Diagnosis: 800 sinus rhythm. Unstable sinus rhythm. The occurrence of pathologies in a child

The normal functioning of the heart is determined by the frequency and rhythm of its contractions. Such parameters can be determined using an electrocardiogram. Wherein important indicator is the sinus pulse. In this article we will tell you what it is, which values ​​are considered normal, and which are a sign of pathology. We will also consider the main methods of treatment and prevention.

Many people have no idea what sinus rhythm is. This is an important parameter that is determined on the electrocardiogram.

The heart is the main organ that ensures the functioning of blood circulation, as a result of which all organs and tissues receive the necessary portion of oxygen and nutrients. In order for it to contract and push blood into the vessels, a specific impulse is required. Heart rate characterizes where such an impulse comes from and what its frequency is. But what does it mean?

If the impulse comes from the sinus node, then the rhythm is called sinus. This node is a concentration of nerves that constantly produce nerve impulses. It is located in the upper part of the right atrium, so it is well supplied with arterial blood.

The node is enveloped in fibers of the vegetative nervous system, which has a strong influence on it. In addition to sinus, there are other rhythms in which impulses come from other parts of the heart. But they are all considered deviations.

Sinus rhythm is determined using special method diagnostics - electrocardiograms (ECG). It allows you to quickly find out where the impulses to the heart muscle come from, what their frequency and rhythm are.

Normal parameters

The cardiogram readings must be deciphered by a specialist. To an ordinary person It can be difficult to understand all the nuances. What should you pay attention to when studying ECG results? So, normal rhythm has the following characteristics:

1. Frequency. It ranges from 60 to 90 beats per minute.
2. Regularity. The pulses should not be wavy. Each contraction of the heart normally occurs over the same period of time. If they fluctuate, arrhythmia is suspected.
3. Subsequence. Heart beats should go in one direction. This means that the impulse first enters the atria and then enters the ventricles.
4. Variability under the influence of environmental factors. If the heart always works in the same rhythm, even normal, this is also a deviation. It must change its rhythm depending on the influence of provoking factors coming from the environment (physical activity, sleep state, pain, emotional experiences). This is a physiological feature.

Interpreting an ECG is a very difficult task. To do this, it is important to understand the following elements:

• intervals P-Q, P-P, R-R;
• P wave;
• QRS complex.

In a normal cardiogram, P is turned upward, has a smaller size than the R wave, and stands in front of each QRS complex. There should be an equally short interval between P and QRS (P-Q). The R waves are the largest and face upward, with the intervals between them being the same length.

The spacing between P-P and R-R must be the same. When evaluating ECG findings, consideration should be given to the frequency, regularity, consistency, and physiological variability of sinus rhythm.

Causes and symptoms of rhythm disturbances

In certain situations, even a sinus pulse may indicate the presence of pathology. In this case, various violations arise. Let's look at them in more detail.

Tachycardia

Tachycardia is a rapid heart rate. It may occur due to various reasons. More often accelerated pulse observed against the background of physiological factors:

• stress;
• emotional experiences (anxiety, excitement, joy, excitement);
• physical activity (especially in untrained people);
• binge eating;
• temperature increase;
• drinking stimulating drinks (coffee, strong tea, energy drinks).

May also cause tachycardia various pathologies. First of all, increasing heart rate cause heart disease (myocarditis, cardiosclerosis, heart disease, heart attack). Tachycardia is also observed when hormonal imbalances(thyrotoxicosis), anemia, lesions nervous system, infectious diseases, renal colic.

Main symptoms sinus tachycardia reflected on the ECG:

• the P wave is in its usual place;
• a decrease in the interval between P and R-R, the duration of these indicators determines the heart rate;
• when counting, the number of heart contractions exceeds 90 beats per minute.

To accurately determine the presence of pathological tachycardia, the patient needs to follow some rules. Before the manipulation, you should avoid physical activity, don’t worry, don’t smoke, and don’t overload your stomach with high-calorie foods.

Bradycardia

Bradycardia is a downward deviation of the heart rate. In this case, a pulse of less than 60 beats per minute is recorded. Often this condition occurs due to hypothermia, with a lack of oxygen (being in stuffy room, wearing restrictive clothing).

A decreased heart rate is observed in the state deep sleep, as well as in athletes and young people. This is considered a normal physiological condition.

