardiac problems are extremely dangerous.

Diagnosis and treatment

Typically, axis deviation is detected on an ECG (electrocardiogram). This method is not more often than others prescribed during a routine examination. The resulting vector and other characteristics of the organ make it possible to evaluate the activity of the heart and calculate deviations in its work. If such a disorder is detected on the cardiogram, the doctor will need to carry out several additional examinations.

Ultrasound of the organ is considered one of the most informative methods. With the help of such a study, it is possible to identify ventricular hypertrophy, disturbances in the structure of the heart and evaluate its contractile characteristics.
X-ray of the chest area, allowing you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
ECG in the form of daily monitoring. It is necessary to clarify the clinical picture in case of disorders related not only to the axis itself, but also to the origin of the rhythm not from the sinus node area, which indicates a disorder of the rhythmic data.
Coronary angiography or coronary angiography. It is used to study the characteristics of damage to the coronary arteries during organ ischemia.
An exercise ECG can detect myocardial ischemia, which is usually the cause of a shift in the direction of the EOS.

It is necessary to treat not a change in the electrical axis indicator, but the disease that caused the pathology. Using diagnostics, doctors accurately determine the factors that provoked such disorders.

Changing the angle of the electrical axis of the heart does not require therapy.

No class of medications will help in this case. The disease that led to such changes needs to be eliminated. Drugs are prescribed to patients only after an accurate diagnosis has been made. Depending on the nature of the lesions, medications are used. Sometimes it is advisable to undergo surgery.

In order to determine the functional abilities of the heart, it is necessary to conduct special examination methods. If it turns out that there are disturbances in the conduction system of the organ, there is no need to panic, you must follow all the doctor’s recommendations. Medicine today can eliminate almost any pathology, you just need to seek help in a timely manner.

What is sinus rhythm on an ECG

The human heart is a kind of trigger for the productive work 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 vital 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.

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?

The results of the cardiogram are deciphered 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 turn Special attention on 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.

Sinus bradycardia is a common abnormality, especially if we're talking about about the child's health. 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 is vital important body not set up correctly. 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 to the 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 representatives adolescence on the cardiogram should have a normal or vertical position of the axis, 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.

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

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, accelerated heartbeat 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.

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.

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.

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

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

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

EOS offsets

To resolve this problem, consult a cardiologist.

The location of the electrical axis is normal

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

Norm of angle alpha EOS

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

Normal alpha angle depending on body type:

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

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

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

Reasons for shift to the left

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

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

Causes of these pathologies:

Symptoms

EOS displacement itself does not have characteristic symptoms.

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

However, sometimes these diseases still make themselves felt.

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

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

Additional diagnostics

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

EchoCG (ultrasound of the heart) - to identify possible organ defects.
Stress echocardiography – ultrasound of the heart under stress – for diagnosing ischemia.
Angiography coronary vessels– their examination to identify blood clots and atherosclerotic plaques.
Holter monitoring – recording an ECG using a portable device throughout the day.

After a detailed examination, appropriate therapy is prescribed.

Treatment

The deviation of the electrical axis of the heart to the left in itself does not require specific treatment because it is just a symptom of another disease.

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

Treatment for LVH depends on what caused the myocardial growth

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

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

The electrical axis of the heart (EOS) is the first word that every person sees when they have a transcript of the cardiogram in their hands. When a specialist next to them adds that the EOS is in a normal position, the person being examined has nothing to worry about his health. But what if the axis takes a different position or has deviations?

It is no secret that the heart is constantly working and producing electrical impulses. The place of their formation is the sinus node, from which they normally pass this way:

As a result, the movement is an electric vector with strictly designated movement. The electrical axis of the heart represents the projection of the impulse onto the anterior plane, which is in a vertical position.

The placement of the axis is calculated by dividing the circle drawn around the triangle by degrees. The direction of the vector gives the specialist an approximate idea of the location of the heart in the chest.

The position of the EOS depends on:

The speed and correctness of impulse movement through the cardiac systems.
Quality of myocardial contractions.
Conditions and pathologies of organs that affect the functionality of the heart.
Heart condition.

For a person who does not suffer from serious diseases, the axis is characteristic:

The normal position of the EOS is located according to Died at coordinates 0 - +90º. For most people, the vector passes the limit of +30 - +70º and is directed to the left and down.

In an intermediate position, the vector passes within +15 - +60 degrees.

