The electrical axis of the heart: norm and deviations. ECG horizontal position of eos Horizontal position of eos of the heart

22.09.2020 Blood glucose meters

Sinus heart rate on an ECG - what does it mean and how to determine it? There are cells in the heart that create momentum through a certain number of beats per minute. They are located in the sinus and atrioventricular nodes, as well as in the Purkinje fibers, which make up the tissue of the heart ventricles.

Sinus rhythm on the electrocardiogram means that this impulse is generated by the sinus node (the norm is 50). If the numbers are different, then the impulse is generated by another node, which gives a different value for the number of beats.

Normally, a healthy sinus heart rhythm is regular with different heart rates depending on age.

Normal readings in the cardiogram

What they look for when conducting electrocardiography:

The P wave on the electrocardiogram necessarily precedes the QRS complex.
The PQ distance corresponds to 0.12 seconds - 0.2 seconds.
The shape of the P wave is constant in each assignment.
In an adult, the rhythm frequency corresponds to 60 - 80.
The P – P distance is the same as the R – R distance.
The P wave in the normal state should be positive in the second standard lead, negative in lead aVR. In all other leads (these are I, III, aVL, aVF), its shape may differ depending on the direction of its electrical axis. Usually P waves are positive in both lead I and aVF.
In leads V1 and in V2, the P wave will be 2-phase, sometimes it can be predominantly positive or predominantly negative. In leads V3 to V6, the wave is predominantly positive, although there may be exceptions depending on its electrical axis.
Normally, each P wave must be followed by a QRS complex, a T wave. The PQ interval in adults has a value of 0.12 seconds - 0.2 seconds.

Sinus rhythm together with the vertical position of the electrical axis of the heart (EOS) shows that these parameters are within normal limits. The vertical axis shows the projection of the position of the organ in the chest. Also, the position of the organ can be in the semi-vertical, horizontal, semi-horizontal planes.

When the ECG registers sinus rhythm, it means that the patient has no problems with the heart yet. It is very important not to worry or be nervous when passing the examination, so as not to receive inaccurate data.

You should not do the examination immediately after physical exertion or after the patient has climbed to the third or fifth floor on foot. You should also warn the patient not to smoke half an hour before the examination, so as not to get unreliable results.

Violations and criteria for their determination

If the description contains the phrase: violations of sinus rhythm, then a blockade or arrhythmia is registered. Arrhythmia is any disruption in the sequence of the rhythm and its frequency.

Blockages can be caused if the transmission of excitation from nerve centers to the heart muscle is disturbed. For example, the acceleration of the rhythm shows that with a standard sequence of contractions, the rhythms of the heart are accelerated.

If the conclusion includes the phrase about an unstable rhythm, it means this is a manifestation of a low heart rate or the presence of sinus bradycardia. Bradycardia has a detrimental effect on the human condition, since the organs do not receive the amount of oxygen required for normal activity.

If an accelerated sinus rhythm is recorded, then, most likely, this is a manifestation of tachycardia. Such a diagnosis is made when the number of strokes is exceeded. heart rate in 110 strokes.

Interpretation of results and diagnosis

In order to diagnose arrhythmia, it is necessary to compare the obtained indicators with the indicators of the norm. The heart rate for 1 minute should not be more than 90. To determine this indicator, you need to divide 60 (seconds) by R-R duration interval (also in seconds) or multiply the number of QRS complexes in 3 seconds (a length of 15 cm of tape) by 20.

Thus, the following deviations can be diagnosed:

Bradycardia - heart rate / min less than 60, sometimes fixed increase P-P interval up to 0.21 seconds.
Tachycardia - heart rate increases to 90, although other signs of rhythm remain normal. Often there can be observed oblique depression of the PQ segment, and the ST segment - ascending. At a glance, it may look like an anchor. If the heart rate rises above 150 beats per minute, blockade of the 2nd stage occurs.
Arrhythmia is an irregular and unstable sinus heart rhythm, when the R-R intervals differ more than 0.15 seconds, which is associated with changes in the number of beats per inhalation and exhalation. Common in children.
Rigid rhythm - excessive regularity of contractions. R-R differs by less than 0.05 sec. This may be due to a sinus node defect or a violation of its neurovegetative regulation.

Reasons for deviations

The most common causes of rhythm disturbances are:

excessive alcohol abuse;
any heart defects;
smoking;
long-term use of glycosides and antiarrhythmic drugs;
bulging of the mitral valve;
pathology of functionality thyroid gland, including thyrotoxicosis;
heart failure;
myocardial diseases;
infectious lesions of the valves and other parts of the heart - a disease of infective endocarditis (his symptoms are quite specific);
overload: emotional, psychological and physical.

Additional research

If the doctor, when examining the results, sees that the length of the area between the P waves, as well as their height, are unequal, then the sinus rhythm is weak.

To determine the cause, the patient may be advised to undergo additional diagnostics: the pathology of the node itself or problems of the nodal autonomic system may be identified.

Then Holter monitoring is prescribed or a drug test is performed, which makes it possible to find out whether there is a pathology of the node itself or the regulation of the vegetative system of the node is disturbed.

For more details on the syndrome of weakness of this node, see the video conference:

If it turns out that the arrhythmia was the result of violations in the node itself, then corrective measurements of the vegetative status are assigned. If for other reasons, then other methods are used, for example, implantation of a stimulator.

Holter monitoring is a common electrocardiogram that is performed throughout the day. Due to the duration of this examination, specialists can examine the state of the heart at different degrees of stress. With a conventional ECG, the patient lies on a couch, and with Holter monitoring, you can study the state of the body during physical exertion.

Treatment tactics

Sinus arrhythmia special treatment does not require. An irregular rhythm does not mean that there is any of the listed diseases. Heart rhythm disturbances are a common syndrome that affects all ages.

Avoiding heart problems can help a lot. correct diet, daily routine, no stress. It will be useful to take vitamins to maintain heart function and improve the elasticity of blood vessels. In pharmacies, you can find a large number of complex vitamins containing all the necessary components and specialized vitamins to support the work of the heart muscle.

In addition to them, you can enrich your diet with foods such as oranges, raisins, blueberries, beets, onions, cabbage, spinach. They contain many antioxidants that regulate the number of free radicals, the excess of which can cause myocardial infarction.

For the smooth functioning of the heart, the body needs vitamin D, which is contained in parsley, chicken eggs, salmon, milk.

If you formulate the diet correctly, adhere to the daily regimen, you can achieve a long and uninterrupted work of the heart muscle and not worry about it until old age.

Finally, we suggest you watch a video with questions and answers about heart rhythm disturbances:

Sinus rhythm classification: what can the cardiogram tell us about the condition of the heart?

The sinus rhythm of the heart is just one of the many indicators that pay attention to when analyzing the cardiogram. Any deviation from the norm may be evidence of a developing disease or already running problems. Often, patients with an unstable sinus rhythm do not even feel this. In order not to miss a symptom, it is worth visiting the clinic at least once a year. This is especially recommended for people:

in whose family cases of similar diseases have already been recorded;
working in stressful conditions;
leading a sedentary lifestyle.

Of course, stress and long sitting at the computer does not always mean that the patient will be found to have an irregular sinus rhythm or other abnormalities, this only puts him at risk.

Read more about what the heart rhythm is, what is its norm, how its violations threaten, and what diseases it can signal - later in the article.

What is sinus rhythm on an ECG, why is it so important?

The ECG can be used to judge the condition of the heart and its problems. As a result of taking the cardiogram, the doctor receives information about the following points:

the functioning of the nodes of the conducting system;
heart rate (HR);
the presence of pathological processes;
functional disorders.