Bradycardia may occur due to pathological reasons. Among them:

• heart diseases (defects, cardiosclerosis);
• hormonal imbalances due to poor functioning of the thyroid gland (hypothyroidism);
• lead, phosphorus, nicotine poisoning;
• neurological disorders;
• vegetative-vascular dystonia;
• the presence of malignant neoplasms;
• infectious diseases;
• peptic ulcer.

Bradycardia may also occur due to an overdose of antihypertensive drugs, as side effect from taking certain medications (beta blockers, glycosides, sedatives).

On the electrocardiogram, symptoms of bradycardia include prolongation between the P and R waves and ventricular contraction complexes. At the same time, the rhythmicity indicators are preserved (P has a constant shape, it precedes the QRS).

Arrhythmia

The main indicator of arrhythmia is an irregular pulse. As a rule, this condition does not have a physiological nature. It is caused by various anomalies:

• disturbances in the structure of the myocardium (scarring, sclerosis);
• inflammatory processes in the heart;
• heart failure;
• vices;
• general oxygen starvation;
• anemia (including bleeding);
• endocrine diseases.

Arrhythmia also occurs due to systematic smoking, alcohol abuse and certain medications.

A variant of the norm is considered to be special kind arrhythmias - respiratory (when inhaling, the pulse rate increases, and when exhaling, it sharply decreases). This condition is observed in athletes, teenagers with hormonal imbalances, and overly impressionable people.

With arrhythmia, it is observed that normal frequency heart contractions, then accelerating the rhythm, then slowing it down. On the ECG this is manifested by different intervals between R waves.

Extrasystole

Sinus extrasystole is the most common type of arrhythmia. In this condition, untimely depolarization and contraction of the heart are observed. As a rule, this deviation is neurogenic in nature and occurs due to stress, smoking, alcohol abuse, caffeine and certain medications.

Pathological extrasystole develops due to myocardial damage. For example, due to dystrophy, ischemia, cardiosclerosis or an inflammatory process.

Signs of disturbance on the cardiogram:

• sinus pulse is abnormal;
• The P wave may not be where it should be;
• the QRS complex remains unchanged.

Also, after an extrasystole, a compensatory pause is observed, twice as long as the normal pause between complexes.

Sinus node weakness

This is a dysfunction of the node that does not allow it to perform its job normally. This pathology occurs due to heart blockades that develop against the background of such factors:

The cardiogram shows an alternation of rapid and rare rhythms. In this case, periods of freezing are observed when there is no pulse.

Making a diagnosis depending on the cardiogram indicators

Put correct diagnosis Only a cardiologist can do this after conducting a cardiographic examination. At the same time, he compares the results obtained with the norm. Most often diagnosed:

The ECG method is informative and quick way obtaining data on heart activity. To make a diagnosis, the frequency and rhythm of heart contractions is studied.

Treatment methods and prevention

After an electrocardiogram, you may need additional methods studies to determine the cause of abnormal heart function. In this case the following is prescribed:

• blood chemistry;
• blood test for hormones and toxins;
• Ultrasound of the heart;
• Holter heart monitoring;
• computed tomography or magnetic resonance imaging.

You should also undergo additional examination by an infectious disease specialist, neurologist, psychiatrist, or endocrinologist. Only after determining the cause of the anomaly is appropriate treatment prescribed. Most often used drug therapy. At severe conditions Surgery may be required.

As a rule, deviations from the normal heart rhythm do not require special manipulations. If there are any problems, you should think about changing your lifestyle. Doctors recommend following preventive measures:

• Healthy food;
• avoid stress and emotional turmoil;
• lead active image life;
• give up bad habits;
• avoid physical overload and fatigue.

If you stick to these simple rules, then you can not only keep your heart rate normal, but also improve general state health.

So, sinus rhythm is an indicator normal functioning heart, which is displayed on the electrocardiogram. To identify deviations, you should compare the results obtained with the norm.

The heart is a complex organ that works in a certain rhythm. It is set by the sinus node in the right atrium, which is a generator of cardiac impulses; they move from top to bottom

It looks like this: the impulse first enters the right atrium, and after that it moves to the left. The impulse then follows along the atrioventricular orifice and passes to the cardiac ventricles. Therefore, the organ rhythmically contracts and relaxes, performing the main function of blood transmission.

Without going into medical terminology, the concept of “sinus rhythm” can be explained this way:

• There are cells in the human heart that create an impulse at a certain number of beats per minute.
• These cells are located in the sinus node, in the septum between the ventricles, called the atrioventricular node, and in the Purkinje fibers, which are the tissue of the ventricles of the heart.
• Sinus rhythm means that the impulse is generated by the sinus node (normally 50 beats per minute).
• If it is changed, a different heart node produces a different number of beats per minute.

