ECG For pathologies, myocarditis, pericarditis, cardiomyopathy

Rarely did anyone think that ECG preparation generally exists. This is not strange, because few doctors have reported the necessary preliminary procedures. Usually the patient comes, kicks on the couch, they connect the device to him and carry out diagnostics. And often the results of such a cardiogram are unpredictable.

An ECG is needed to get information about the work of the heart. For a long time, with this method of research, doctors have prevented possible complications in the functioning of this organ. Conducting electrocardiography is quite simple, but compliance with elementary rules contributes to the accurate result of the examination.

The attending physician should describe in detail to the patient all the necessary actions before taking the ECG. Men with abundant vegetation on the body are better off shaving it – this will allow for a closer contact between the electrodes and the body. The day before the scheduled procedure, you need to take a warm shower. The same thing must be done the morning before.

Clean skin is better suited for attaching electrodes. If the contact is close enough, the likelihood of interference will decrease dramatically. Be sure to conduct a water treatment after the session. This is due to the application of a special gel on the attachment points for better current conductivity. People who are scrupulous about cleanliness, it is better to bring a towel and a bed sheet.

Just remember how many patients are on the couch per day.

The main requirement for a person’s condition is calm. If before a cardiological examination a person was subjected to increased physical exertion, excitement or stress, it is necessary to come to rest. Better relax while sitting in a comfortable position. It is useful to carry out breathing exercises. You can allocate time for this while waiting in line.

Clothing for visiting a cardiologist, it is advisable to choose a loose, easily removable. This will speed up the process of the event.

When the examination period is in the cold, the ECG room should be warm and comfortable. If a person freezes, this can adversely affect the electrocardiogram.

Women should not use a cream so as not to leave a greasy mark on the skin. This prevents the device from being tightly attached to the body.

A person should give up all tonic drinks. The list includes tea, coffee, energy cocktails and even more so containing alcohol. This should be done no later than 4-6 hours before the procedure. This does not apply to alcohol.

You can not drink it at least a few days before the procedure.

Energy drinks, which contain a large dose of caffeine, not only distort the readings of cardiography, but also adversely affect the work of many organs.

It is not recommended to eat heavy and fatty foods within an hour before the procedure. Spicy and salty is also not desirable. Eating too much can cause shortness of breath and distort monitoring results. If you are not recommended to refuse breakfast for any reason, or simply do not want to, you can have a light meal in a small amount.

Vasoconstrictor drugs are also contraindicated before the start of the session. Eye drops and nasal sprays are not used before the cardiogram procedure.

It is strictly forbidden to smoke before the event. Tobacco constricts blood vessels and makes inaccurate source materials of the analysis.

As well as stimulants, strong sedatives are contraindicated. If the patient takes such drugs, the doctor may erroneously diagnose bradycardia (or tachycardia in the case of stimulants).

Holter monitoring is a modern method of electrocardiogram, which allows it to be carried out for 24 hours a day. The method is more effective than a one-time short-term procedure, the result of which can be affected by many factors.

Preparing a patient for an Holter ECG involves a series of simple steps. A person should understand that research involves observing the work of the heart in an ordinary way of life.

It is necessary to conduct daily affairs, go to work and not try to influence monitoring.

The device holter is a small block with electrodes that are attached to the chest.

When using the device, it is recommended to wear loose clothing, preferably made from natural materials.

Clothing should not have metal parts. Metal jewelry will also have to be removed. Before using the apparatus, it is necessary to carry out water procedures, since this cannot be done during the study.

During monitoring, you should refuse:

  • caffeine (coffee, strong tea, energy);
  • alcohol;
  • excessive physical exertion;
  • swimming and swimming;
  • taking drugs that affect cardiac function.

Applying ointments, creams and various cosmetics is undesirable. As with a normal ECG, precautions must be taken. These include taking pacemaker drugs, nervous system stimulants, and vasoconstrictors.