According to the ECG, the specialist sees that the positive waves are longer in the second, aVF and aVL leads.

Babies have a strong axis deviation to the right side, which during the first year of life turns into a vertical plane. This situation has a physiological explanation: right part the heart “overtakes” the left in weight and production of electrical impulses. The transition of the axis to normal is associated with the development of the LV.

Children's EOS standards:

Up to a year - the passage of the axis is between +90 - +170 degrees.
From one to three years - vertical EOS.
6-16 – stabilization of indicators to adult standards.

ECG signs in the analysis of EOS are determined by the rightogram and the leftogram.

A rightogram is finding a vector between indicators 70-900. On electrocardiography it is demonstrated by long R waves in the QRS group. The vector of the third lead is larger than the wave of the second. For the first lead, the RS group is considered normal, where the depth of S exceeds the height of R.

The levogram on an ECG is the alpha angle passing between 0-500. Electrocardiography helps to determine that the usual lead of the first QRS group is characterized by an R-type expression, but already in the third lead it has an S-type shape.

When the axis is deviated to the left, this means that the patient has left ventricular hypertrophy.

The causes of the disease include:

Hypertension. Especially in cases of frequent increases in blood pressure.
Ischemic diseases.
Chronic heart failure.
Cardiomyopathy. This disease is the growth of the heart muscle in a mass and expansion of its cavities.
Pathology of the aortic valve. They can be congenital or acquired. They provoke blood flow disturbances and LV reloading.

Important! Very often, hypertrophy worsens in people who spend a lot of time on varied sports activities.

With a strong deviation of the axis to the right, a person may have PR hypertrophy, which is caused by:

High pressure in the arteries of the lungs, which causes bronchitis, asthma and emphysema.
Pathological diseases of the tricuspid valve.
Ischemia.
Heart failure.
Blocking of the posterior branch of the His node.

A vertical position is characterized by a range of +70 - +90º. Characteristic of tall, thin people with a narrow sternum. According to anatomical indicators, with such a physique, the heart seems to be “hanging.”

On the electrocardiogram, the highest positive vectors are observed in aVF, negative ones - in aVL.

In a horizontal position, the vector passes between +15 - -30º. Most often observed in people with a hypersthenic physique: short stature, wide chest, excess weight. From an anatomical point of view, in this case, the heart is located on the diaphragm.

On the cardiogram, the highest positive waves appear in aVL, and negative ones in aVF.

The deviation of the electrical axis to the left is the location of the vector in the range of 0 - -90º. A distance of up to -30º in some cases is normal, but the slightest excess of the indicator can be regarded as a symptom of a serious illness. In some people, such indicators are provoked by deep exhalation.

Important! In women, a change in the coordinates of the heart in the chest can be triggered by pregnancy.

Reasons why the axis deviates to the left:

LV hypertrophy.
Disruption or blockage of the His bundle.
Myocardial infarction.
Myocardial dystrophy.
Heart defects.
Violation of CM contractions.
Myocarditis.
Cardiosclerosis.
Calcium accumulations in the organ, blocking normal contraction.

These ailments and pathologies can provoke an increase in the mass and size of the LV. Because of this, the tooth on this side is longer, resulting in a deviation of the electrical axis to the left.

The deviation of the axis to the right is fixed when it passes between +90 - +180º. This shift can be caused by:

Damage to the pancreas by infarction.
The simultaneous occurrence of coronary artery disease and hypertension - they deplete the heart with a vengeance and provoke failure.
Pulmonary diseases of a chronic nature.
Incorrect passage of electrical impulses along the right branch of the His bundle.
Pulmonary emphysema.
Severe strain on the pancreas caused by obstruction of the pulmonary artery.
Dextrocardia.
Mitral heart disease, which provokes pulmonary hypertension and stimulates the work of the pancreas.
A thrombotic block of blood flow in the lungs, which causes a deficiency of the organ in the blood and overloads the entire right side of the heart.

Because of these pathologies, the specialist determines on electrocardiography that the EOS is deviated to the right.

If you are diagnosed with a pathological deviation of the axis, the specialist must resort to new studies. Each ailment that provokes displacement of the EOS is accompanied by several symptoms that require careful analysis. Most often they resort to ultrasound diagnostics hearts.

Determining the electrical axis of the heart is just a technique that allows you to understand the location of the heart and diagnose it for the presence of pathologies and ailments. A conclusion on it can only be drawn qualified specialist, since deviation does not always mean the presence of heart problems.