A patient who does not have the necessary knowledge is unlikely to be able to give an objective assessment of a cardiac cardiogram. Therefore, do not worry if the doctor does not give the cardiogram and is going to take it to a specialist on his own. If a visitor has a serious problem, such as acute heart failure or myocardial infarction, he is immediately taken to a cardiologist.

On the ECG, sinus rhythm indicates that the heart is contracting correctly. Any violations can signal that the sinus node is weak and cannot cope with its functions. This is fraught with violations of the normal frequency of beats per minute and their regularity.

For more information on how the decoding of the cardiogram of the heart is carried out, read further in the article.

ECG interpretation: general rules

What does the sinus rhythm of this or that nature mean? Only a doctor can judge. However, he focuses on the norms of indicators - in adults and children, they are somewhat different. This article discusses an adult electrocardiogram.

On the latter, several areas are distinguished, which are signs of sinus rhythm:

the P wave in the second standard lead is positive and necessarily goes before the QRS complex;
the PQ interval in duration is 0.12-0.2 seconds, the same throughout the entire cardiogram;
the shape of the P waves has the same appearance in one lead;
the P-P distance is equal to the R-R distance.

All this testifies to the relatively normal functioning of the heart. It is necessary to pay attention to the fact that the heart rate on the ECG of an adult should be in the range of 60-85 beats in 60 seconds. For children under 12 years old, this figure is different. You can see it in the table below.

Note! As you can see, in adults, the norm is much stricter. Any deviations can indicate rhythm disturbances.

The ECG results can be considered favorable if the sinus rhythm, heart rate is in order and EOS - the electrical axis of the heart is vertical. If the EOS is rejected, then this may indicate some problems. A change in position can provoke pressure on some areas, thereby interfering with the normal activity of the heart.

In fact, the deviation of the EOS to the left or to the right is not critical. The axis of the heart can be in the position:

vertical;
horizontal;
semi-vertical;
the opposite.

However, a certain turn of the heart can signal problems. If the axis is tilted to the left, this may indicate left ventricular hypertrophy, arterial hypertension, heart block, or intraventricular conduction disturbances. If the position of the electrical axis of the heart is deviated to the right, left ventricular hypertrophy or blockade may also occur. An altered position of the electrical axis of the heart is considered normal, however, upon first detection, it is recommended to undergo a thorough examination.

Some patterns are interesting:

the vertical position of the EOS is typical for tall and thin people of the asthenic type;
the horizontal position of the EOS is typical for short and dense people with a wide chest.

The position of the heart axis must be taken into account when drawing up an opinion.

What can a violation in the sinus rhythm on the cardiogram speak about?

First of all, you should understand that the normal heart rhythm can be easily ruined by the slightest stress or hassle. Before making a diagnosis, the doctor will have to make sure that the abnormalities on the ECG are not caused by external factors. This is especially true for children who are afraid of sensors - their cardiogram may be incorrect.

Attention: the sinus rhythm of the heart is a norm that testifies to the correct functioning of the conducting system of this organ.

The following abnormalities in the contractions of the heart are distinguished:

Bradycardia. The heart rate decreases, the patient feels dizzy, tired, apathetic, and tends to faint. P-P interval lengthens to 0.21 seconds.
Tachycardia. With a normal heart rate rhythm of 70 beats, the indicators of such a patient can be higher than 90, even in a calm state. This pulse can cause a Level 2 block. An accelerated sinus rhythm is noted.
Arrhythmia. It is characterized by irregularity of R-R intervals (more than 0.15 seconds). In this case, the patient may feel discomfort, severe anxiety, be sensitive to pressure changes. Normal heart rate in patients at rest is 75, 80 or 85 beats per second. Such an uneven rhythm is often found in children - this is the norm, and the vast majority outgrow this condition.
Ectopic rhythm. In this case, the rhythm is set not by the sinus node, but by other conductive fibers. The atrial rhythm, the rhythm from the AV node, the ventricular idioventricular rhythm and the rhythm of the coronary sinus or coronary sinus are distinguished when the excitation site is very close to the coronary sinus (recorded only by ECG).

It is important to understand that normosystole speaks about the health of the heart muscle.

Any changes in sinus normal rhythm are reflected on the ECG so that a professional can easily diagnose the condition.

What affects the contraction of the heart?

When a doctor deciphers data, he considers not only what meaning he sees on paper, but also the patient's lifestyle. Have a negative effect on cardiac activity:

stress;
smoking;
alcohol consumption;
taking antiarrhythmic drugs;
physical overload.

The situation often returns to normal when a person finds himself in a calm environment. More than half of heart rate problems go away with stress relief. As a percentage, this figure is 62%. It is important to understand that most patients feel uncomfortable due to the busy work. Regardless of the reasons, if there are clear signs of a violation, it is recommended to visit a doctor.

The number of beats per minute also depends on age. So, for children, 160 beats per minute may be the norm, while for adults (over 12) this figure should be 75 beats per minute.

Sometimes, to clarify the details of the rhythm, doctors prescribe a daily study. In this case, sensors and a memory device are attached to the patient, which he must wear all day. This allows you to track the behavior of the heart muscle throughout the day in various conditions.

The ECG shows a wrong rhythm: how to carry out the treatment?

If the heart rhythm deviates from the norm, then this does not mean pathological changes. Only if a doctor has made a diagnosis can we talk about prescribing medications. The conclusion of the ECG only provides a direction for additional research, but does not become a verdict.

Often, problems with heart rhythm are eliminated by organizing the correct mode of work and rest, normalizing nutrition, and eliminating stress.

It is best to prevent problems from occurring, so it is important to:

do not overload yourself with physical exercise;
if possible do not deviate from correct image life;
take heart-strengthening drugs (after consulting a doctor).

It is worth noting that the patient does not have to understand what this or that disease means. It is enough for him to adhere to the treatment plan and recommendations of the attending doctor.

If the rhythm (sinus) is somewhat abnormal, it can be normalized with medication. They are prescribed by a cardiologist.

oranges;
raisin;
blueberries;
beets;
cabbage;
spinach.

These foods strengthen cardiovascular system, reduce the risk of rhythm interruptions. A well-chosen diet will at the same time reduce the likelihood of myocardial infarction, which is especially important for older people.

When should you see a cardiologist?

Cardiology is a developed branch of medicine, and now all diseases lend themselves to reading drug treatment... Normally, it is worth visiting a doctor at least once a year - this will help to timely detect the onset of the pathological process. Even in paid clinics, the average cost of a comprehensive consultation is 1100 rubles, which is affordable for most people.

In any case, an ECG, the decoding of which should be carried out only by a doctor, is considered the basis for recognizing the cause of the disease. Each number from the electrocardiogram has a specific meaning. What they mean - the cardiologist will help you figure it out.

Note! It should be remembered that some symptoms appear differently in children. Therefore, the Union of Pediatricians of Russia (Union of Pediatricians of Russia) has its own prescriptions for the treatment of such diseases in children.

Violation of sinus rhythm: results

Sinus rhythm accompanies the normal functioning of the heart, its changes: tachycardia, bradycardia. arrhythmias indicate disturbances in the conducting system and require careful examination of the ECG by a cardiologist.

It is worth warning about the peculiarities of the location of the organ in advance, since deviations of the heart along the axis make some adjustments to the cardiogram. Otherwise, you will have to re-pass a thorough examination every time. Knowing the characteristics of the patient's body, the doctor can make an accurate conclusion.

To prevent rhythm disturbances, it is worth revising your lifestyle and diet. This will reduce the risk of symptoms. It is recommended to visit a cardiologist at least once a year. If there are already violations, you need to go to the appointment strictly according to the plan. The doctor will schedule appointments based on the severity of the illness. In severe cases, special sensors are attached to a person, which immediately record critical changes and inform others about it.

Even if there are no complaints, one should not neglect a visit to a cardiologist. Some diseases run latently, without causing inconvenience to the patient until a certain time.

