Cardiovascular system is a vital organic mechanism providing various functions. For diagnostics, various indicators are used, the deviation of which may indicate the presence of a pathological process. One of these is the deviation of the electric axis capable of indicating different diseases.

Under the electrical axis of the heart (EOS) is understood as an indicator reflecting the nature of the flow of electrical processes in the heart muscle. This definition is widely used in the cardiological sphere, especially when. Electric axis Reflects the electrodynamic abilities of the heart, and is practically an identical anatomical axis.

The EOS definition is possible due to the presence of a conductive system. It contains sections of tissues whose components are atypical muscle fibers. Them distinctive feature It consists in enhanced innervation, which is necessary to ensure the synchronization of the heartbeat.

The type of heartbeat healthy person is called, since it is in a sinus node that a nervous impulse occurs, which causes the myocardium compression. In the future, the pulse is moved according to the atrocadic and ventricular node, with further penetration into the GIS beam. This element of the conductive system has several branches in which a nerve signal passes, depending on the heartbeat cycle.

Normally, the mass of the left ventricle of the heart is superior to the right. This is due to the fact that this body is responsible for the release of blood in the artery, in view of which the muscle is much more powerful. In this regard, the nerve impulses in this area are also much stronger, which explains the natural arrangement of the heart.

The position axis may 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 body structure. Vertical OES is most often found in people who have a high growth and asthenic constitution of the body. The horizontal position is more characteristic of low-spirited people having a wide chest.

The resultant vector of all bioelectric oscillations of the heart muscle is called an electric axis. Most often it coincides with anatomical. This indicator is used when analyzing ECG data to assess the predominance of one of the parts of the heart, which may be indirect sign Myocardial hypertrophy.

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Normal electric heap axis

The direction of the heart axis is calculated in degrees. To do this, use such a concept as an angle alpha. It forms a horizontal line, which is carried out through the electric center of the heart. To determine it, the axis of the first leading ECG shifts to the center of Enthoven. This is a triangle, the tops serve as brushes in the direction of hands and left stop.

A healthy person has an electric axis ranges from 30 to 70 degrees. This is due to the fact that the left ventricle is stronger than the right, therefore, pulses from it comes more. This position of the heart happens with a normosenic physique, and the ECG is called a normogram.

Deviations

Not always a change in the direction of the heart axis on an electrocardiogram is a sign of pathology. Therefore, to form a diagnosis of its deviations have auxiliary value and are used to preliminary formulation of concluding.

Right

Program (alpha 90 - 180) on the ECG occurs with increasing the mass of the myocardial of the right ventricle. The following diseases lead to this state:

• chronic obstructive pulmonary diseases;
• bronchitis;
• bronchial asthma;
• narrowing trunk pulmonary artery, mitral hole;
• insufficiency of blood circulation with stagnation in the lungs;
• termination of the passage of pulses (blockade) of the left leg of GISS;
• thrombosis of pulmonary vessels;
• cirrhosis of the liver.

Left

Left-sided shift of an electric axis (alpha from 0 to minus 90) occurs quite often. It leads to it. This may be associated with such states:

How to determine by ecg

In order to identify the position of the axis, you need to explore two AVL and AVF leads. They need to measure the tooth R. In the norm of its amplitude equal. If it is high in AVL, and there is no avf in AVF, then the position is horizontal, everything will be the opposite.

The deviation of the axis to the left will be, if R in the first standard assignment is greater than S in the third. Program - S1 exceeds R3, and if R2, R1, R3 is located in decreasing, then this is a sign of a normogram. For more detailed research use special tables.

Additional research

If the ECG revealed an axis displacement to the right or left, such additional examination methods use to clarify the diagnosis:

If there is only the pathological angle of alpha, and other manifestations on the ECG were not identified, the patient does not have difficulty breathing, pulse and pressure normally, then no further action requires such a state. This is due to an anatomical feature.

A more unfavorable feature is the legal grid for the diseases of the lungs, as well as the leveogram combined with hypertension. In these cases, on the displacement of the heart axis, one can judge the degree of progression of the main pathology. If the diagnosis is unknown, and there is a significant deviation of the axis with cardiological symptoms, then the patient must be fully examined to identify the cause of such a phenomenon.