The main examination in cardiology is electrocardiography. An ECG records the electrical fields generated by cardiac activity, giving a specialist the opportunity to assess the condition the most important body human body.
An electrocardiogram is used for various tests:

1. Determination of contraction frequency, extrasystoles - rapid contractions, arrhythmias - missed contractions.
2. Myocardial damage – infarction, ischemia.
3. Electrolyte metabolism disorders: magnesium, calcium, etc.
4. Cardiac conduction disorders - blockades.
5. Screening for ischemic heart disease.
6. Physical condition of the heart muscle.
7. Data on diseases outside the field of cardiology - thromboembolism pulmonary artery and etc.
8. The cardiogram of the heart determines sinus rhythm, which is one of the main tasks of electrocardiographic research.

If you feel changes in cardiac activity, you should contact a cardiologist, who will give you a referral for electrocardiography before prescribing treatment.

If on the ECG the P waves have the same shape, the distance between P-P or R-R is the same, and the frequency of contractions does not exceed 60-80 beats per minute, the interval between beats is in the range from 0.12 to 0.22 seconds - this is the norm.

If the doctor sees that the distance between the P waves and their height are not the same, the sinus rhythm is weak. To determine the cause of weakness, the patient is prescribed special diagnostics, which helps to identify the reasons: either there is a pathology of the node, or there are problems in the autonomic system.

Remember: If the doctor wrote: “Sinus rhythm, vertical position heart", this means that the heart is normal.

IN in this case vertical position - normal position of the cardiac axis in chest.

Sinus rhythm disorder

If violated, arrhythmias (impaired heart contraction functions) or blockades are possible, which occur when the transmission of cardiac impulses to the muscle is disrupted. If acceleration is detected, this may be a sign of tachycardia; if deceleration is observed, bradycardia is possible.
In cases of irregular rhythm, the body lacks oxygen. The patient feels the symptoms of this pathology: dizziness, fluctuating blood pressure, pain in the chest, difficulty breathing, etc.
When the rhythm exceeds 110 beats/min, tachycardia occurs. If a person is healthy, an acceleration of the heart rate can occur as a result of physical activity, excitement, or stress.

Important: If the rhythm is less than 50, as well as more than 90, the patient needs a cardiac examination.

Factors influencing its change:

• Congenital and acquired defects.
• Diseases of the myocardium with changes in structure and function - cardiomyopathy.
• Infectious lesions of the valves and other parts of the heart - infective endocarditis.
• Various overloads: in the emotional and psychological sphere, as well as physical.

Disorders in children

Despite the fact that this pathology can be observed in childhood, adolescence, and adulthood, in many cases it does not affect general health and is diagnosed during examination for the presence of other diseases.
Except common reasons, disorders in children also have specific, age-related ones:

1. Congenital defects caused by pregnancy and birth process mother.
2. Neurological diseases.
3. Pathologies of the endocrine system.
4. Intolerance or overdose of certain pharmacological drugs.
5. Lack of selenium and magnesium in the body.

It is worth noting: arrhythmia is diagnosed in 25% of children, but this does not mean a disease. The incidence of arrhythmia increases in adolescence.

In children and adolescents, respiratory sinus arrhythmia, also called paradoxical pulsus, is often detected. This type arrhythmias are characterized by an increase in heart rate during inhalation and a significant decrease during exhalation.
To normalize the condition, sometimes it is enough to regulate your daily routine and diet. But if the problem cannot be solved in this way, a detailed examination by a doctor who specializes in the diagnosis and treatment of cardiac diseases in children is necessary.

Disorders in pregnant women

Pregnancy is a period of restructuring of all systems female body. Special changes also occur in cardiovascular functions.
During pregnancy, sinus rhythm, as a rule, accelerates by 10 beats per minute, and 50% of subjects experience either arrhythmia or tachycardia. Doctors believe that such changes are a relapse of an existing pathology or a manifestation of the female body’s adaptation to the pregnancy process.
Due to the need for additional (increased) nutrition, the frequency of contractions of the heart muscle increases. Also the reason may be physiological changes, occurring during these months. In the vast majority of cases, after childbirth the condition returns to normal.

When you hear such a concept as sinus heart rhythm, not everyone knows what it means, and the question often interests people who have known heart disease. In case of suspicion of the presence or possibility of developing the disease of cardio-vascular system in humans, it is necessary to conduct a special examination called an electrocardiogram. Thanks to this procedure, it is revealed possible deterioration available pathological condition. The presented procedure is carried out before any types of surgical operations In addition, it affects the activities of other organs. Specific indicators of cardiac activity are recorded based on the results of the ECG.