Children often resist various manipulations with them. A session of taking a heart suggests a calm state, and it can sometimes be too difficult to calm a child.

If the study is performed on a newborn, it is best to do this during his sleep or after feeding. No need to expose the baby to various actions, so as not to provoke fits of hysteria.

A stressful state can alter the diagnostic results. With older children, parents can play a “doctor’s appointment”. Thus, the child will be informed about the course of the event.

He will be calmer and take the procedure as part of the game.

On the eve of the examination, the baby needs to be redeemed without the subsequent use of milk or body cream. The crumb wardrobe should consist of things that are easy to take off quickly. The blouse should not have metal accessories and a large number of fasteners.

If the child strongly resists the doctor’s intentions, has a tantrum and refuses to lie down on the couch at all, it is necessary to reassure the baby and, if possible, postpone the procedure.

An electrocardiogram is a method that promotes the most complete study of the human heart. It helps to make a final diagnosis. Proper preparatory measures greatly simplify the diagnostic procedure and help to obtain accurate data.

The main method for assessing the performance of the heart muscle is the removal of an ECG. Thanks to this technique, doctors will learn not only about the presence of pathologies in the cardiovascular system, but also about the causes that caused them. Few patients know how this procedure is performed, and what preparatory measures are needed before the study.

Patients who have not undergone an ECG are wondering how to prepare for the procedure, and what to bring with you. The basic rules before the event are not to use heavy foods for digestion several hours before the examination, to limit psycho-emotional stress. What to take with you on an ECG? It is recommended that you grab a clean diaper to cover the couch for inspection.

How to prepare for an ECG? Before the procedure, remember the following nuances:

  • At the time of diagnosis, the patient should be in a calm state. It is advisable that your breathing be even. If the doctor permits, then you can sit in the medical office for 10-15 minutes. The specialist helps the patient restore breathing, explaining the safety of the measures taken. It is advisable that before the diagnosis, the alarmed person has time to adapt to the room and the medical staff.

Consultation with a doctor before an ECG

  • Before registering an electrocardiogram, you should refuse to drink alcohol and smoke. Do not drink coffee or drinks containing caffeine. It is not recommended to eat a few hours before a visit to the doctor. Smoking, caffeine and heavy foods help accelerate the heart rate, which may introduce inaccuracies in the results of the ECG. Optimally, if the examination is performed on an empty stomach.
  • If a person takes a shower before the procedure, then he should refuse to use oily body lotions and oil-based shower gels. Such compositions create an obstacle in contact with the skin and sensors of the device.
  • It is important to wear comfortable clothes so that later there is no problem removing them before research. It is worth considering that during the procedure you will have to expose the areas of the upper and lower extremities or remove clothing to the waist.
  • It is not recommended to wear jewelry made of metal. If you take them with you, then be prepared for the fact that the jewelry will have to be removed.

Preparation of the patient for an ECG of the heart includes informing about the indications and possible prohibitions to the procedure. A cardiologist prescribes diagnostic measures for the prevention of heart pathologies or for the detection of existing diseases. The procedure is also prescribed for complaints of a person:

  • burning sensation in the sternum;
  • pain in the abdominal cavity, extending to the back;
  • for increased blood pressure;
  • for constant shortness of breath in the absence of significant physical exertion.

An ECG should be regularly performed by people suffering from the following pathologies:

  1. Hypertension. In patients with the disease, hypertrophy of the left ventricle may eventually develop.
  2. Cardiac ischemia as a result of coronary atherosclerosis. The lack of therapeutic measures for this disease becomes the cause of constant oxygen starvation of the body.
  3. Arrhythmia.
  4. Hypertrophic cardiomyopathy.

The procedure can be performed once a year. Mandatory electrocardiography is prescribed to people who, by the nature of their profession, experience strong physical exertion – astronauts, sailors.

With the same frequency, ECG is recommended for patients who have crossed the 40-year mark. A diagnostic event is mandatory for patients before surgery or childbirth.