The displacement of the electrical axis can be left and right, depending on whether the activity of which of the ventricles of the heart prevails. Such changes on the ECG are an indirect sign of myocardial hypertrophy and are considered in the complex with other indicators. In the presence of complaints of the heart, an additional survey is required. In young children, the Program is a physiological state that does not require intervention.

Read also

The detected blockade of the leg beam legs indicates many deviations in myocardial. It is right and left, complete and incomplete, branches, front branches, two- and three-coup. What is dangerous blockade in adults and children? What are the ECG signs and treatment? What are the symptoms of women? Why was detected during pregnancy? Is it dangerous if the blockade of His beams is dangerous?

Abbreviation "ECG" is well known to the inhabitant and is often used by patients when describing problems who have killed on them. Many even know that ECG is a reduction from "Electrocardiography" and that the term itself means the registration of electrical activity of the heart. However, on this, as a rule, knowledge from the ECG region from the average person ends and misunderstanding begins, which still mean the results of this study, as they say detected deviations, what to do to return to the norm. About this - in our article.

What is ECG?

Since the appearance of the method and to our time, ECG is the most affordable, simple performance and informative cardiological study, which can be held in hospital, clinic, ambulance, on the street and at home in the patient. If it is simple, then the ECG is a dynamic recording of an electric charge, thanks to which it works (that is, it is reduced) our heart. To estimate the characteristics of this charge, the record is conducted from several sections of the heart muscle. For this purpose, electrodes are used - metal plates - which are superimposed on different sections of the breast, wrist and the ankles of the patient. Information from the electrodes enters the ECG apparatus and is converted to twelve graphs (we see them on paper tape or on the monitor of the device), each of which reflects the operation of a certain heart department. Designations of these graphs (they are also called leads) - I, II, III, AVR, AVL, AVF, V1-V6 - can be seen on the electrocardiogram. The study itself takes 5-7 minutes, as much will need a doctor to decrypt the result of the ECG (if the decoding is not conducted by the computer). ECG is a completely painless and safe study, it is carried out by adults, children and even pregnant women.

In what cases does the doctor appoint an ECG?

The direction at the ECG may give a doctor of any specialty, but most often a cardiologist directs this research. The most frequent indications of the ECG are discomfort or pain in the heart, chest, back, stomach and neck (which is dictated by a variety of manifestations ischemic Disease hearts); dyspnea; interruptions in the work of the heart; Increased arterial pressure; fainting; swelling on the legs; weakness; noise in the heart; Availability sugar diabetes, rheumatism; Transferred stroke. ECG is also carried out in the framework of preventive inspections, when preparing for an operation, during pregnancy, before issuing permission to occupy active sports, when issuing documents for sanatorium-resort treatment, etc. All people over 40 years old are encouraged to pass ECG annually, even in the absence of any complaints to eliminate the asymptomatic spending of ischemic heart disease, violations heart Rhythm, transferred "on the legs" of myocardial infarction.

ECG makes it possible to diagnose a variety of heart rate disorders and intracardiac conductivity, detect the change in the size of the heart cavities, thickening myocardium, signs of violation electrolyte exchange, identify localization, size, depth of ischemia or myocardial infarction, the prescription of the suffered infarction, diagnose toxic damage to the heart muscle.

ECG-CONCLUSION: Terminology

All changes detected on the electrocardiogram are estimated by a functional diagnostician and briefly recorded in the form of concluding on a separate form or immediately, on the film. Most ECG finds are described by special terms, understandable doctors, in which after reading this article will be able to understand the patient himself.

Heart rate - This is not a disease and not a diagnosis, but just an abbreviation from the "heart rate", which denotes the number of abbreviations of the heart muscle per minute. Normally, an adult man has 60-90 beats per minute. With an increase in the heart rate above 91 UD / min talk about tachycardia; If the heart rate is 59 dd / min and less is a sign bradycardia. Both tachycardia and bradycardia can be as a manifestation of the norm (for example, tachycardia against the background of nervous experiences or bradycardia in trained athletes) and a clear sign of pathology.