The location of the electrical axis must be calculated to determine the total component of the bioelectrical changes that occur in the muscle tissue of the heart during its contractile activity. The main organ is three-dimensional, and in order to correctly determine the direction of the EOS (which means the electrical axis of the heart), you need to imagine the human chest as a system with some coordinates that allow you to more accurately determine the angle of displacement - this is what cardiologists do.

Features of the conduction system

Parameters in healthy people

What positions of the electrical axis exist:

semi-vertical electrical position of the heart;
vertically directed electrical position of the heart;
horizontal state of the EOS;
vertical placement of the electrical axis.

It should be noted that all five positions can occur in a person in good health. Finding the reason for such features is quite easy; human physiology explains everything.

The horizontal axis of the heart is more often detected in people who have a stocky figure and short stature, and these individuals usually have a wide sternum. This type of appearance is called hypersthenic, and the EOS direction indicator varies from 0 to +30 degrees. The horizontal position of the electrical cardiac axis is often the norm.
The range of the vertical position of this indicator varies between 70 and 90 degrees. This EOS vector is detected in a person of asthenic figure type, with a thin body structure and tall stature.

In what cases are we talking about pathology, the causes of violations

What diseases cause hypertrophy and a sharp tilt of the EOS to the left:

Ischemic damage to the main organ.
Arterial hypertension, especially with regular pressure surges to high tonometer values.
Cardiomyopathy. The disease is characterized by an increase in the weight of the muscle tissue of the heart and the expansion of all its cavities. This disease often appears after anemia, myocardial infarction, myocarditis or cardiosclerosis.
Chronic heart failure.
Disturbances in the aortic valve, its insufficiency or stenosis. A pathological process of this type can be acquired or congenital in nature. Such diseases cause disruption of blood flow in the cavities of the organ, which leads to overload of the left ventricle.
People involved in sports activities professionally also often exhibit these disorders.

A blockade found in the left bundle branch is often diagnosed, which also refers to a pathology that shifts the EOS to the left.

What diseases lead to a tilt of the EOS to the right:

Pathological processes in the triscupid valve.
Stenosis and narrowing of the lumen of the pulmonary artery.
Pulmonary hypertension. This disorder often occurs against the background of other ailments, such as obstructive bronchitis, organ damage by emphysema, and bronchial asthma.

In addition, diseases that lead to a shift in the direction of the axis to the left can also cause the EOS to be tilted to the right.

Norms for children

As for children, this indicator changes with age. In newborn babies, a significant deviation of the EOS to the right side is usually detected, which is absolutely normal. By adolescence, this angle is already established. Such changes are associated with a difference in the weight ratio and electrical activity of both ventricles of the organ, as well as with a change in the position of the heart in the chest area.

A teenager already has a certain angle of EOS, which normally remains throughout his life.

Symptoms

pain in the head and chest area;
breathing problems, shortness of breath, suffocation;
swelling of the tissues of the lower, upper extremities and facial area;
weakness, lethargy;
arrhythmia, tachycardia;
disturbance of consciousness.

Diagnosis and treatment

Ultrasound of the organ is considered one of the most informative methods. With the help of such a study, it is possible to identify ventricular hypertrophy, disturbances in the structure of the heart and evaluate its contractile characteristics.
X-ray of the chest area, allowing you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
ECG in the form of daily monitoring. It is necessary to clarify the clinical picture in case of disorders related not only to the axis itself, but also to the origin of the rhythm not from the sinus node area, which indicates a disorder of the rhythmic data.
Coronary angiography or coronary angiography. It is used to study the characteristics of damage to the coronary arteries during organ ischemia.
An exercise ECG can detect myocardial ischemia, which is usually the cause of a shift in the direction of the EOS.

Changing the angle of the electrical axis of the heart does not require therapy.

What is sinus rhythm on an ECG

What is sinus rhythm

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.

What criteria are used to decipher the ECG result?

The results of the cardiogram are deciphered 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.

What sinus rhythm problems can be seen on an ECG?

Electrocardiogram readings can indicate clear signs of 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.

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 horizontal position of the EOS is observed, then this cannot immediately be considered a pathological condition. Such axis indicators are observed in people who are short in stature but have fairly broad shoulders. If the axis deviates to the left or right, and this is very noticeable, then such indicators may indicate a pathological condition of the organ, an 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 to the right side. Such a deviation may also indicate abnormalities in the development of the heart muscle.