Show all

The essence of the term

Sinus rhythm, revealed by the results of an ECG, indicates the absence of deviations in the functioning of the human heart muscle. The sinus rhythm of the heart is certain oscillations, the formation of which leads to the fact that impulses are formed in a special node, then divided depending on the location, i.e. into the ventricle and atrium. Thanks to the presented moment, the heart muscle contracts in an adult.

A cardiac cardiogram may show correct results only when the person is in a calm state.

The presence of the presented condition based on the ECG results is a reflection normal level distribution of excitation impulses. Their absence indicates an assessment of tact in a different capacity. In this case, the source is located in other areas.

The vertical position obtained from the ECG of the heart indicates that the location of the central axis, including the course, is in in good condition. It follows that based on the presented data, the possible location of the heart in the chest is revealed. The heart muscle can move in directions such as forward, backward, left, right depending on the transverse axis. This means that the structure of the human body contains individual characteristics.





Deviations indicating illness

Most people have some kind of health problem. In certain cases, based on the results of diagnosis, violations are identified. When a negative ECG is formed, the diagnosis of “sinus rhythm” may be a reflection of existing blockades or arrhythmia. The appearance of this condition is caused by the formation of unusual transmission of impulses to the heart muscle. For example, accelerated or increased vibrations lead to an increased heart rate. The rhythm is disrupted by incorrect sequence, regularity and frequency of contractions.

The irregular sinus rhythm reflected in the ECG results indicates a difference in the interval between the teeth. In most cases, this is how the weakness of the node is expressed. Holter monitoring, including a drug test, helps determine the suspected pathology.





Various description options

The recording used in ECG is sinus rhythm. The absence of other recordings and a frequency level (heart rate) in the region of 60-90 beats per minute or sinus rhythm with a heart rate of 75 (average value) is the most preferable option, which indicates excellent functioning of the heart.

A pathological condition is considered to be the presence of atrial, atrioventricular or ventricular, which are characteristic of the corresponding sections. This option in to the greatest extent appears in young people and children. Within the framework of the presented state, the output of impulses from the sinus node is observed, however, differences are formed between heart contractions. About 1/3 of the cases presented require observation by a specialist in order to prevent possible consequences and the development of diseases.



If the heart rate is less than 50 beats per minute, bradycardia is observed. The occurrence of this condition in adults occurs during sleep, as well as in professional athletes. If there is a pause in heart contractions for up to 3 seconds per daytime and up to 5 seconds at night, various disturbances in the process of supplying tissues with oxygen and frequent fainting are observed. To prevent this condition, operations are performed to install a heart pacemaker, which normalizes the rhythm of contractions.



Possible violations

Frailty syndrome or FSS is the combined results of an ECG and clinical indicators, indicating actual damage to the source of influence. Diagnosis of arrhythmia is possible only if there is information about a normal ECG.

In this case, the heart rate within 1 minute should not be more than 90 beats. The ECG data reflects the actual presence of certain abnormalities, namely:

1. 1. Bradycardia, in which key features states are unchanged, however, heart rate/min is less than 60 beats.
2. 2. Tachycardia, in which there is an increase in the number of muscle contractions up to 90 beats. If the heart rate exceeds 150, the risk of second-degree blockade increases sharply.
3. 3. Arrhythmia.
4. 4. Rigid, in which there is too much high rate contraction frequency.



The occurrence of pathologies in a child

The presented disorders in a child compared to an adult are characterized by the presence distinctive features. Puberty accompanied by an increase in the frequency of these violations. Measuring the length, size of segments and amplitude of wave vibrations is the entire process of deciphering ECG indicators. Indicator Research Process healthy person allow you to compare information and determine actual problems in the functioning of the heart under the influence of pathological changes.



The presented interval allows you to detect the heartbeat. In most cases, the increased growth of a child leads to the appearance of disorders in the heart muscle, which are reflected in the cardiogram. The presented condition is short-lived and does not require long-term treatment.

In some cases, the presence of an imbalance in the autonomic nervous system acts as a cause of sinus arrhythmia.

There is no need for any treatment for this condition as there is no effect on overall health.

It should be noted that not in all cases in which this condition is observed in children, heart disease is detected. In most cases, the presented deviations are formed under the influence of age-related changes. In other words, the vast majority of heart rhythm disturbances in children, if diagnosed in short time And proper treatment, subject to treatment.