Important! An ECG must be passed to pregnant women – at least 1 time during the entire period of gestation. In pregnant women, a sharp change in the hormonal background occurs, which affects the volume of blood circulating in the body.

ECG during pregnancy

There are no absolute contraindications to ECG. The device evaluates the performance of the heart, without exerting a negative effect on the body. Therefore, this type of diagnosis is prescribed for children, infants and pregnant women.

ECG instructional v >I. Acute situations:
– Coronary artery spasm
– Acute myocarditis
– Taco Tsubo Syndrome
– TELA
– Toxic agents

II. Chronic situations:
– artifact
– The normal option is in aVL with the vertical position of the EOS, in III – with the horizontal position of the EOS and dextrorotation.
– QS in VI – septal fibrosis, pulmonary emphysema, in the elderly, chest deformities.
– GPG, GLZH, GKMP – BLNPG
– Infiltrative processes (amyloidosis, sarcoidosis, tumor, myocarditis)
– Overexcitation Syndrome (Wolf-Parkinson-White)
– Dextrocardia
– Pheochromocytoma

In our opinion, an important difference between ECG changes in myocarditis, in contrast to acute coronary syndrome, is the absence of dynamics typical of the latter.

This is especially clearly seen with a daily and subsequent 2-3 week comparison: with myocardial infarction, there is a dynamics of pathological signs (ST segment, T or Q waves), with myocarditis such an obvious dynamics is not observed.

Interpretation of an ECG patient 19 years old.

In leads II, III, aVF V4-V6 there is an elevation of the ST segment, in lead III a tooth Q is determined,

decrease in voltage of QRS complexes in standard leads and leads from limbs.

Thus, ECG manifestations with myocarditis can be as follows:
– normal ECG,
– sinus tachycardia,
– conduction disturbances (AV block, blockade of the bundle branch block)
– arrhythmias (from extrasystole to ventricular tachycardia),
– heart attack changes (more often changes in the ST segment and T wave), a decrease in the voltage of the main teeth.

How to make an ECG: a technique

Electrocardiography (ECG) is used to diagnose diseases of the cardiovascular system. The type of study depends on how the ECG is done. The overlay pattern and labeling of the electrodes will vary with different techniques.

Electrocardiography is a non-invasive technology for graphically recording the potential difference of the electric field generated by the heart. It is carried out using an electrocardiograph.

The device has electrodes that are attached to specific points on the patient’s body. They pick up the electrical impulses of the heart, which, after amplification, are recorded with a galvanometer and recorded on paper using curved lines. The result is a cardiogram, which is to be further transcribed by a cardiologist or therapist.

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Goal and tasks

The removal of an electrocardiogram is necessary for the diagnosis of cardiac abnormalities, and is also a mandatory element of the annual medical examination of the population. Cardiologists recommend an ECG every year after 40 years.

Looking at the cardiogram, the doctor will evaluate:

  1. Frequency (pulse), rhythm and regularity of heart contractions.
  2. The physical condition of the heart.
  3. The presence of electrolyte metabolism disorders (potassium, calcium, magnesium and others).
  4. The conduction system of the heart (various blockades and arrhythmias).
  5. The effectiveness of treatment in acute and chronic diseases.
  6. Localization, size and degree of damage in ischemia and myocardial infarction.
  7. The presence of heart complications in diseases of other organs and systems (pulmonary embolism).

A cardiogram is done at the slightest complaint:

  • heart failure;
  • shortness of breath;
  • heaviness and pain behind the sternum;
  • weakness, dizziness;
  • high blood pressure;
  • back, chest, and neck pains.
  • before operations;
  • at professional examinations;
  • during pregnancy;
  • if there is a risk of developing heart disease;
  • to get a medical book when applying for a job.

For a full diagnosis, one cardiogram is not enough. The doctor can draw conclusions about your health on the basis of a comprehensive examination, taking into account the results of other examinations, tests, your complaints and medical history.