EOS. - reduction from the "Electrical Heart Axis" - this indicator allows you to roughly determine the location of the heart in chest, make an idea of \u200b\u200bthe form and function of various departments of the heart. In the conclusion of the ECG, the EOS position is indicated, which can be normal, vertical or horizontal, rejected to the right or left. The position of the EOS depends on the influence of many factors: the physications, age, gender, changes in the heart muscle, intracardiac conductivity disorders, the presence of pulmonary diseases, heart defects, atherosclerosis, etc. So, with hypertension, the deviation of the EOS left or the horizontal location of the EOS is often found. In chronic diseases of the lungs (chronic obstructive bronchitis, bronchial asthma) is often detected by the deviation of the EOS to the right. Sleepy people are usually the vertical position of the EOS, and in dense people and persons with obesity - a horizontal position. Of great importance is the sudden change in the EOS position: for example, it was a normal position, and suddenly - sharply rejected to the right or left. Such changes are always alarming a doctor and make a more in-depth patient examination.

Sinus rhythus regular - This phrase means an absolutely normal heart rate, which is generated in a sinus node (the main source of heart electric potentials).

Rhythm Nesinusova - This means that the heart rate is generated not in the sinus unit, but in one of the secondary sources of potentials, which is a sign of cardiac pathology.

Rhythm sinus unregular - Sinovaya arrhythmia synonym.

Sinus arrhythmia - incorrect sinus rhythm with periods of gradual increase and decrease in heart rate. Sine arrhythmia is two species - respiratory and lacking. Respiratory arrhythmia is associated with the act of breathing, is the norm and does not require treatment. Protecting arrhythmias (to identify the patient during the registration of the ECG, they ask to delay their breathing) is a symptom of the disease, whose character will indicate other changes to the ECG and the results of further cardiology surveys.

Cleaning arrhythmia or flickering atrial - The most common impaired heart rhythm in people over 60 years often proceeds asymptomatic, but over time (in the absence of treatment) leads to the development of heart failure and brain stroke. The source of electrical pulses at shimmer arrhythmia is not a sinus assembly, but atrial muscle cells, which leads to an infallible chaotic atrial abbreviations with subsequent irregular cuts of the ventricles of the heart. An abnormal reduction in atria contributes to the formation of blood clots in their cavity, which creates a serious risk of developing a brain stroke. The identification of ECG signs of flickering arrhythmia requires the appointment of long-term antiarrhythmic and lifelong antithrombotic therapy, even in the absence of complaints.

Paroxysmal flickering arrhythmia or paroxysm flickering arrhythmia - Suddenly emerged attack of flicker arrhythmia. Requires mandatory treatment. If treatment is started on early stages The development of paroxysmal flicker arrhythmia is a fairly high chances of restoring normal heart rhythm.

Atrial tremble - This type of arrhythmia is very similar to tanning arrhythmia. The main difference is the smaller efficiency of antiarrhythmic therapy, a smaller probability of return to normal sinus rhythm. As in the case of clear arrhythmia It is necessary for a long, often lifelong treatment.

Extrasystole or extrasyistol - Extraordinary reduction in the heart muscle, which causes an anomalous electrical pulse outgoing from a sinus node. Depending on the origin of the electrical pulse, the atrial, atrioventricular and ventricular extrasystole is distinguished. Sometimes political extrasystoles occur - that is, impulses, their causing, proceed from various hearthly hotels. Depending on the number of extrasystoles, single and group, single (up to 6 per minute) and frequent (more than 6 per minute) extrasystoles are distinguished. Sometimes the extrasystolia is ordered and arises, for example, every 2, 3 or 4 normal heart complexes - then in the conclusion, bigemia, trigemines or quadrigations are written.

Extrasystolia can be called the most frequent ECG-find, besides, not all extrasystoles are a sign of the disease. So called functional extrasystoles often occur in practically healthy peoplenot having changes from the heart, athletes, pregnant women, after stress, physical overvoltage. Often, extrasystoles find people with vegetual-vascular dystonia. In such situations, extrasystoles are usually single, atrial, they are not dangerous to health, although accompanied by a mass of complaints.

Potentially dangerous is the emergence of political, group, frequent and ventricular extrasystoles, as well as extrasystolia, developed against the background of the already known cardiology disease. In this case, treatment is necessary.

WPW syndrome or Wolf Parkinson-White Syndrome - An innate disease for which the ECG signs are characterized indicating the presence of additional (abnormal) paths of the electrical impulse by myocardium, and hazardous attacks (paroxysms) of cardiac arrhythmia. If the ECG results are suspicious for the presence of WPW syndrome - the patient needs reassigning and treatment, sometimes in conducting a surgical operation that violates the conductivity of the abnormal paths. If ECG changes are not accompanied by the development of arrhythmia attacks, such a state is expelled and called WPW-phenomenon.