The appearance of a severe form of cardiac pathology, accompanied by a violation of sinus rhythm in children, is associated with three main types of developmental defects, namely:

• cardiac;
• combined;
• extracardiac.

In order to normalize the functioning children's heart Long-term treatment is required. In some cases, drastic measures are used - surgical intervention.



In most cases, the presented condition does not affect the well-being of children. The child in this case shows physical activity without any discomfort. The disorder appears accidentally, after examination by a pediatrician or in other cases. In this regard, it is necessary to closely monitor the child.

Causes of diseases

The main reasons due to the influence of which violations occur in this case include:

• congenital heart defects;
• cardiomyopathy;
• infective endocarditis;
• various types of overloads.



These disorders can occur at any age. Very often characteristic of children. However, the presented disorders do not have a significant impact on well-being, and their detection occurs by chance.

In addition, the occurrence of the condition in question is influenced by changes that occur with age, namely:

• senile amyloidosis;
• arrhythmia;
• decreased thyroid function;
• liver diseases;
• typhus, etc.

In addition, there is a close connection with insufficient oxygen levels, increased blood pressure, and increased blood acidity levels. Key reasons violations are various diseases hearts.



Normal ECG value and its interpretation

Decoding ECG values is a matter for an experienced physician. Within the framework of this, the following indicators are assessed:

• heart rate;
• the actual state of the heart muscle.



In the case of a diagnosis such as sinus accelerated heart rate, this is evidence of sinus tachycardia in the patient. The occurrence of this condition in an adult is associated with the presence high level loads and stress emotional state. The presented condition is short-lived and occurs when taken medicines, alcohol due sharp decline blood pressure. In any case, a person notices the heartbeat.

If a person has an unstable sinus rhythm, this is evidence of sinus arrhythmia. As part of the presented disease, indicators such as the rhythm, frequency and sequence of contractions of the heart are disturbed.

Basic treatment methods

Diagnosing the condition, in addition to performing an ECG, includes procedures such as echography or ultrasound. The presence of abnormal sinus rhythm does not reflect all diseases considered. This condition can occur in people of any age. By giving up bad habits, excessive stress, and using certain medications, it is possible to get rid of abnormalities in the heart. As a result, positive ECG data are generated, namely sinus rhythm.

In addition, everyone can independently monitor the work of the main body, best time to check are morning hours. In this case, it is necessary to count the number of pulse beats per minute and compare it with normal value. The norm in adults is about 60-80 beats per minute, this is sinus rhythm.



Conclusion on the topic

The heart is the main organ of the human body, a kind of “motor”. Thanks to this organ, the entire body is supplied with the necessary oxygen and nutrients. Its functioning is carried out without stops and breaks, throughout the day; a slowdown in activity can be observed in some cases. In this regard, careful monitoring of the actual condition and activity of both the heart itself and the entire cardiovascular system is particularly relevant. Thanks to the sinus node, the normal activity of the heart is formed.

To characterize the normal level of heart rate without any pathologies, the concept of sinus heart rhythm is used. Identification of violations is carried out as a result of an ECG. Due to the action of certain factors that affect the conductive fibers, disturbances in the activity of the heart are formed. The presented condition is subject to mandatory inspection by specialists. The sinus rhythm of the heart, formed under the influence of physiological processes, is eliminated independently without medical intervention.

Irregularities in the functioning of the heart can pose a serious danger to human life. The work of the heart muscle is extremely complex and depends on the coordinated functioning of various anatomical formations, responsible for the creation and conduction of electrical impulses. The sinus node plays an important role in this. It sets the sinus rhythm, which coordinates the work of various departments

hearts.

Sinus arrhythmia

At rest, the heart rate of most people fluctuates around 60-80 beats/min. In other conditions, for example in a state of emotional overexcitation or during heavy physical exertion, this frequency may change. Arrhythmia will occur if the sinus rhythm is changed. The norm of 0.1 s, according to the ECG, between the R-R intervals will be exceeded. Changes in heart rate during sleep or physical activity are a normal reaction of a healthy body. The vast majority of people face this. However, certain diseases can also affect sinus rhythm and cause changes in it.

Sinus tachycardia

This term refers to an increase in heart rate to 90-100 beats/min. A pronounced tendency to this condition may indicate neurocirculatory dystonia. Accelerated sinus rhythm can be caused by some medical supplies or drinking alcohol. Fever, heart failure, myocarditis, thyrotoxicosis, and anemia can also lead to this. In these cases, treatment of tachycardia should be aimed at eliminating the underlying disease.

