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What is the electrical axis of the heart? Deviation of the electrical axis of the heart left and right

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

The position of the electric axis of the heart shows the specialist what exactly happens in the heart muscle every minute. This parameter is the sum of all the bioelectric changes observed in the organ. When removing the ECG, each electrode of the system registers an excitation that passes at a strictly defined point. If you transfer these values to a conditional three-dimensional coordinate system, you can understand how the electric axis of the heart is located, and calculate its angle with respect to the organ itself.

How is the electrocardiogram removed?

ECG recording is performed in a special room, as much as possible shielded from various electrical disturbances. The patient is conveniently located on the couch, putting a pillow under his head. To remove the ECG, electrodes are applied (4 on the limbs and 6 on the chest). The recording of the electrocardiogram is performed with quiet breathing. In this case, the frequency and regularity of cardiac contractions, the position of the electric axis of the heart and some other parameters are recorded. This simple method allows you to determine whether there are abnormalities in the work of the body, and if necessary, refer the patient to a consultation with a cardiologist.

What influences the location of the EOS?

Before discussing the direction of the electrical axis, it is necessary to understand what the conductive system of the heart is. It is this structure that is responsible for the passage of the pulse on the myocardium. The conductive heart system is an atypical muscle fiber that connects various parts of the body. It begins with a sinus node located between the mouths of the hollow veins. Further, the impulse is transmitted to the atrioventricular node localized in the lower part of the right atrium. The next baton takes a bundle of Geese, which quickly diverges into two legs - left and right. In the ventricle, the branches of the bundle of Gis immediately pass into Purkinje fibers, which penetrate the entire heart muscle.

The impulse that has come to the heart does not escape the conductive system of the myocardium. It is a complex structure with fine tunings, sensitive to the slightest changes in the body. At any disturbances in the conducting system, the electric axis of the heart is able to change its position, which will be immediately fixed on the electrocardiogram.

EOS location options

As you know, the heart of a man consists of two atria and two ventricles. Two circles of blood circulation (large and small) ensure the normal functioning of all organs and systems. Normally, the mass of the myocardium of the left ventricle is somewhat larger than that of the right ventricle. It turns out that all the pulses passing through the left ventricle will be somewhat stronger, and the electric axis of the heart will be oriented precisely to it.

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

Normal location of the electrical axis of the heart

There are three main provisions of EOS. Normal range is from +30 to + 70 °. This variant is found in the overwhelming majority of patients who looked to see a cardiologist. The vertical axis of the electric axis of the heart is found in thin, asthenic people. In this case, the angle will range from +70 to + 90 °. The electrical axis of the heart is horizontal in low, densely packed patients. In their card, the doctor will mark the angle of the EOS from 0 to + 30 °. Each of these options is the norm and does not require any correction.

Pathological location of the electrical axis of the heart

The condition in which the electric axis of the heart is rejected is not in itself a diagnosis. However, such changes on the electrocardiogram may indicate various abnormalities in the work of the most important organ. The following diseases lead to serious changes in the functioning of the conducting system:

• cardiac ischemia;

• chronic heart failure;

• cardiomyopathy of different origin;

• congenital malformations.

Knowing about these pathologies, the cardiologist will be able to notice the problem in time and send the patient to inpatient treatment. In some cases, when registering an abnormality of EOS, the patient needs emergency care in an intensive care setting.

Deviation of the electrical axis of the heart to the left

Most often, such changes on the ECG are noted with an increase in the left ventricle. Usually this happens with the progression of heart failure, when the body simply can not fully exercise its function. It is not ruled out that such a state can develop in case of arterial hypertension accompanied by pathology of large vessels and an increase in blood viscosity. With all these conditions, the left ventricle is forced to work on wear and tear. Its walls thicken, leading to the inevitable violation of the passage of the pulse along the myocardium.

Deviation of the electric axis of the heart to the left also happens when the aortic aorta is narrowed. In this case, the stenosis of the valve lumen located at the exit from the left ventricle occurs. This condition is accompanied by a violation of the normal flow of blood. Part of it lingers in the cavity of the left ventricle, causing it to stretch, and, as a result, the densification of its walls. All this causes a regular change in EOS as a result of improper conduct of the pulse on the myocardium.

Deviation of the electric axis of the heart to the right

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

What is the danger of changing the EOS?

Most often deviations of the electrical axis of the heart are associated with hypertrophy of one or another ventricle. This condition is a sign of a long-standing chronic process and, as a rule, does not require an emergency cardiologist. The real danger is the change in the electrical axis in connection with the blockade of the bundle. In this case, impulse is broken on the myocardium, which means there is a risk of sudden cardiac arrest. This situation requires urgent intervention of a cardiologist and treatment in a specialized hospital.

With the development of this pathology, EOS can be rejected both to the left and to the right, depending on the localization of the process. The cause of the blockade may be myocardial infarction, infectious damage to the heart muscle, as well as taking certain medications. The usual electrocardiogram allows you to quickly diagnose, and therefore, to give the doctor the opportunity to prescribe treatment taking into account all important factors. In severe cases, it may be necessary to install a pacemaker (pacemaker), which will send pulses directly to the cardiac muscle and thereby ensure normal functioning of the organ.

What if the EOS is changed?

First of all, it is worth considering that, in itself, the deviation of the axis of the heart is not the basis for setting a diagnosis. The position of EOS can only give impetus to a more thorough examination of the patient. At any changes on the electrocardiogram, a cardiologist can consult. An experienced doctor will be able to recognize the norm and pathology, and also, if necessary, prescribe an additional examination. It can be echocardioscopy for sighting the condition of the atria and ventricles, monitoring blood pressure and other techniques. In some cases, a consultation of related specialists is required to address the issue of further management of the patient.

Summarizing, we should highlight several important points:

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

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

• Deviations of the EOS to the left or right may indicate various violations in the conduction system of the heart and require specialist advice.

• The change in EOS detected on a cardiogram can not be set as a diagnosis, but it is an occasion to visit a cardiologist.

The heart is an amazing organ that ensures the functioning of all systems of the human body. Any changes that occur in it, inevitably affect the work of the whole organism. Regular examinations of the therapist and the passage of ECG will allow to reveal in time the appearance of serious diseases and avoid the development of any complications in this area.

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