Sinoatrial blockade - Violation of the pulse from the sinus node to the myocardium atrialism - frequent phenomenon in myocardits, cardiosclerosis, myocardial infarction, cardiopathy, overdose medicinal preparations (Heart glycosides, beta-adrenoblays, potassium preparations), after the operation on the heart. Requires surveys and treatment.

Atrioventricular blockade, A-V (A-B) blockade - Violation of the pulse from the atria to the ventricles of the heart. The result of this violation is an incomplete reduction in various departments of the heart (atrial and ventricles). Degree a-in The blockade indicates the severity of conduction disorders. Reasons a-in The blockages often become myocarditis, cardiosclerosis, myocardial infarction, rheumatism, heart patterns, overdose of beta-blockers, calcium antagonists, drugs, antiarrhythmic drugs. A-in blockade I degree is often found among athletes. An atrioventricular blockade, with rare exception, requires treatment, in severe cases - installation of a cardiac championship.

Blockade of legs (left, right, left and right) Gis beam (BPG, BNN), full, incomplete - This is a violation of a pulse on a conductive system in the thickness of the myocardial ventricles. The identification of this feature indicates the presence of serious changes in the myocardium of the ventricles of the heart, which often accompany myocardits, myocardial infarction, cardiosclerosis, heart defects, myocardial hypertrophy and arterial hypertension. Also occurs when overdosing drugs of vice-tanks. To eliminate the blockade of the Gis beam legs, the main cardiac disease is required.

Left ventricular hypertrophy (GLB) - This is the thickening of the wall and / or an increase in the size of the left ventricle of the heart. SAME frequent reasons Hypertrophy are arterial hypertension, heart defects and hypertrophic cardiomyopathy.

Hypertrophy of the right ventricle - the thickening of the wall or an increase in the size of the right ventricle. Surfy causes - heart patterns, chronic diseases Lungs (chronic monitant bronchitis, bronchial asthma), pulmonary heart.

In some cases, next to the conclusion of the presence of hypertrophy, the doctor indicates - "with overload" or "with signs of overload". This conclusion indicates an increase in the size of the heart chambers (their dilatation).

Myocardial infarction, Q-infarction myocardium, not Q-infarction myocardium, transmural infarction Myocardial, Non-Transmural Myocardial Infarction, Miocardial Self-Quality Infarction, Melo-Favoric Myocardial Infarction, Intramural Myocardial Infarction are all variants of the ECG-description of myocardial infarction (heart muscle necrosis arising from the violation of its blood supply). Further indicates the localization of myocardial infarction (for example, in the front wall of the left ventricle or the rear-side myocardial infarction). Such ECG changes require emergency medical care and immediate hospitalization of the patient in a cardiological hospital.

Scar changes, scars - These are signs of myocardial infarction suffered once. In such a situation, the doctor appoints treatment aimed at the prevention of re-infarction and eliminate the cause of blood circulation in the heart muscle (atherosclerosis).

Cardiordytic changes, ischemic changes, acute ischemia, ischemia, changes in teeth T and ST segment, low teeth are a description of reversible changes (myocardium ischemia) associated with a disturbance of coronary blood flow. Such changes are always a sign of ischemic heart disease (IBS). The doctor will definitely react to these ECG signs and appoints the corresponding anti-chemical treatment.

Dystrophic changes, cardiophytic changes, metabolic changes, changes in myocardial metabolism, electrolyte changes, violation of repolarization processes - so indicate a violation of metabolism in myocardium, not associated with a sharp impaired blood supply. Such changes are characteristic of cardiomyopathy, anemia, endocrine diseases, liver diseases, kidneys, hormonal disorders, intoxication, inflammatory processes, Heart injuries.

Qt extended interval syndrome - Congenital or acquired impairment of intracardiac conductivity, for which the tendency to severe heart rate disorders, fainting, stopping the heart. It is necessary to identify and treat this pathology. Sometimes a cardiac implantation is required.

ECG features in children

Normal ECG indicators in children are somewhat different from normal indicators Adults and dynamically change as the child grows.