The definition "rotation of the electrical axis of the heart around the axis" may well be found in descriptions of electrocardiograms and is not something dangerous. When the electrical axis of the heart is deviated to the right, the alpha angle will be determined in the range of 70-90 °.

The direction of the electrical axis of the heart shows the total value of bioelectrical 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 present chest as a coordinate system. If you project the electrodes onto a conventional coordinate system, then you can calculate the angle of the electrical axis, which will be located where the electrical processes are strongest.

Horizontal position of the electrical axis of the heart (e.s.)

The conducting system of the heart is a portion of the heart muscle, consisting of the so-called atypical muscle fibers. These fibers are well innervated and provide synchronous contraction of the organ. The contraction of the myocardium 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 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. The conducting system of the myocardium is a powerful source of electrical impulses, which means that in it, first of all, electrical changes occur in the heart that precede the heartbeat. The mass of the heart muscle of the left ventricle is normally much greater than the mass of the right ventricle.

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) are found in healthy people and are not pathological.

By itself, the position of the EOS is not a diagnosis. However, there are a number of diseases in which there is a shift in the axis of the heart. These defects can be either congenital or acquired. The most commonly acquired heart defects are the result of previous rheumatic fever. In this case, it is necessary to consult a highly qualified sports doctor to resolve the issue of the possibility of continuing to play sports.

A displacement of 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. None of the above diagnoses can be made on the basis of EOS bias alone. The position of the axis serves only as an additional indicator in the diagnosis of a particular disease.

And yet, the main reason for the displacement of the EOS is myocardial hypertrophy. The situation should be alarming when, with a pre-existing position of the EOS, there is a sharp deviation on the ECG. In this case, the deviation most likely indicates the occurrence of a blockade. By itself, the displacement of the electrical axis of the heart does not need treatment, refers to electrocardiological signs and requires, first of all, clarification of the cause of its occurrence. Attention! We are not # 171; clinic # 187; and are not interested in providing medical services to readers.

Different variants of the shape of the QRS complex of a normal ECG may be due to variants of the sequence of intraventricular conduction or the anatomical location of the heart in the chest. With RaVF = SaVF, the angle a = 0 °, i.e. AQRS at the border of the horizontal position and deviation to the left. Teeth TIII and PIII are low, and sometimes negative or isoelectric.

The resulting vector of excitation of the ventricles is the sum of three momentary vectors of excitation: the interventricular septum, the apex and the base of the heart. This vector has a certain directionality in space, which we interpret in three planes: frontal, horizontal and sagittal. In each of them, the resulting vector has its own projection. Changing the alpha angle within 0 # 8212; minus 30 ° indicates a sharp deviation of the electrical axis of the heart to the left, or, in other words, a sharp levogram.

On the contrary, if in the I standard lead we have the S-type of the ventricular complex, and in the III lead the R-type of the QRS complex, then the electrical axis of the heart is deflected to the right (right-sided). Simplified, this condition is written as SI-RIII. The resulting vector of ventricular excitation is normally located in the frontal plane so that its direction coincides with the direction of axis II of the standard lead.

In this case, the deviation of the electrical axis is found by analyzing the R and S waves in I and III standard leads. This, of course, does not mean that in the normal or, for example, vertical position of the electrical axis, significant changes cannot take place in the ventricular myocardium. As with the left ventricle, RH is caused by coronary artery disease, chronic heart failure, and cardiomyopathies. In some cases, the electrocardiogram fails to find the conditions described for determining the electrical position of the heart.

Electrical axis of the heart: norm and deviations

Electric axis of the heart # 8212; those words that are first encountered when decoding an electrocardiogram. When they write that her position is normal, the patient is satisfied and happy. However, in the conclusions, they often write about the horizontal, vertical axis, its deviations. In order not to experience unnecessary anxiety, it is worth having an idea about EOS: what it is, and what threatens its position, which is different from normal.

General idea about EOS # 8212; what is this

It is known that the heart, during its tireless work, generates electrical impulses. They originate in a certain area - in the sinus node, then normally electrical excitation passes to the atria and ventricles, spreading along a conductive nerve bundle, called a bundle of His, along its branches and fibers. This is summed up as an electric vector that has a direction. EOS # 8212; the projection of this vector onto the front vertical plane.

Doctors calculate the position of the EOS, postponing the magnitude of the amplitudes ECG waves on the axis of Einthoven's triangle formed by standard ECG leads from the extremities:

the amplitude of the R wave minus the amplitude of the S wave of the first lead is plotted on the L1 axis;
a similar magnitude of the amplitude of the teeth of the third assignment is plotted on the L3 axis;
from these points perpendiculars are set towards each other before crossing;
the line from the center of the triangle to the point of intersection is the graphical expression of the EOS.

Its position is calculated by dividing the circle describing Einthoven's triangle by degrees. Usually, the direction of the EOS roughly reflects the location of the heart in the chest.

Normal position of EOS # 8212; what is this

Determine the position of the EOS

the speed and quality of the passage of the electrical signal through the structural units of the cardiac conduction system,
the ability of the myocardium to contract,
changes internal organs that can affect the work of the heart, and in particular, on the conducting system.

In a person without serious health problems, the electric axis can be in a normal, intermediate, vertical or horizontal position.

It is considered normal when the EOS is located in the range from 0 to +90 degrees, depending on the constitutional characteristics. Most often, a normal EOS is located between +30 and +70 degrees. Anatomically, it is directed downward and to the left.

The intermediate position is between +15 and +60 degrees.

On the ECG, the positive teeth are higher in the second, aVL, aVF leads.

EOS vertical position

When vertical, the electric axis is between +70 and +90 degrees.

It occurs in people with a narrow chest, tall and thin. Anatomically, the heart literally "hangs" in their chest.

On the ECG, the highest positive waves in are recorded in aVF. Deep negative - in aVL.

EOS horizontal position

The horizontal position of the EOS is between +15 and -30 degrees.

Typical for healthy people with a hypersthenic physique - a wide chest, short stature, increased weight. The heart of such people "lies" on the diaphragm.

On the ECG, the highest positive waves are recorded in aVL, and the deepest negative ones in aVF.

Deviation of the electrical axis of the heart to the left # 8212; what does it mean

EOS deviation to the left - its location in the range from 0 to -90 degrees. Up to - 30 degrees can still be considered a variant of the norm, but a more significant deviation indicates a serious pathology or a significant change in the location of the heart. for example, during pregnancy. It is also observed during the deepest exhalation.

Pathological conditions accompanied by a deviation of the EOS to the left:

hypertrophy of the left ventricle of the heart - a companion and a consequence of long-term arterial hypertension;
violation, blockade of conduction along the left leg and fibers of the His bundle;
left ventricular myocardial infarction;
heart defects and their consequences that change the conducting system of the heart;
cardiomyopathy, which impairs the contractility of the heart muscle;
myocarditis - inflammation also disrupts the contractility of muscle structures and the conduction of nerve fibers;
cardiosclerosis;
myocardial dystrophy;
deposits of calcium in the muscle of the heart, preventing it from contracting normally and disrupting innervation.

These and similar diseases and conditions lead to an increase in the cavity or mass of the left ventricle. As a result, the excitation vector moves longer from the left side and the axis deviates to the left.

The ECG in the second, third leads is characterized by deep S waves.

Deviation of the electrical axis of the heart to the right # 8212; what does it mean

Eos is rejected to the right if it is in the range from +90 to +180 degrees.