What can we say about normal indicators?

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.

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

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 has been smoking cigarettes on a regular basis for quite a long time;
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.

Why should a person undergo an ECG test?

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.

Please note that all information posted on the site is for reference only and

not intended for self-diagnosis and treatment of diseases!

Copying of materials is permitted only with an active link to the source.

Deviation of EOS to the left: causes, diagnosis and treatment

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

To resolve this problem, consult a cardiologist.

The location of the electrical axis is normal

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

Norm of angle alpha EOS

Normal alpha angle depending on body type:

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

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

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

Reasons for shift to the left

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

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

Causes of these pathologies:

Symptoms

EOS displacement itself does not have characteristic symptoms.

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

However, sometimes these diseases still make themselves felt.

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

But let us repeat once again - symptoms do not always appear; they usually develop in the later stages of the disease.

Additional diagnostics

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

EchoCG (ultrasound of the heart) - to identify possible organ defects.
Stress echocardiography – ultrasound of the heart under stress – for diagnosing ischemia.
Angiography of the coronary vessels - their examination to identify blood clots and atherosclerotic plaques.
Holter monitoring – recording an ECG using a portable device throughout the day.

After a detailed examination, appropriate therapy is prescribed.

Treatment

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

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

Treatment for LVH depends on what caused the myocardial growth

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

Deviation of the electrical axis of the heart to the left: everything you need to know about it

Normal values and causes of violation

In a state of health, the electrical axis shifts to the left under the following conditions:

at the moment of deep exhalation;
when the body position changes to horizontal, the internal organs put pressure on the diaphragm;
with a high-standing diaphragm - observed in hypersthenics (short, strong people).

A shift of the indicator to the right in the absence of pathology is observed in the following situations:

at the end of a deep breath;
when changing body position to vertical;
For asthenics (tall, thin people), the norm is the vertical position of the EOS.

Diagnosis using ECG

Alpha angle offset detection

The value of the sum of teeth from the first lead is found on the horizontal axis, and from the third - on the vertical axis. The intersection of the resulting lines determines the alpha angle.

Visual definition

Establishing diagnosis

What does it mean if the electrical axis of the heart is deviated to the left? EOS displacement is not an independent disease. This is a sign of changes in the heart muscle or its conduction system that lead to the development of the disease. Deviation of the electrical axis to the left indicates the following violations:

an increase in the size of the left ventricle - hypertrophy (LVH);
malfunction of the left ventricular valves, which causes the ventricle to be overloaded with blood volume;
cardiac blockades, for example, blockade of the left bundle branch (on the ECG this looks like this, which you can learn about from another article);
disturbances in electrical conductivity inside the left ventricle.

Diseases that are accompanied by levogram

If a patient has a deviation in EOS, this may be a consequence of diseases such as:

In addition to diseases, blockage of the conduction system of the heart can result from taking certain medications.

Additional Research

Bicycle ergometry (electrocardiogram while walking on a treadmill or on an exercise bike). Test to detect ischemia of the heart muscle.
Ultrasound. Using ultrasound, the degree of ventricular hypertrophy and disturbances in their contractile function are assessed.
24-hour Holter ECG monitoring. The cardiogram is taken within 24 hours. Prescribed in cases of rhythm disturbance, which is accompanied by deviation of the EOS.
X-ray examination of the chest. With significant hypertrophy of myocardial tissue, an increase in the cardiac shadow in the image is observed.
Coronary artery angiography (CAG). Allows you to determine the degree of damage to the coronary arteries with diagnosed ischemic disease.
Echocardioscopy. Allows targeted determination of the condition of the patient’s ventricles and atria.

Treatment

Ischemia, heart failure and some cardiopathy are treated with medications. Additional adherence to diet and a healthy lifestyle leads to normalization of the patient’s condition.

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

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

How is an electrocardiogram taken?

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

What influences the location of the EOS?

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

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

EOS location options

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

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

Normal location of the electrical axis of the heart

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

Pathological location of the electrical axis of the heart

A condition in which the electrical axis of the heart is deviated is not a diagnosis in itself. However, such changes in the electrocardiogram may indicate various disorders in the functioning of the most important organ. The following diseases lead to serious changes in the functioning of the conduction system:

Cardiac ischemia;

Chronic heart failure;

Cardiomyopathies of various origins;

Congenital defects.