Normal ECG in children aged 1 - 12 months. Typically, the oscillation of heart rate depending on the behavior of the child (the increase in crying, anxiety). Average heart rate - 138 beats per minute. The location of the EOS is vertical. The appearance of an incomplete blockade of the right leg of the Gis beam is allowed.

ECG in children aged 1 year - 6 years. Normal, vertical, less often - horizontal position of EOS, heart rate 95 - 128 per minute. Sine respiratory arrhythmia appears.

ECG in children aged 7 - 15 years. Characterized by respiratory arrhythmia, CSS 65-90 per minute. The position of the EOS is normal or vertical.

Finally

Of course, our article will help many people far from medicine to understand what is written as a result of the ECG. But it is not necessary to dedicated - reading and even seemingly by chanting all the information stated here, you will not be able to do without the help of a competent cardiologist. The ECG data interpretation is carried out by a doctor in a complex with all available information, taking into account the history of the disease, complaints of the patient, inspection results and other research methods - this art is impossible to learn how to read only one article. Take care of health!

Let's figure out what implies a given conclusion, and whether it is necessary to beat the alarm if the cardiac electric axis is displaced on your cardiogram.

1 Cardiac Axis and ECG

The human heart has a ability to reduce. Electrical pulses sequentially cover heartcams, taking their origin in the atrial sinus node. If you submit the progress of these pulses in the form of directional vectors, then it can be noted that they have a similar direction. Summing up the vectors, you can get one main vector. This will be the electrical axis of the heart (EOS).

The doctors of functional diagnostics determine the Cardiogram eOS often visually, but more accurately do it with special tables. If you carefully look at the QRS complex in leads I, II, III to the ECG, you can see that R II\u003e RI\u003e RIII, it means that the EOS on the cardiogram is normal.

If the doctor is difficult to visually determine the axis of the heart, it defines the angle of alpha, and calculates the EOS according to special tables. Without deepening in the course of measurements, we note that for normal EOS, the angle of alpha (RII\u003e RIII, the conclusion of the doctor will be as follows: the deviation of the electrical axis of the heart left. Deviation of the EOS is confirmed when the angle of alfa is ranging from 00 to -900.

2 When the axis of the heart "goes to the left"?

The conclusions of the doctor of functional diagnosis on the deviation of the cardiac axle are not a self-diagnosed diagnosis. But always give reason to think about why the axis of the heart "went to the left." A slight displacement of the EOS to -190, as well as a half-proportional position, in some cases is not considered pathology. Such a position of the axis can be observed in healthy, high, thin people, in athletes with a trained heart, in children of asthenic physique, with a high standing of the dome of the diaphragm.

If the heart axis is significantly rejected on the left side, then this pathological state indicates problems with the heart, the reason for such a displacement requires necessarily to establish. After all, this symptom can sometimes be the first "bell" in the pathology of the heart and blood vessels. According to some data, the deviation of the electrical axis of the heart to the left to -29-300 is sometimes referred to as a small deviation, and if the angle is from -450 to -900 speak of a sharp deviation.

3 Pathological reasons for displacement EOS left

As mentioned above, a minor deviation of the EOS should be considered by doctors as an option of the norm, if with a more thorough examination, the doctor did not reveal any disease and the patient's well-being good. If the EOS is rejected to the left significantly, or with small ECG changes, the patient has health problems, the following pathological conditions should be suspected, in which the offset of the left cardiac axis is most common:

4 Hypertrophy of the left ventricle

The deviation of the cardiac axis to the left with an increase in the left ventricle is quite explained, because the physiologically this heart chamber and the most powerful by weight. And this means that the heart of the heart will "take the left ventricle" on itself. And the more it will increase in size and grow, the more will "leave the left" EOS. This pathology occurs when high pressure or arterial hypertensionwhen heart cameras without standing increased pressure and loads, begin to compensately typing the mass - hypertrophy. Hypertrophy as one of the symptoms occurs in heart failure, atherosclerotic vascular changes, angina, cardiac asthma, cardiomyopathy.

5 conduction disorders

Violations in the conductive system will lead to a change in the heart vector and the deviation of the cardiac axis. It is most often observed with the blockade of the left leg of the Gis beam, or with the blockade of its front-top branching. There are other ECG signs, thanks to which this type of arrhythmia can be diagnosed. Help in diagnosis will also have Holter monitoring ECG.