Possible reasons for this phenomenon:

violation of the conduction of electrical excitation along the fibers of the bundle of His, its right branch;
myocardial infarction in the right ventricle;
overload of the right ventricle due to constriction pulmonary artery;
chronic pulmonary pathology, the consequence of which is " cor pulmonale"Characterized by intense work of the right ventricle;
the combination of ischemic heart disease with hypertension - depletes the heart muscle, leads to heart failure;
PE - blocking blood flow in the branches of the pulmonary artery, of thrombotic origin, as a result, the blood supply to the lungs is depleted, their vessels spasm, which leads to a load on the right parts of the heart;
mitral heart disease, valve stenosis, causing congestion in the lungs, which causes pulmonary hypertension and increased work of the right ventricle;
dextrocardia;
emphysema of the lungs - shifts the diaphragm down.

On the ECG, a deep S wave is noted in the first lead, while in the second, third it is small or absent.

It should be understood that a change in the position of the heart axis is not a diagnosis, but only signs of conditions and diseases, and only an experienced specialist should understand the reasons.

What is the electrical axis of the heart?

The electrical axis of the heart is a concept that reflects the total vector of the electrodynamic force of the heart, or its electrical activity, and practically coincides with the anatomical axis. Normally, this organ has a conical shape, directed downward, forward and left with its narrow end, and the electric axis has a semi-vertical position, that is, it is also directed downward 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, in which any of the following positions of the heart axis is indicated: not rejected, has a semi-vertical, semi-horizontal, vertical or horizontal position. Closer to the vertical position, the axis is in thin tall people asthenic physique, and to horizontal - in strong stocky persons of hypersthenic physique.

Electric axis position range is normal

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

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

Deviations from the norm are the 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 an electrical axis

Determination of the position of the axis of the heart is carried out by the doctor of functional diagnostics, decoding the ECG, using special tables and diagrams, according to 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 a deviation of the axis to the left. If in III it is more than in I, then the right-hand diagram. Normally, the R wave is higher in lead II.

Reasons for deviations from the norm

Deviation of the axis to the right or to the left is not considered an independent disease, but it can speak of 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 normally occur 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, which are necessary for the normal functioning of the whole heart. Hypertrophy can be caused by the following diseases:

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

Deviation of the axis of the heart to the right is a variant of the norm 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, as a rule, is a sign of right ventricular hypertrophy, which develops with such diseases:

diseases of the bronchopulmonary system - long-term bronchial asthma, severe obstructive bronchitis, pulmonary emphysema, leading to an increase in blood pressure in the pulmonary capillaries and increasing the load on the right ventricle;
heart defects with damage to the tricuspid (tricuspid) valve and the valve of the pulmonary artery extending 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. Disorders of well-being appear in a patient if myocardial hypertrophy leads to severe hemodynamic disturbances and to heart failure.

The disease is characterized by pain in the region of the heart.

Of the signs of diseases accompanied by deviation of the heart axis to the left or to the right, headaches, pain in the region of the heart, edema are characteristic lower limbs and on the face, shortness of breath, attacks of suffocation, 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 found on the cardiogram, an additional examination should be performed to establish the cause of this condition, especially if it is detected in a child.

Diagnostics

To determine the cause when the ECG axis of the heart deviates to the left or to the right, a cardiologist or therapist may prescribe additional research methods:

Ultrasound of the heart is the most informative method for assessing anatomical changes and revealing ventricular hypertrophy, as well as determining the degree of impairment of their contractile function. This method is especially important for examining a newborn child for congenital heart disease.
Exercise ECG (walking on a treadmill - treadmill test, bicycle ergometry) can reveal myocardial ischemia, which can be the cause of deviations of 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, there are rhythm disturbances.
Chest X-ray - with severe myocardial hypertrophy, expansion of the cardiac shadow is characteristic.
Coronary angiography (CAG) - performed to clarify the nature of the lesions coronary arteries with ischemic disease a.

Treatment

Direct deviation of the electrical axis does not need treatment, since it is not a disease, but a criterion by which one can assume that a patient has one or another cardiac pathology. If, after an additional examination, some disease is revealed, it is necessary to start treatment as soon as possible.

In conclusion, it should be noted that if a 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 - a sign, even if there are no symptoms does not arise.

The normal location of the EOS and the reasons for its displacement

The electrical axis of the heart is a concept that reflects the electrical processes in this organ. The EOS direction shows all bioelectrical changes in the amount that occur during the work of the heart muscle. During the removal of an electrocardiogram, each electrode records a bioelectric reaction in a strictly abducted part of the myocardium. Then doctors, to calculate the position and angle of the EOS, represent the chest in the form of a coordinate system, in order to further project the indicators of the electrodes onto it. Possible horizontal position of EOS, vertical and a number of other options.

The importance of the cardiac conduction system for EOS

The conduction system of the heart muscle is an atypical muscle fibers that connect different parts of the organ and help it contract in sync. Its beginning is considered to be the sinus node, located between the mouths of the vena cava, therefore, in healthy people, the heart rhythm is sinus. When an impulse occurs in the sinus node, the myocardium contracts. If the conduction system malfunctions, the electrical axis changes its position, since it is there that all changes take place before the contraction of the heart muscle.

Axis directions and offset

Since the weight of the left ventricle of the heart muscle in completely healthy adults is greater than that of the right, all electrical processes are stronger there. Therefore, the axis of the heart is turned towards it.

Normal position. If you project the location of the heart on the assumed coordinate system, then the direction of the left ventricle from +30 to +70 degrees will be considered normal. But it depends on the characteristics of each person, therefore, the range from 0 to +90 degrees is considered the norm for this indicator for different people.

Horizontal position (from 0 to +30 degrees). It is displayed on the cardiogram in stunted people with a broad sternum.

Vertical position. EOS is in the range from +70 to +90 degrees. It is observed in tall people with a narrow chest.

There are diseases in which the axis is displaced:

Deviation to the left. If the axis deviates to the left, this may indicate an increase (hypertrophy) of the left ventricle, which indicates its overload. This condition is often caused by arterial hypertension, which lasts for a long time, when blood hardly passes through the vessels. As a result, the left ventricle is working hard. Deviation to the left occurs with various blockages, lesions of the valve apparatus. With progressive heart failure, when the organ cannot fully perform its functions, the electrocardiogram also records the shift of the axis to the left. All these diseases force the left ventricle to work hard, so its walls become thicker, the impulse through the myocardium passes much worse, the axis deviates to the left.

Offset to the right. Deviation of the electrical axis of the heart to the right most often occurs with an increase in the right ventricle, for example, if a person has heart disease. It can be cardiomyopathy, ischemic disease, abnormalities in the structure of the heart muscle. Right deviation is also caused by such problems with the respiratory system as obstruction of the lungs, bronchial asthma.

EOS norm indicators

So, in healthy people, the direction of the heart axis can be normal, horizontal, vertical, the heart rate is sinus regular. If the rhythm is not sinus, then this indicates some kind of disease. Irregular sinus rhythm is an indicator of the disease, if it persists during breath holding. A displacement of the cardiac axis to the left or right may indicate problems with the heart and respiratory organs. In no case should the diagnosis be made only on the basis of the EOS displacement. A cardiologist can determine the disease and prescribe treatment after a number of additional studies.

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

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

Each electrode, when taking an ECG, registers bioelectric excitation that occurs in a certain area of the myocardium. If you project the electrodes onto a conventional coordinate system, then you can calculate the angle of the electrical axis, which will be located where the electrical processes are strongest.

The conduction system of the heart and why is it important for the determination of EOS?

The contraction of the myocardium 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, an impulse of electrical excitation passes to the atrioventricular node and further along the bundle of His. This bundle passes in the interventricular septum, where it is divided into the right, heading towards the right ventricle, and the left leg. The left pedicle of 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 slightly to the left of the anterior one.

The conducting system of the myocardium is a powerful source of electrical impulses, which means that in it, first of all, electrical changes occur in the heart that precede the heartbeat. In case of 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 heart 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 in total stronger, and the EOS will be directed precisely at it. If you project the position of the heart on the coordinate system, then the left ventricle will be in the region of +30 + 70 degrees. This will be the normal axis position. However, depending on the individual anatomical features 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.