Sinus bradycardia

In this case, the sinus rhythm does not exceed 55 beats/min. This deviation is often accompanied by respiratory arrhythmia, and in in rare cases extrasystole. Its occurrence can be influenced by various unfavorable processes occurring in the body. For example, ischemic, inflammatory or sclerotic pathologies in the area of ​​the sinus node. They prevent the normal formation of impulses in it or disrupt their transmission to the atrium tissue. Bradycardia can also be caused by viral infections, posterior phrenic myocardial infarction, and certain medications.

Ectopic rhythms

When the sinus node is weak, so-called “ectopic” rhythms may appear. They consist in contractions of the heart under the influence of the automatism of its other parts. As a rule, the frequency of such contractions is less than that supported by sinus rhythm.

Extrasystoles

This term refers to premature heart contractions caused by impulses originating outside the sinus node. Such heart contractions can be caused by any heart disease. However, in many cases, other factors also influence the occurrence of extrasystole. For example, it often manifests itself as a result of psycho-emotional and autonomic disorders. Its appearance can be provoked by certain medications, taking stimulants and smoking.

An electrocardiograph (ECG) is a device for assessing the electrical activity of the heart muscle. In cardiology, it is most in demand, as it allows you to detect any changes in the heartbeat, organic lesions and electrolyte imbalances. Sinus rhythm when deciphering the cardiogram is detected in the absence pathological abnormalities. An experienced specialist evaluates the final results. To the common man Latin letters and curved lines will not say anything. Generally accepted standards and definitions will help you figure out the decoding yourself.

The sinus rhythm detected on the electrocardiogram is displayed by identical teeth at equal intervals of time and indicates proper operation hearts. The source of impulses is set by the natural pacemaker, the sinus (sinusoidal) node. It is localized in the angle of the right atrium and serves to generate signals that cause sections of the heart muscle to contract one by one.

A feature of the sinus node is its abundant blood supply. The number of impulses it sends is influenced by the divisions (sympathetic, parasympathetic) of the autonomic nervous system. If there is a malfunction in their balance, the rhythm is disturbed, which is manifested by an increase in heart rate (tachycardia) or slowdown (bradycardia).

Normally, the number of pulses generated should not exceed 60-80 per minute.

Maintaining sinus rhythm is important for stable circulation. Under the influence of external and internal factors, disruption of the regulation or conduction of impulses may occur, which will lead to disruptions in hemodynamics and dysfunction internal organs. Against this background, the development of signal blockade or weakening of the sinusoidal node is possible. On the electrocardiogram, the resulting disorder is displayed as the presence of a focus of replacement (ectopic) impulses in a certain part of the heart muscle:

• atrioventricular node;
• atria;
• ventricles.

When the signal source is located anywhere other than the sinus node, we are talking about heart pathology. The patient will have to undergo a series of examinations ( daily monitoring ECG, stress tests, ultrasonography) to identify the causative factor of the disorder. Treatment will be aimed at eliminating it and restoring sinus rhythm.

Decoding the cardiogram of the heart: sinus rhythm

Panic when a “sinus rhythm” recording is detected is typical for those unfamiliar with in medical terms to people. Usually the cardiologist prescribes a series of examinations, so you will be able to see him again only after receiving all the results. The patient can only wait patiently and familiarize himself with publicly available sources of information.

In fact, sinus rhythm is the generally accepted norm, therefore, there is no point in worrying. Deviations are possible only in heart rate (HR). It is influenced by various physiological factors, the influence vagus nerve and vegetative failures. The number of heart beats per minute may become higher or lower than normal for age, despite sending signals from the natural pacemaker.

A diagnosis of “tachycardia” or “bradycardia” of sinus type is made only after a comprehensive assessment of all the nuances. The doctor will pay attention to the patient’s condition and ask about the actions performed immediately before the study. If the decrease or increase in heart rate is minor and is associated with exposure external factors, then the procedure will be repeated a little later or on another day.

Identification of the natural pacemaker during electrocardiography occurs according to generally accepted criteria:

• the presence of a positive P wave in the second lead;
• there is an equal interval between the P and Q waves, not exceeding 0.2 seconds;
• negative P wave in lead aVR.

If the transcript indicates that the patient is in sinus rhythm and in normal position electrical axis hearts (EOS), then they are afraid of nothing. The rhythm is set by its natural driver, that is, it comes from the sinus node into the atria, and then into the atrioventricular node and ventricles, causing alternate contractions.