What kind of doctor does?

In the clinic, the direction for cardiography is given by the therapist. And the doctor who decrypts it is called a cardiologist.

Also, a conclusion can also be made:

  • functional diagnostics doctor;
  • ambulance doctor;
  • family doctor;
  • pediatrician.

The procedure itself is carried out by nurses in a specially equipped room.

After receiving the results of the study, you must make an appointment with the doctor who prescribed the ECG in order to receive recommendations or treatment appointments.

How long the study will last depends on the type of ECG.

Type of studyTime
Standard ECG5 – 10 minutes
ECG with load10 – 15 minutes

ECG preparation rules:

  1. On the day of the procedure, you should refrain from drinking coffee, tea and energy drinks.
  2. Do not eat heavy food 2 hours before the study.
  3. Do not take sedative medications. If you regularly drink cardiological drugs (antiarrhythmic, beta-blockers, cardiac glycosides) – be sure to inform your doctor.
  4. To smokers one hour before an electrocardiogram to refuse cigarettes.
  5. Do not subject yourself to physical activity. It is advisable to come 10-15 minutes before the examination and relax on the couch.
  6. Do not use oily cream or lotion in the chest area.
  7. Clothing should be comfortable so that you can quickly expose your wrists, legs, and chest. And also it is necessary to remove all metal jewelry and watches.
  8. Be sure to bring along the previous cardiograms and test results.
  1. The healthcare provider writes all patient data to a log.
  2. The wrists, lower legs and chest are exposed.
  3. In the prone position, electrodes are attached. Before this, the skin is degreased with alcohol, and for better contact with the sensors, a special gel is applied, or wet gauze wipes are used.
  4. The indicators are recorded on paper, after that the terminals are removed, the skin is wiped dry.

During the passage of the ECG, you do not need to be nervous and talk. The recording technology is absolutely safe and painless. The duration of the examination is 10-15 minutes.

Breathing should be even and calm. It may be necessary to register indicators on inspiration. In this case, the nurse will give a command to take a deep breath and hold your breath.

ECG manipulation is carried out in the office of functional diagnostics. The room should be warm and insulated from possible sources of electrical noise. It is also recommended to turn off the mobile phone.

The electrocardiography technique has a simple procedure and is carried out in stages:

  • patient preparation;
  • electrode overlay;
  • recording bioelectric activity on paper;
  • decoding of the results.

It is important not to confuse the electrodes, but before working, check the device for serviceability.

The video about the ECG recording technique was shot by the channel – OFFICIAL TNU.

To record standard and reinforced leads, three electrodes (red, yellow and green) are used, which are superimposed on the arms and left leg and form the Einthoven triangle. The black electrode, which is superimposed on the right leg, the system is grounded.

You need to put them like this:

  • red – the right hand;
  • yellow – left hand;
  • green – left leg;
  • black is the right leg.
  • To register chest leads, one or six electrodes in the form of a pear are used (depending on the type of cardiograph).
  • How to put breast electrodes:
  • Lead V1 – in the IV intercostal space on the right edge of the sternum;
  • Lead V2 – in the IV intercostal space along the left edge of the sternum;
  • Lead V3 – between the second and fourth position;
  • Lead V4 – in the V intercostal space along the left m >

    The scheme of application of the chest electrodes

    1. For convenience, all electrodes have their own color.
    2. The location of the four main ones is easy to remember by a traffic light or by a funny reminder “Every Woman Is Meaner Than A Damn”.
    3. In a single-channel cardiograph, one white pear is used to remove the chest leads on an ECG.
    4. In the six-channel:
    • V1 – red;
    • V2 – yellow;
    • V3 – green;
    • V4 – brown;
    • V5 – black;
    • V6 – blue.