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

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

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

Rotation of the heart around the longitudinal axis helps to determine the position of the organ in space and, in some cases, is an additional parameter in the diagnosis of diseases.

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

When can the EOS position speak of heart disease?

By itself, the position of the EOS is not a diagnosis. However, there are a number of diseases in which there is a shift in the axis of the heart. Significant changes in the position of the EOS are caused by:

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

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. its 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 resistance of blood vessels 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. Coronary artery disease, chronic heart failure, cardiomyopathies also cause left ventricular hypertrophy.

hypertrophic changes in the left ventricular myocardium - the most common cause of deviation of the EOS to the left

In addition, LVH develops when the left ventricular valve apparatus is affected. This condition is caused by stenosis of the aortic orifice, in which the ejection of blood from the left ventricle is difficult, 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 commonly acquired heart defects are the result of previous rheumatic fever. Left ventricular hypertrophy is found in professional athletes. In this case, it is necessary to consult a highly qualified sports doctor to resolve the issue of the possibility of continuing to play sports.

Also, the EOS can be rejected to the left with violations of intraventricular conduction and various heart blockages. Deviation email 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 displacement of 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 diseases respiratory organs, accompanied by pulmonary hypertension, such as bronchial asthma, chronic obstructive pulmonary disease, with a prolonged course, cause hypertrophy. Pulmonary artery stenosis and tricuspid valve insufficiency lead to right ventricular hypertrophy. As with the left ventricle, RH is caused by coronary artery disease, chronic heart failure, and cardiomyopathies. EOS deviation to the right occurs with complete blockade of the posterior branch of the left bundle branch.

What to do if an EOS offset is found on the cardiogram?

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

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

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

The resulting vector of all bioelectric oscillations of the heart muscle is called the electrical axis. Most often it coincides with the anatomical. This indicator is used in the analysis of ECG data to assess the predominance of one of the parts of the heart, which may be indirect sign myocardial hypertrophy.

📌 Read in this article

Normal electrical axis of the heart

The direction of the heart axis is calculated in degrees. For this, they use such a concept as the angle alpha. It is formed by a horizontal line that is drawn through the electrical center of the heart. To determine it, the axis of the first ECG lead is shifted towards the center of Einthoven. This is a triangle, its vertices are the hands of the arms spread out to the side and the left foot.

In a healthy person, the electrical axis fluctuates between 30 and 70 degrees. This is due to the fact that the left ventricle is more developed than the right one, therefore, more impulses come from it. This position of the heart occurs with a normosthenic physique, and the ECG is called a normogram.

Position deviations

Not always a change in the direction of the axis of the heart on the electrocardiogram is a sign of pathology. Therefore, for the diagnosis of its deviations are of secondary importance and are used for the preliminary formulation of the conclusion.

To the right

The right-hand gram (alpha 90 - 180) on the ECG occurs with an increase in the mass of the right ventricular myocardium. The following diseases lead to this condition:

chronic obstructive pulmonary disease;
bronchitis;
bronchial asthma;
narrowing of the pulmonary artery trunk, mitral opening;
circulatory failure with congestion in the lungs;
cessation of the passage of impulses (blockade) of the left leg of His;
pulmonary thrombosis;
cirrhosis of the liver.

Cardiomyopathy is one of the reasons for the deviation of the heart axis to the right

To the left

Left-sided shift of the electrical axis (alpha from 0 to minus 90) occurs quite often... Leads to him. This may be due to conditions such as:

How to determine by ECG

In order to identify the position of the axis, you need to examine two leads aVL and aVF. They need to measure the tooth R. Normally, its amplitude is equal. If in aVL it is high, but in aVF it is absent, then the position is horizontal, in the vertical everything will be the other way around.

Axis deviation to the left will be if R in the first standard lead is greater than S in the third. Rightogram - S1 exceeds R3, and if R2, R1, R3 are in descending order, then this is a sign of a normogram. For a more detailed study, special tables are used.

Additional research

If the ECG revealed a shift of the axis to the right or left, then to clarify the diagnosis, use the following additional examination methods:

If there is only a pathological angle alpha, and no other manifestations were detected on the ECG, the patient does not experience difficulty breathing, the pulse and pressure are normal, then this condition does not require any further action. This is sometimes due to the anatomical feature.

A more unfavorable sign is a right-hand gram for lung diseases, as well as a levogram, combined with hypertension. In these cases, the displacement of the heart axis can be judged on the degree of progression of the underlying pathology. If the diagnosis is unknown, and there is a significant deviation of the axis with cardiac symptoms, then the patient should be fully examined to identify the cause of this phenomenon.

The displacement of the electrical axis can be left and right, depending on which of the ventricles of the heart is predominant. Such changes on the ECG are an indirect sign of myocardial hypertrophy and are considered in conjunction with other indicators. If there are complaints about the work of the heart, additional examination is required. In children younger age a pravogram is a physiological condition that does not require intervention.

Concept and specificity

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

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

The vertical position of the EOS is observed when it is in the range from +70 to +90 degrees. This is characteristic of people of thin build with tall stature (asthenics).

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

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

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

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

Sinus rhythm with these pathologies is disturbed.

Left and right position

When the electrical axis is shifted to the left, the left ventricle and its myocardium are hypertrophied (LVH). This is the most common specificity of the deviation. Such a pathology acts as an additional symptomatology, and not independently, and indicates an overload of the ventricle and a change in the process of its work.

These problems appear with prolonged arterial hypertension.

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

The left location of the electrical axis and LVH is also observed with violations of the valve system, while the sinus rhythm of contractions is also disturbed. The pathology is based on the following processes:

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

The indicated disorders are acquired or congenital. Often the reason for the former is rheumatism. Changes in ventricular volume are also observed in people who are professionally involved in sports. They are highly recommended to consult a doctor to determine if physical activity will cause irreparable harm to health.

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

Hypertrophic processes of the right ventricle (RV) accompany the right deviation of the EOS. The right side of the heart is responsible for bringing blood to the lungs, where it is saturated with oxygen. RH is characteristic of pathologies of the respiratory system: asthma, chronic obstructive processes in the lungs. If the disease continues for a long time, it causes hypertrophic changes in the ventricle.

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

Consequences of displacement and their specificity

The EOS displacement is found on the cardiogram. Consultation with a cardiologist and additional studies are required when the deviation is outside the normal range, which is set in the range from 0 to +90 degrees.

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

By itself, the deviation of EOS does not need therapeutic measures; it is referred to cardiological parameters, which require, first of all, to determine the cause of its occurrence. Only the cardiologist decides whether treatment is necessary in each individual case.

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

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

The conduction system of the heart and why is it important for the determination of EOS?

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

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) are found 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.

Rotation of the heart around the longitudinal axis helps to determine the position of the organ in space and, in some cases, is an additional parameter in the diagnosis of diseases.

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

When can the EOS position speak of heart disease?

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

EOS deviations to the left

hypertrophic changes in the left ventricular myocardium - the most common cause of deviation of the EOS to the left

EOS deviations to the right

A displacement of 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 diseases of the respiratory system, accompanied by pulmonary hypertension, such as bronchial asthma, chronic obstructive pulmonary disease with a long course cause hypertrophy. Pulmonary artery stenosis and tricuspid valve insufficiency lead to right ventricular hypertrophy. As with the left ventricle, RH is caused by coronary artery disease, chronic heart failure, and cardiomyopathies. EOS deviation to the right occurs with complete blockade of the posterior branch of the left bundle branch.

What to do if an EOS offset is found on the cardiogram?