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

Deviation of the electrical axis of the heart to the left

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

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

Deviation of the electrical axis of the heart to the right

This condition clearly indicates right ventricular hypertrophy. Similar changes develop in certain respiratory diseases (for example, bronchial asthma or chronic obstructive pulmonary disease). Some congenital heart defects can also cause the right ventricle to become enlarged. First of all, it is worth noting pulmonary artery stenosis. In some situations, tricuspid valve insufficiency can also lead to a similar pathology.

Why is changing EOS dangerous?

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

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

What to do if the EOS is changed?

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

To summarize, several important points should be highlighted:

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

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

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

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

The heart is an amazing organ that ensures the functioning of all systems of the human body. Any changes that occur in it inevitably affect the functioning of the whole organism. Regular checkups A therapist and an ECG will allow you to timely identify the emergence of serious diseases and avoid the development of any complications in this area.

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

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

Electric axis position range is normal

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

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

Deviations from the norm are deviation of the axis to the left and sharply to the left, to the right and sharply to the right, as well as the presence of a non-sinus heart rhythm.

How to determine the position of the electrical axis

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

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

Reasons for deviations from the norm

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

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

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

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

Deviation of the heart axis to the right is a normal variant when conducting an ECG in a newborn child, and in this case there may be a sharp deviation of the axis.

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

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

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

Symptoms

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

The disease is characterized by pain in the heart area

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

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

Diagnostics

To determine the reason for deviation according to ECG axis heart left or right, a cardiologist or therapist may prescribe additional research methods:

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

Treatment

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

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

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

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

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

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

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

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

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

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

Methods for determining the position of the EOS.

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

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

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

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

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

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

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

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

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

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

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

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

When can the position of the EOS indicate heart disease?

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

Normal ECG readings

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

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

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

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

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

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

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The electrical axis of the heart is located vertically. What problems will the electrical axis of the heart tell you about?

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

Effect of direction of ventricular depolarization

How to recognize EOS deviation to the right and left

Axis deviation to the right

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

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

When can the position of the EOS indicate heart disease?

EOS deviations to the left

EOS deviations to the right

What to do if EOS displacement is found on the cardiogram?

Normal values ​​and causes of violation

Diagnosis using ECG

Alpha angle offset detection

Visual definition

Establishing diagnosis

Diseases that are accompanied by levogram

Additional Research

Treatment

Axis location

Reasons for rejection

Determination of ECG signs

The location of the electrical axis is normal

: everything you need to know about it

Normal values ​​and causes of violation

Diagnosis using ECG

Alpha angle offset detection

Visual definition

Establishing diagnosis

Diseases that are accompanied by levogram

Additional Research

Treatment

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

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

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

When can the position of the EOS indicate heart disease?

EOS deviations to the left

EOS deviations to the right

What to do if EOS displacement is found on the cardiogram?

If the EOS is deviated to the left or right - what does this mean?

And a little about secrets.

Deviation of the electrical axis of the heart to the left

1 Cardiac axis and ECG

2 When does the heart axis “go to the left”?

3 Pathological causes of EOS shift to the left

4 Left ventricular hypertrophy

5 Conduction disorders

6 Special forms of ventricular tachycardia

7 Heart defects

8 A set of examinations to clarify the diagnosis

9 Is it necessary to treat an axle tilted to the left?

Sinus bradycardia deviation of EOS to the left

What is the electrical axis of the heart?

Features of the conduction system

Parameters in healthy people

In what cases are we talking about pathology, the causes of violations

Norms for children

Symptoms

Diagnosis and treatment

What is sinus rhythm on an ECG

What is sinus rhythm

What criteria are used to decipher the ECG result?

What sinus rhythm problems can be seen on an ECG?

What can we say about normal indicators?

Why ECG readings may deviate from the norm

Why should a person undergo an ECG test?

The location of the electrical axis is normal

Reasons for shift to the left

Symptoms

Additional diagnostics

Treatment

Features of the conduction system

Parameters in healthy people

In what cases are we talking about pathology, the causes of violations

Norms for children

Symptoms

Diagnosis and treatment

What is sinus rhythm on an ECG

What is sinus rhythm

What criteria are used to decipher the ECG result?

Normal values and causes of violation

Normal values and causes of violation

Normal values and causes of violation