    Lead Pattern

    • When registering an ECG, 12 standard leads are currently used: 6 from the limbs and 6 chest.
    • Each of the 6 leads shows a particular part of the heart.
    • On standard leads:
    • I – the front heart wall;
    • II – posterior heart wall;
    • III – their combination.

    Scheme of standard limb leads

    On reinforced leads:

    • aVR – lateral heart wall on the right;
    • aVL – lateral heart wall in front of the left;
    • aVF – back wall of the heart.

    Scheme of reinforced limb leads

    On the chest leads:

    • V1 and V2 – the right ventricle;
    • V – a partition between two ventricles;
    • V4 – upper cardiac region;
    • V5 – the side wall of the left ventricle in front;
    • V6 – the left ventricle.

    Chest assignment scheme

    Thus, the task of diagnosing diseases is simplified. Changes in each lead characterize the pathology in a particular area of ​​the myocardium.

    Cardiogram recording

    On different cardiographs, the procedure may vary. Consider the algorithm for recording ECG on the example of the apparatus EK1T-03M2.

    Photo of an electrocardiograph EK1T-03M2

    If the device is powered by a 220V network, it must be grounded. To do this, one end of the ground wire is connected to the ground socket, and the other is connected to a water tap or unpainted portion of the central heating battery. Devices with a battery do not require grounding.

    After applying the electrodes and turning on the apparatus, the control millivolt is recorded. This is the recording scale, it is important for further measurements and for comparing electrocardiograms recorded on different devices with each other.

    On the example of the device EK1T-03M2, this is done as follows:

    1. Using the switch, set the height of mV equal to 10 mm, check that the lead switch is set to 1 mV.
    2. Turn on the tape movement at a speed of 50 mm / sec. And immediately 3-4 times quickly press the millivolt record button, after which the tape movement will stop.
    3. Several rectangular teeth with a height of 10 mm are recorded on the tape, when decoding the ECG they are called millivolts.

    Then there is a sequential recording of standard leads:

    1. To do this, switch the device to recording mode I assignment.
    2. Then turn on the movement of the tape, record 4–5 complexes and stop the tape.
    3. Switch the device to recording mode II leads and repeat the whole procedure.
    4. After recording the III lead, you should ask the patient to take a deep breath, hold your breath, and in this position write the rd lead again.
    5. Then record the reinforced leads aVR, aVL and aVF.

    Record of chest assignments:

    1. To do this, the lead switch is set to position V.
    2. The chest electrode is placed on the patient’s chest at the recording point of the V1 lead and the pen calm is turned on.
    3. Turn off the damper. Record at a speed of 50 mm / sec. 4–5 complexes.
    4. Turn on the damper and rearrange the electrode at point V2.
    5. The entire procedure is repeated until the V6 lead is recorded.

    Again, the control millivolt is recorded, the tape is passed forward and torn off. The device is turned off.

    The cardiogram indicates:

    • F. I. O. of the patient;
    • age;
    • date and time of recording.

    In medicine, there is another way to conduct electrocardiography – ECG according to Slopak. It differs from the standard procedure. It is used to diagnose posterior basal myocardial infarction.

    1. Green is the left leg.
    2. Black is the right foot.
    3. The yellow electrode is placed on the fifth intercostal space on the left along the posterior axillary line (at the level of the thoracic V6).
    4. Red moves sequentially and is used to remove chest leads.

    The marking looks like this:

    • S1 – at the left edge of the sternum;
    • S2 – in the middle of the distance between leads S1 and S3;
    • S3 – the second intercostal space on the left along the midclavicular line;
    • S4 – the second intercostal space on the left along the anterior axillary line.

    In this case, the contact switch must remain in position I.

    ECG removal for children

    An ECG can be recorded not only for adults, but also for children of any age, using appropriate sized electrodes.

    Parents should reassure the child, during the manipulation he should be calm and motionless. Older children can be explained how the procedure will go and what is required of them.

    An ECG should be given to children who have heart and vascular diseases or are at risk of their occurrence, at least once a year.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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