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

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 the results of ultrasound. Any disease leading to a displacement of the heart axis is accompanied by a number of clinical signs and requires additional examination. The situation should be alarming when, with a pre-existing position of the EOS, there is a sharp deviation on the ECG. In this case, the deviation most likely indicates the occurrence of a blockade.

Determination of the position of the electrical axis of the heart - why is it needed?

The electrical axis of the heart is associated with the total vector of the electrodynamic force of the heart. Most often it coincides with the anatomical axis of the organ. As a rule, the heart has the shape of a cone, it is directed with a narrow part down to the left and forward. In this case, the position of the electric axis is in the range from 0 to 90 degrees.

The presence of the electrical axis is due to the conduction system of the heart, which consists of muscle fibers. Thanks to their contractions, the heart contracts.

I recently read an article that talks about Monastery tea for the treatment of heart disease. With the help of this tea, you can FOREVER cure arrhythmia, heart failure, atherosclerosis, ischemic disease heart, myocardial infarction and many other diseases of the heart and blood vessels at home.

I was not used to trusting any information, but I decided to check it and ordered a bag. I noticed the changes after a week: the constant pains and tingling in my heart that had tormented me before - receded, and after 2 weeks they disappeared altogether. Try and you, and if anyone is interested, then below is the link to the article.

The contraction originates in the sinus node, where an electrical impulse occurs. This impulse passes through the atrioventricular node and is directed to the bundle of His. In case of disturbances in the conducting system, the electrical axis of the heart can change its position.

How can EOS be located?

It is possible to determine the features of the location of the electrical axis of the heart using an ECG. The following options are usually considered normal:

Vertical (positioning range from 70 to 90 degrees).
Horizontal (positioning range from 0 to 30 degrees).
Semi-horizontal.
Semi-vertical.
Lack of tilt.

The figure shows the main options for the passage of the electrical axis of the heart. It is possible to determine what type of axis arrangement is characteristic of a particular person (vertical, horizontal or intermediate) using an ECG.

Electrical axis of the heart

Often, the position of the EOS depends on the physique of a person.

For tall people with a lean physique, a vertical or semi-vertical type of arrangement is characteristic. Stunted and dense people are characterized by horizontal and semi-horizontal position of the EOS.

Intermediate placement options for EOS are formed due to the fact that the physique of each person is individual, and there are many others between the lean and dense body type. This explains the different position of the EOS.

Deviations

Deviation of the electrical axis of the heart to the left or to the right is not a disease in itself. Most often, this phenomenon is a symptom of a different pathology. Therefore, doctors pay attention to this anomaly and carry out diagnostics in order to determine the reasons why the axis has changed its position.

A deviation of the axis to the left is sometimes observed in healthy people who are actively involved in sports.

For the treatment of cardiovascular diseases, Elena Malysheva recommends a new method based on Monastic tea.

It contains 8 useful medicinal plants who have extremely high efficiency in the treatment and prevention of arrhythmias, heart failure, atherosclerosis, coronary artery disease, myocardial infarction, and many other diseases. In this case, only natural ingredients, no chemistry and hormones!

But most often this phenomenon indicates left ventricular hypertrophy. This disease is characterized by an increase in the size of this part of the heart. It can be accompanied by the following diseases:

Cardiomyopathy.
High blood pressure (hypertension).
Acquired heart defects.
Congenital heart defects.
Problems with patency in the left part of the His bundle.
Atrial fibrillation.

If the electrical axis of the heart is displaced to the right, this can also be considered the norm, but only in the case of a newborn baby. The baby may even have a strong deviation from the norm.

Note! In other cases, this position of the electrical axis is a symptom of right ventricular hypertrophy.

Diseases that cause it:

Respiratory problems (asthma, obstructive bronchitis).
Heart defects.

The more pronounced hypertrophy, the more EOS changes position.

Having studied the methods of Elena Malysheva in the treatment of HEART DISEASE, as well as the restoration and cleaning of the VESSELS, we decided to offer it to your attention.

Fallot's tetrad (vice)

Also, the electrical axis of the heart can be displaced due to coronary artery disease or heart failure.

Do I need to be treated?

If the EOS has changed its position, unpleasant symptoms, as a rule, do not arise. More precisely, they do not arise due to the deviation of the axis. All difficulties are usually associated with the cause that caused the displacement.

Most often, this cause is hypertrophy, so the symptoms are the same as in this disease.

Sometimes no signs of the disease may appear until, due to hypertrophy, more serious diseases of the heart and cardiovascular system are formed.

To avoid danger, any person needs to carefully monitor their health and pay attention to any unpleasant sensations, especially if they are often repeated. You should see a doctor if you have any of the following symptoms:

Unpleasant sensations in the chest, tightness.
Swelling of the face or legs.
Headache.
Shortness of breath with minor physical exertion and at rest.
Labored breathing.
Suffocation.

All these signs can indicate the development of heart disease. Therefore, the patient needs to visit a cardiologist and undergo an EKG. If the electrical axis of the heart is displaced, then additional diagnostic procedures need to be carried out to find out what caused this.

Diagnostics

To establish the cause of the deviation, the following diagnostic methods are used:

Ultrasound of the heart
Holter monitoring
X-ray
Coronary angiography

Ultrasound of the heart

This diagnostic method allows you to identify changes in the anatomy of the heart. It is with its help that hypertrophy is detected, and also the features of the functioning of the cardiac chambers are determined.

This diagnostic method is used not only for adults, but also for very young children, in order to make sure that they do not have serious pathologies.

Holter monitoring

In this case, the ECG is performed during the day. The patient performs all his usual activities during the day, and the instruments record the data. This method is used in case of deviations in the position of the EOS, accompanied by a rhythm outside the sinus node.

X-ray

This method also allows one to judge the presence of hypertrophy, since the cardiac shadow will be expanded in the image.

ECG during exercise

The method is a conventional ECG, the data of which are recorded while the patient is performing physical exercise(running, push-ups).

This method can be used to establish ischemic heart disease, which can also affect the change in the position of the electrical axis of the heart.

Coronary angiography

I use this method to diagnose problems with blood vessels.

EOS deviation does not imply therapeutic effects. The disease that caused such a defect should be treated. Therefore, after a thorough examination, the doctor must prescribe the necessary therapeutic effects.

This defect, revealed during the examination, needs to be examined, even if the patient does not have any complaints of the heart. Heart disease is often asymptomatic and often diagnosed too late. If the doctor, after diagnosing, prescribed treatment and advised to adhere to certain rules, this must be done.

The treatment of this defect depends on what kind of disease provoked it, so the methods may be different. The main one is drug therapy.

In extremely life-threatening situations, the doctor may recommend surgery to neutralize the underlying disease.

With the timely detection of the pathology of the EOS, it is possible to return to a normal state, which occurs after the elimination of the underlying disease. However, in most cases, the actions of doctors are aimed at preventing deterioration in the patient's condition.

Also useful as a treatment folk ways using medicinal fees and tinctures. But before using them, you need to ask your doctor if such actions will harm. It is unacceptable to start taking medications on your own.

It is also important to comply with the measures for the prevention of heart disease. They are associated with healthy way life, adequate nutrition and rest, reducing the amount of stress. It is necessary to carry out feasible loads and lead an active lifestyle. It is worth giving up bad habits and abuse of coffee.

Changes in the position of the EOS do not necessarily indicate problems in the human body. But the detection of such a defect requires attention from doctors and the patient himself.

If measures are assigned therapeutic effect, then they are associated with the cause of the defect, and not with itself.

Incorrectly positioned electrical axis does not mean anything by itself.

Do you often have discomfort in the area of the heart (pain, tingling, constriction)?
You may suddenly feel weak and tired ...
Permanently felt high blood pressure…
Shortness of breath after the slightest physical exertion and there is nothing to say ...
And you have been taking a bunch of medications for a long time, dieting and keeping track of your weight ...