6 Special forms of ventricular tachycardia

Some forms of ventricular tachycardia can also be the reason that the EOS values \u200b\u200bare far from the norm.

7 Heart Forms

The vices of the heart, the ECG symptom of which can be the left left axis of the heart, in nature can be both congenital and acquired. Vices of any etiology, accompanied by overloading left heart departments, will be characterized by this ECG symptom.

Based on the consequences of the reasons for the deviation of the EOS, it can be concluded that the displacement of the left cardiac axis is not such a harmless ECG sign. It may testify to the presence of serious problems in the patient's body. But at the same time, you should not panic! With a well-being of a patient, a stable ECG for several years, in the absence of confirming data on the pathological change of the heart and blood vessels after a thorough examination, a slight deviation of the heart axle to the left may be an option for the norm! But the conclusion that this is the norm can be made by a doctor after a careful examination of the patient, and in the absence of data on the pathology of the cardiovascular system. What examination should a doctor appoint a doctor who diagnosed in a patient to the left of the heart left axis?

8 Surveillance Complex for Diagnosis

It should be understood that the deviation of the left EOS is not a diagnosis, but an ECG sign, which can be both an option for the norm and the symptom of numerous diseases. The conclusion about which information is borne by this symptom can only do a doctor after a complex of diagnostic procedures.

9 Do I need to treat a rejected left axis?

As the only separable ECG sign - no. If this symptom is one of others in the presence of a disease in the human body - the disease is definitely need to be treated. Tactics of treatment depends directly from the disease that caused changes in the direction of the cardiac axis. With hypertension, led to an increase in left ventricle, adequate selection of hypotensive drugs is necessary. With arrhythmias - antiarrhythmic medicinal productsOr, if there is an indication - implantation of the artificial driver of the rhythm. With diagnosed heart defects - operational treatment According to the testimony.

Let's look through simple, available words What is the electric axis of the heart? If you imagine the propagation of electrical pulses from the sinus node to the underlying departments of the conductive heart system in the form of vectors, it becomes obvious that the data of the vector apply to different parts of the heart at the beginning of the atrium to the top, then the excitation vector is sent along the side walls of the ventricles somewhat-up. If the direction of the vectors are folded or summed, then one main vector is obtained, which has a completely specific direction. This vector is EOS.

1 Theoretical Basics of Definition

How to learn to determine the EOS on the electrocardiogram? Initially a bit of theory. Let me imagine the triangle Enthoven with the axes of alliances, as well as add it a circle that passes through all the axes, and point out the degrees or coordinate system: along the line I of leads -0 and +180, above the first lead line will be negative degrees, in increments In -30, and the downward degrees are projected down, with +30 increments.

Consider another concept required to determine the position of the EOS - the angle of alpha (

2 Practical Basics of Definition

Before you the captured cardiogram. So, proceed to the practical definition of the position of the heart axis. Carefully look at the QRS complex in lead:

1. With the normal axis, the prong R in the second allocation is greater than R in the first definition, and R in the first assignment larger Ri in the third: R II\u003e RI\u003e RIII;
2. The deviation of the EOS left on the cardiogram looks like this: the largest cluster R in the first definition, slightly smaller - in the second, and the smallest - in the third: R i\u003e rii\u003e riii;
3. The rotation of the EOS to the right or the offset of the heart axis to the right on the cardiogram is manifested as the largest R in the third assignment, somewhat less - in the second, the smallest - in the first: R III\u003e RII\u003e Ri.

But it is not always visually simply to determine the height of the teeth, sometimes they can be approximately one size. What to do? After all, the eye meter can suspend ... For maximum accuracy, the angle of alpha is performed. Do it like:

1. We find QRS complexes in I and III leads;
2. We summarize the height of the teeth in the first assignment;
3. We summarize the height in the third assignment;

   Important moment! It should be remembered under the sum that if the tooth is directed down from the insulance, its height in MM will be with the sign "-", if up - with the sign "+"

4. Found two amounts we substitute in a special table, we find the location of the data intersection, which corresponds to a certain radius with degrees of the angle of alpha. Knowing the rules of the angle of alpha is easy to determine the position of the EOS.