Acceptable standards

Whether the cardiogram readings are normal can be determined by the position of the teeth. Heart rhythm is assessed by the interval between teeth R-R. They are the highest and should normally be the same. Slight deviation acceptable, but not more than 10%. Otherwise, we are talking about a slowdown or increase in heart rate.

The following criteria are typical for a healthy adult:

• P-Q interval varies within 0.12-0.2 seconds;
• Heart rate is 60-80 beats per minute;
• the distance between the Q and S teeth remains in the range from 0.06 to 0.1 sec;
• the P wave is 0.1 sec;
• The Q-T interval varies from 0.4 to 0.45 seconds.

In children, the indicators are slightly different from adults, which is due to the characteristics of the child’s body:

• QRS interval does not exceed 0.1 second;
• Heart rate varies depending on age;
• the distance between the Q and T teeth is no more than 0.4 seconds;
• P-Q interval 0.2 sec.
• the P wave does not exceed 0.1 sec.

In adults, as in children, in the absence of pathologies, there should be a normal position of the electrical axis of the heart and sinus rhythm. You can see the permissible frequency of reductions by age in the table:

Reasons for deviation from the norm

Heart rate varies depending on the time of day, psycho-emotional state and other external and internal factors. To obtain reliable data, you will need to take into account many nuances:

Equally important is careful preparation for the procedure:

If you were unable to follow all the rules, then upon arrival at the diagnostic room you should tell the specialist about it. He will take this nuance into account and, if necessary, schedule an examination for another day.

A general list of factors that can affect the frequency and rhythm of the heart rhythm is as follows:

• mental disorders;
• overwork (psycho-emotional, physical);
• developmental defects (congenital, acquired);
• taking medications with antiarrhythmic effect;
• disruption of the valve apparatus (insufficiency, prolapse);
• dysfunction of the endocrine glands;
• advanced stage of heart failure;
• pathological changes in the myocardium;
• inflammatory heart diseases.

About taking medications, especially to stabilize blood pressure (“Mexarithma”, “Amidarone”) and improve metabolic processes(“Metonate”, “Adenosine”), must be reported before the procedure. Many heart medications can slightly distort the results.

Features of deciphering an electrocardiogram

Based on the electrocardiogram, the cardiologist will be able to assess the electrical potential of the heart muscle during systole (contraction) and diastole (relaxation). Displays data in 12 curves. Each of them demonstrates the passage of an impulse through a specific part of the heart. Waveforms are recorded on 12 leads:

• 6 leads on the arms and legs designed to assess vibrations in the frontal plane.
• 6 leads in the chest area for recording potentials in the horizontal plane.

Each curve has its own elements:

• Teeth by appearance resemble convexities directed up and down. They are designated by Latin letters.
• Segments are the distance between several teeth located nearby.
• An interval is a gap consisting of several teeth or segments.

General principles of decoding

Electrocardiogram evaluation is complex process. The doctor carries it out step by step so as not to miss the slightest changes:

To better understand the information, it is advisable to familiarize yourself with various options expert opinions:

• A healthy person is characterized by sinus rhythm, 60-80 heartbeats per minute, EOS in normal position and absence of pathologies.
• With an increased or decreased heart rate, sinus tachycardia or bradycardia is indicated in conclusion. The patient will be advised to undergo several more examinations or repeat the procedure on another day if the result was influenced by external factors.
• In elderly patients and people who do not lead a healthy lifestyle, pathological changes in the myocardium of a diffuse or metabolic nature are often detected.
• A record of the presence of nonspecific changes in the ST-T interval indicates the need for additional examinations. To figure out the real reason Only using electrocardiography in this case is not possible.
• The detected repolarization disorder indicates incomplete recovery of the ventricles after contraction. Usually, various pathologies and hormonal imbalances affect the process. To detect them, several more examinations will be required.

For the most part, the conclusions are positive. Changes can be overcome with lifestyle changes and medications. Poor prognosis usually upon detection coronary disease, proliferation (hypertrophy) of the chambers of the heart muscle, arrhythmias and disruptions in the conduction of impulses.

Causes of deviations in sinus rhythm

Abnormal sinus rhythm appears under the influence of pathologies or physiological factors. The forms of failure differ depending on the frequency and rhythm of contractions:

Despite the correct source of signals, the problem that has arisen must be dealt with. If no action is taken, a more severe form of arrhythmia may develop and dangerous symptoms of hemodynamic disturbances may appear.