Read better what Olga Markovich says about this. For several years she suffered from atherosclerosis, ischemic heart disease, tachycardia and angina pectoris - pain and discomfort in the heart, heart rhythm disturbances, high blood pressure, shortness of breath even at the slightest physical activity... Endless tests, visits to doctors, pills did not solve my problems. BUT thanks simple recipe, constant pain and tingling in the heart, high blood pressure, shortness of breath - all this is in the past. I feel great. Now my doctor is wondering how it is. Here is a link to the article.

EOS (electrical axis of the heart)

EOS - the total vector of the electromotive force or depolarization of the ventricles. This definition is given in almost all manuals for decoding cardiograms. It is quite difficult to understand and can scare off the inquisitive minds of beginners, especially non-medical ones.

Let's analyze in simple, accessible words what is the electrical axis of the heart? If we conditionally imagine the propagation of electrical impulses from the sinus node to the underlying parts of the cardiac conduction system in the form of vectors, it becomes obvious that these vectors propagate to different parts of the heart, first from the atria to the apex, then the excitation vector is directed along the lateral walls of the ventricles somewhat upward. If the direction of the vectors is added or summed up, then you get one main vector, which has a very specific direction. This vector is EOS.

1 Theoretical foundations of the definition

Diagram for determining the electrical axis of the heart

How to learn to determine EOS by electrocardiogram? First, a little theory. Let's imagine Einthoven's triangle with lead axes, and also supplement it with a circle that passes through all axes, and indicate degrees or a coordinate system on the circles: along the I line of leads -0 and +180, above the line of the first lead there will be negative degrees, with a step at -30, and positive degrees are projected downward, in increments of +30.

Consider another concept that is necessary to determine the position of the EOS - the angle alpha (RI> RIII;

The deviation of the EOS to the left on the cardiogram looks like this: the largest R wave in the first lead, a little smaller - in the second, and the smallest - in the third: R I> RII> RIII;

Rotation of the EOS to the right or displacement of the heart axis to the right on the cardiogram manifests itself as the largest R in the third lead, slightly less in the second, the smallest in the first: R III> RII> RI.

Determining the alpha angle

But it is not always visually easy to determine the height of the teeth, sometimes they can be approximately the same size. What to do? After all, the eye can fail ... For maximum accuracy, measurements of the angle alpha are made. They do it like this:

Finding QRS complexes in leads I and III;
We summarize the height of the teeth in the first assignment;
We summarize the height in the third assignment;

An important point! It should be remembered during the summation that if the tooth is directed downward from the isoline, its height in mm will be with a "-" sign, if upward - with a "+"

3 What is a pencil for a diagnostician or when you don't need to look for an alpha angle?

Determining the alpha angle visually

There is one more method of determining the position of the EOS using a pencil, which is the simplest and most favorite method of students. It is not effective in all cases, but sometimes it simplifies the determination of the cardiac axis, allows you to determine whether it is normal or there is a displacement. So, with the non-writing part, we apply a pencil to the corner of the cardiograms near the first lead, then in leads I, II, III we find the highest R.

Direct the opposite sharpened part of the pencil to the R wave in the abduction where it is maximal. If not the writing part of the pencil is in the upper right corner, but the pointed tip of the writing part is in the lower left, then this position indicates the normal position of the heart axis. If the pencil is located almost horizontally, one can assume that the axis is shifted to the left or its horizontal position, and if the pencil takes a position closer to vertical, then the EOS is deflected to the right.

4 Why define this parameter?

Limits of deviation of the electrical axis of the heart

Questions related to the electrical axis of the heart are discussed in detail in almost all books on ECG, the direction of the electrical axis of the heart is an important parameter that must be determined. But in practice, it does little to help diagnose most heart diseases, of which there are more than a hundred. Deciphering the direction of the axis turns out to be really useful for diagnosing 4 main conditions:

Blockade of the anterior-superior branch of the left bundle branch;
Right ventricular hypertrophy. A characteristic feature its increase is the deviation of the axis to the right. But if there is a suspicion of left ventricular hypertrophy, the displacement of the heart axis is not at all necessary and the determination of this parameter does not help much in its diagnosis;
Ventricular tachycardia. Some of its forms are characterized by a deviation of the EOS to the left or its indefinite position, in some cases there is a turn to the right;
Blockade of the posterior-superior branch of the left bundle branch.

5 What can be normal EOS?

EOS position options

In healthy people, the following EOS descriptions take place: normal, semi-vertical, vertical, semi-horizontal, horizontal. Normally, as a rule, the electrical axis of the heart in persons over 40 years old is located at an angle of -30 to +90, in persons under 40 years old - from 0 to +105. In healthy children, the axis can deviate up to +110. For most healthy people, the indicator ranges from +30 to +75. In thin, asthenic persons, the diaphragm is located low, the EOS is deflected more often to the right, the heart occupies a more vertical position. In obese people, hypersthenics, on the contrary, the heart lies more horizontally, there is a deviation to the left. In normostenics, the heart occupies an intermediate position.

6 Norm in children

In newborns and infants, a pronounced deviation of the EOS to the right on the electrocardiogram is observed, by the year, in most children, the EOS goes into a vertical position. This is explained physiologically: the right heart sections somewhat prevail over the left ones both in mass and in electrical activity, and changes in the position of the heart - rotations around the axes - can also be observed. By the age of two, many children still have a vertical axis, but in 30% it becomes normal.

The transition to the normal position is associated with an increase in the mass of the left ventricle and cardiac rotation, in which there is a decrease in the adherence of the left ventricle to the chest. In preschoolers and schoolchildren, normal EOS prevails; vertical, less often horizontal, electrical axis of the heart may occur. Summarizing the above, the norm in children is:

during the neonatal period, the deviation of the EOS from +90 to +170
1-3 years - vertical EOS
school, adolescence - half of the children have a normal axis position.

7 Reasons for deviating EOS to the left

Left ventricular hypertrophy

The deviation of the EOS at an angle from -15 to -30 is sometimes called a slight deviation to the left, and if the angle is from -45, they will agree on a significant deviation to the left. What are the main causes of this condition? Let's consider them in more detail.

A variant of the norm;
GSV of the left bundle branch;
Left bundle branch block;
Left ventricular hypertrophy;
Positional changes associated with the horizontal location of the heart;
Some forms of ventricular tachycardia;
Malformations of the endocardial pillows.

8 Reasons for deviation of EOS to the right

Right ventricular hypertrophy

Criteria for deviation of the electrical axis of the heart in adults to the right:

The axis of the heart is located at an angle from +91 to +180;
The deviation of the electric axis at an angle of up to +120 is sometimes called a slight deviation of it to the right, and if the angle is from +120 to +180, a significant deviation to the right.

Most common reasons deviations of the EOS to the right can become:

A variant of the norm;
Right ventricular hypertrophy;
Posterior-superior bifurcation block;
Pulmonary embolism;
Dextrocardia (right-sided location of the heart);
A variant of the norm for positional changes associated with the vertical position of the heart due to emphysema, COPD, and other pulmonary pathologies.

It should be noted that the doctor may be alerted by a sharp change in the electrical axis. For example, if the patient has a normal or semi-vertical position of the EOS on previous cardiograms, and when taking an ECG at the moment, there is a pronounced horizontal direction of the EOS. Such abrupt changes may indicate any irregularities in the work of the heart and require an early additional diagnostics and additional examination.

Deviation of the electrical axis of the heart to the left - causes

Electrical cardiac defibrillation: indications and conduct

The publication of site materials on your page is possible only if you specify a full active link to the source

Electrical axis of the heart: norm and deviations

The electrical axis of the heart are the words that are first encountered when decoding an electrocardiogram. When they write that her position is normal, the patient is satisfied and happy. However, in the conclusions, they often write about the horizontal, vertical axis, its deviations. In order not to experience unnecessary anxiety, it is worth having an idea about EOS: what it is, and what threatens its position, which is different from normal.