3 For what is a pencil diagnostic or when you do not need to look for an alpha corner?

There is another simplest and most beloved students to determine the position of the EOS with a pencil. It is effective not in all cases, but sometimes simplifies the definition of the cardiac axis, it allows you to determine the normal one or there is a displacement. So, not writing a part of the pencil apply to the corner cardiograms near the first lead, then in leads I, II, III find the highest R.

The opposite pointed part of the pencil is directed to the prog r to the lead, where it is maximum. If not writing part of the pencil is in the upper right corner, and the pointed tip of the writing part in the left left, then such a position indicates the normal position of the heart axis. If the pencil is located almost horizontally, you can assume the axis offset to the left or its horizontal position, and if the pencil takes a closer position to the vertical, then the EOS is rejected to the right.

4 To determine this parameter?

Questions related to the electrical axis of the heart are considered in detail in almost all ECG books, the direction of the electrical axis of the heart is an important parameter that needs to be determined. But in practice, it helps little in the diagnosis of most heart diseases, which are more than a hundred. Decoding axis directions is really useful for diagnostics of 4 main states:

1. Blockade of the front-top branch of the left feet of the beam of Gis;
2. Hypertrophy of the right ventricle. Characteristic sign Its increase is the deviation of the axis to the right. But if the left ventricle is suspected of hypertrophy, the offset of the heart axis is not at all necessary and the definition of this parameter helps a little in its diagnosis;
3. Stomatricular tachycardia. Some of its forms are characterized by the deviation of the EOS to the left or an uncertain position, in some cases there is a turn to the right;
4. Blockade of the rear-top branch of the left leg of a beam of Gis.

5 What can be EOS in normal?

Healthy people have the following EOS descriptions: normal, half-propical, vertical, semi-risal, horizontal. Normally, as a rule, the electrical axis of the heart in people over 40 is located at an angle of -30 to +90, in persons under 40 years old - from 0 to +105. In healthy children, the axis may deviate up to +110. Most healthy people have an indicator range from +30 to +75. Sleepy, asthenic groups of the diaphragm is located low, the EOS is rejected more often, the heart occupies a more vertical position. In obese people, hyperstics, on the contrary, the heart lies more horizontally, the deviation is observed left. For normostas, the heart occupies an intermediate position.

6 Norm in children

Newborn and infants have a pronounced deviation of the EOS to the right on the electrocardiogram, by the year most of the children EOS goes into a vertical position. This is explained by physiologically: the right heart departments are somewhat dominated over the left in both the mass and electrical activity, as well as changes in the position of the heart - turns around the axes. For two years, many children still have a vertical axis, but 30% it becomes normal.

The transition to a normal position is associated with the growth of the mass of the left ventricle and the heart turn, in which the left ventricular adherence to the chest occurs. Children of preschoolers and schoolchildren prevail the normal EOS, it can more often encounter vertical, less often a horizontal electric axis of the heart. Summarizing the foregoing, the norm in children consider:

• in the period of newborn, the deviation of the EOS from +90 to +170
• 1-3 years - Vertical EOS
• school, teenage age - half of the children have a normal position of the axis.

7 Causes of EOS deviations left

The deviation of the EOS at an angle from -15 to -30 is sometimes called a small deviation to the left, and if the angle is from -45 to -90 - they say a significant deviation to the left. What are the main reasons for this state? Consider them in more detail.

1. Normal version;
2. BPV left leg feet of Gis;
3. Blockade of the left leg feet of the Gis;
4. Positional changes associated with the horizontal arrangement of the heart;
5. Some forms of ventricular tachycardia;
6. Development of endocardial pillows.

8 Causes of EOS deviations to the right

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

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

The most frequent causes of the deviation of the EOS can be:

1. Normal version;
2. Blockade of rear-top branching;
3. Embolism of the Emighty Artery;
4. Dextrocardia (right-sided arrangement of the heart);
5. Option standards for positional changes associated with the vertical arrangement of the heart due to emphysema, COPD, other pulmonary pathologies.

It should be noted that the doctor can alert a sharp change in the electric axis. For example, if a patient on previous cardiograms is a normal or semi-propical position of the EOS, and when removing the ECG at the moment - expressed horizontal direction EOS. Such sharp changes may indicate any violations in the work of the heart and require a speedy additional diagnosis and retreat.