Sinus tachycardia

The sinus form of tachycardia can be pathological or physiological. In the first case, it occurs due to other diseases, and in the second, after stress and overwork. The electrocardiogram usually reveals an increased frequency of contractions from 100 to 220 per minute and a short P-P interval.

The following symptoms are characteristic of an attack of sinus tachycardia:

• feeling of heartbeat;
• lack of air;
• general weakness;
• dizziness;
• sleep disturbance;
• chest pain;
• noise in ears.

Seizures sinus bradycardia, like tachycardia, occur as a symptom of other diseases or as a reaction to physiological factors. They are characterized by a decrease in heart rate to 60 beats per minute or less. The electrocardiogram shows a noticeable increase in the distance between the P-P waves.

In addition to a slow heartbeat, during an attack of bradycardia the following symptoms appear:

• dizziness;
• fainting state;
• pain in the heart area;
• pale skin;
• tinnitus;
• fast fatiguability.

Sinus arrhythmia

The sinus type of arrhythmia usually manifests itself irregular rhythm. The heart rate can increase or decrease sharply under the influence of various stimuli. Length RR interval is changing.

An attack of sinus arrhythmia is characterized by the following symptoms:

Features of ECG interpretation in children

Electrocardiography is performed in children in the same way as in adults. Problems can only arise with hyperactive kids. They must first be reassured and the importance of the procedure explained. The results obtained differ only in heart rate. During active growth, the heart has to work harder to supply all tissues of the body in full. As the child develops, the heartbeat gradually returns to normal.

Signs of sinus rhythm in children are similar to adults. The increase in heart rate must be within the acceptable age limit. If a focus of ectopic impulses is detected, then we can talk about congenital defect heart development. It can only be completely removed through surgery.

Cases of mild sinus arrhythmia are most often associated with respiratory system. During inhalation, the heart rate increases and stabilizes as you exhale. Such failures are typical for children and go away over time. At conducting an ECG respiratory arrhythmia must be taken into account, since a cold couch, fear and other factors provoke its aggravation.

The sinus form of arrhythmia can be provoked by more dangerous causes:

Due to the voiced pathological processes, the likelihood of developing complications that can lead to fatal outcome and disability. Among less serious reasons active growth, rickets and vegetative-vascular dystonia. In most cases, they go away on their own. It is enough for parents to give their child vitamin complexes and diversify his diet.

Decoding the electrocardiogram during pregnancy

During pregnancy, significant changes occur in a woman’s body that affect the results of electrocardiography:

• An increase in circulating blood volume contributes to the development of tachycardia and the manifestation of signs of overload in certain parts of the heart muscle.
• The growing uterus provokes displacement of internal organs, which is manifested by a change in the location of the electrical axis of the heart.
• Hormonal surges affect all systems in the body, especially the nervous and cardiovascular systems. A woman experiences attacks of tachycardia after any physical activity. Heart rate usually increases by no more than 10-20 beats per minute from normal.

The changes that occur go away on their own after the birth of the child, but in some cases they develop into a full-fledged pathological process. To prevent it, it is necessary to be observed by a doctor throughout the entire pregnancy.

The meaning of letters and numbers on an electrocardiogram

The definitions of the Latin letters that label the teeth will help you understand what is being said in the electrocardiogram:

• The PQ interval shows how long it takes for an electrical impulse to travel through the heart muscle (from the atria to the ventricles). In the absence of irritating factors, the length does not exceed 0.2 seconds. Based on this indicator, the doctor will assess the general condition of the conduction system. If there is a lengthening of the distance between the P and Q waves, then the problem may be the development of heart block.
• Along the space between the teeth R-R doctor determines the regularity of contractions and counts them.
• The QRS complex helps you see how the signal is conducted through the ventricles.
• The segment between the S and T waves shows the moment the excitation wave passes through the ventricles. Its permissible length is 0.1-0.2 seconds. The segment is located on an isoline. If it is slightly displaced, then certain pathological processes can be suspected:
  • higher by 1 mm or more – myocardial infarction;
  • lower by 0.5 or more – ischemic disease;
  • saddle-shaped segment – ​​pericarditis.

It will not be easy for an ordinary person to decipher an electrocardiogram. First, you will have to familiarize yourself with the definition of the Latin symbols that indicate the teeth, and the features of the intervals between them. Then you need to study the types of heart rhythm and generally accepted heart rate norms. Finally, it is advisable to review the options for expert opinions and general principles transcripts. Based on the information studied, even a person far from medicine will be able to understand the cardiogram.