General understanding of EOS - what is it

It is known that the heart, during its tireless work, generates electrical impulses. They originate in a certain area - in the sinus node, then normally electrical excitation passes to the atria and ventricles, spreading along a conductive nerve bundle, called a bundle of His, along its branches and fibers. This is summed up as an electric vector that has a direction. EOS is the projection of this vector onto the front vertical plane.

Doctors calculate the position of the EOS, postponing the magnitudes of the amplitudes of the ECG teeth on the axis of the Einthoven triangle, formed by standard ECG leads from the extremities:

the amplitude of the R wave minus the amplitude of the S wave of the first lead is plotted on the L1 axis;
a similar magnitude of the amplitude of the teeth of the third assignment is plotted on the L3 axis;
from these points perpendiculars are set towards each other before crossing;
the line from the center of the triangle to the point of intersection is the graphical expression of the EOS.

Its position is calculated by dividing the circle describing Einthoven's triangle by degrees. Usually, the direction of the EOS roughly reflects the location of the heart in the chest.

The normal position of the EOS - what is it

Determine the position of the EOS

the speed and quality of the passage of the electrical signal through the structural units of the cardiac conduction system,
the ability of the myocardium to contract,
changes in internal organs that can affect the work of the heart, and in particular, on the conducting system.

In a person without serious health problems, the electric axis can be in a normal, intermediate, vertical or horizontal position.

The intermediate position is between +15 and +60 degrees.

On the ECG, the positive teeth are higher in the second, aVL, aVF leads.

EOS vertical position

When vertical, the electric axis is between +70 and +90 degrees.

It occurs in people with a narrow chest, tall and thin. Anatomically, the heart literally "hangs" in their chest.

On the ECG, the highest positive waves in are recorded in aVF. Deep negative - in aVL.

EOS horizontal position

The horizontal position of the EOS is between +15 and -30 degrees.

Typical for healthy people with a hypersthenic physique - a wide chest, short stature, increased weight. The heart of such people "lies" on the diaphragm.

On the ECG, the highest positive waves are recorded in aVL, and the deepest negative ones in aVF.

Deviation of the electrical axis of the heart to the left - what does it mean

Pathological conditions accompanied by a deviation of the EOS to the left:

hypertrophy of the left ventricle of the heart - a companion and consequence of prolonged arterial hypertension;
violation, blockade of conduction along the left leg and fibers of the His bundle;
left ventricular myocardial infarction;
heart defects and their consequences that change the conducting system of the heart;
cardiomyopathy, which impairs the contractility of the heart muscle;
myocarditis - inflammation also disrupts the contractility of muscle structures and the conduction of nerve fibers;
cardiosclerosis;
myocardial dystrophy;
deposits of calcium in the muscle of the heart, preventing it from contracting normally and disrupting innervation.

The ECG in the second, third leads is characterized by deep S waves.

Deviation of the electrical axis of the heart to the right - what does it mean

Eos is rejected to the right if it is in the range from +90 to +180 degrees.

Possible reasons for this phenomenon:

violation of the conduction of electrical excitation along the fibers of the bundle of His, its right branch;
myocardial infarction in the right ventricle;
overload of the right ventricle due to narrowing of the pulmonary artery;
chronic pulmonary pathology, the consequence of which is the "cor pulmonale", characterized by the intense work of the right ventricle;
the combination of ischemic heart disease with hypertension - depletes the heart muscle, leads to heart failure;
PE - blocking blood flow in the branches of the pulmonary artery, of thrombotic origin, as a result, the blood supply to the lungs is depleted, their vessels spasm, which leads to a load on the right parts of the heart;
mitral heart disease, valve stenosis, causing congestion in the lungs, which causes pulmonary hypertension and increased work of the right ventricle;
dextrocardia;
emphysema of the lungs - shifts the diaphragm down.

On the ECG, a deep S wave is noted in the first lead, while in the second, third it is small or absent.

Alas, there are no comments yet. Be the first!

ECG to determine EOS, interpretation of indicators, norms and deviations

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

What is EOS?

It's 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 the following path:

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

Axis placement is calculated by dividing the circle outlined around the triangle by degrees. The direction of the vector gives the specialist a rough idea of the location of the heart in the chest.

The concept of the EOS norm

The position of the EOS depends on:

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

For a person not suffering from serious illnesses, the axis is characteristic:

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

At an intermediate position, the vector passes within the range of +15 - +60 degrees.

On the ECG, the specialist sees that the positive teeth are longer on the second, aVF and aVL leads.

Correct placement of EOS in children

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

EOS standards for children:

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

Measurement of indicators by electrocardiography

Signs of an ECG in the analysis of EOS are determined by the rightogram and the levogram.

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

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

Why does the deviation occur?

When the axis is tilted to the left, it means that the subject has left ventricular hypertrophy.

The causes of the disease include:

Hypertension. Especially in cases of frequent increases in blood pressure.
Diseases of an ischemic nature.
Heart failure of a chronic nature.
Cardiomyopathy. This ailment is the growth of the heart muscle in mass and the expansion of its cavities.
Aortic valve pathology. They are congenital or acquired. They provoke blood flow disturbances and LV reboot.

Important! Very often, hypertrophy is exacerbated in people who spend a lot of time on diverse 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, due to which bronchitis, asthma and emphysema occur.
Pathological ailments of the tricuspid valve.
Ischemia.
Heart failure.
Blocking the back branch of the His node.

EOS vertical position

The range of +70 - + 90º is typical for vertical arrangement. Typical for tall, thin people with a narrow sternum. According to anatomical indicators with such a physique, the heart seems to "hang".

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

EOS horizontal position

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

The cardiogram shows the highest positive waves in aVL, and negative ones in aVF.

EOS deviation to the left

The deviation of the electrical axis to the left is the position of the vector in the limit. Distance 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 a deep exhalation.

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

The reasons due to which there is a deviation of the axis to the left:

LV hypertrophy.
Violation or blockage of the His bundle.
Myocardial infarction.
Myocardial dystrophy.
Heart defects.
Violation of CM contractions.
Myocarditis.
Cardiosclerosis.
Calcium accumulation 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, as a result of which there is a deviation of the electrical axis to the left.

Reasons for deviating EOS to the right

Axis deviation to the right is fixed when it passes between +90 - + 180º. This shift can be provoked by:

Damage to the pancreas with a heart attack.
The simultaneous course of ischemic heart disease and hypertension - they with a vengeance deplete the heart 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 load on the pancreas caused by obstruction of the pulmonary artery.
Dextrocardia.
Mitral heart disease that provokes pulmonary hypertension and stimulates the work of the pancreas.
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.

Due to these pathologies on electrocardiography, the specialist establishes that the EOS is rejected to the right.

What to do if the axis deviates?

If you have found a pathological deviation of the axis, the specialist is obliged to resort to new research. Each ailment that provokes a shift in the EOS is accompanied by several symptoms that require careful analysis. Most often, they resort to ultrasound diagnostics of the heart.

Finally

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 carried out by a qualified specialist, since a deviation does not always mean the presence of heart problems.

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

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

The determination of EOS is possible due to the presence of a conducting system. It consists of tissue sections, the components of which are atypical muscle fibers. Their distinctive feature consists in enhanced innervation, which is necessary to ensure synchronization of the heartbeat.

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

Normally, the mass of the left ventricle of the heart is greater than the right one. This is due to the fact that this organ is responsible for the release of blood into the arteries, which makes the muscle much more powerful. Concerning, nerve impulses in this area is also much stronger, which explains the natural position of the heart.

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

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