ECG (Electrocardiogram): Qhov Kev Ntsuas Lub Plawv Qhia Dab Tsi? thiab Dab Tsi Nws Qhia Tsis Tau

Tus yuam sij takeaways

• Ceev thiab tsis mob: ib qho ECG 12-lead uas ib txwm muaj kaw tau ob peb vib nas this thiab tsis ua rau mob.
• Nws yog ib daim duab thaij: ib qho ECG ib txwm piav qhia txog lub plawv lub zog ua haujlwm tsuas yog thaum lub sijhawm ntawd xwb.
• Nws tsis thaij duab cov hlab ntsha lossis cov qhov dej: daim ECG qhia cov teeb liab hluav taws xob, tsis yog cov ntshav ntws, cov khoom thaiv lossis cov qauv ntawm lub valve.
• Kev txhais lus xav tau cov ntsiab lus: tib qho kev taug qab tuaj yeem yog qhov ib txwm muaj rau ib tus neeg thiab tseem ceeb rau lwm tus.
• Cov tsos mob uas kav ntev dhau qhov tshwm sim ib txwm muaj: yog tias mob hauv siab lossis lub plawv dhia tsis tu ncua, rov qab mus rau koj tus kws kho mob.

Ib nrais muag

Kuj hu ua

• ECG, EKG (kev sau ntawv German, elektrokardiogramm)
• Kev kuaj mob hluav taws xob ntawm lub plawv (electrocardiogram), kev kuaj mob hluav taws xob ntawm lub plawv
• "Kev kuaj ECG", "kev ntsuas lub plawv", "kev kuaj daim duab plawv", "ECG 12-lead"
• Kev siv Hindi / vernacular hauv Indian chaw kho mob: "dil ka ECG", "dil ki jaanch wali tshuab"

ECG yog dab tsi

Txhua lub plawv dhia pib ua lub zog hluav taws xob hauv lub sinus node, nthuav dav mus rau hauv atria, hla mus rau hauv atrioventricular node thiab mus rau hauv ventricles. Lub ECG khaws cov kev hloov pauv hluav taws xob no ntawm qhov chaw ntawm daim tawv nqaij thiab luam tawm lawv ua nthwv dej: nthwv dej P (atrial activation), QRS complex (ventricular activation) thiab nthwv dej T (ventricular recovery). Kaum lub electrodes tsim kaum ob lub "pom" hluav taws xob sib txawv ntawm lub plawv.

Lub tshuab ECG yog ib lub cuab yeej mloog. Nws tsis xa hluav taws xob mus rau hauv lub cev.

Vim li cas thiaj ua ECG

• Mob hauv siab los yog mob hauv siab: nrhiav cov qauv ntawm kev mob ischemia lossis infarction, thiab coj kev txiav txim siab kho tam sim ntawd.
• Lub plawv dhia ceev, tsaus muag lossis yuav luag tsaus muag: los sau cov ntaub ntawv txog lub suab nrov yog tias muaj cov tsos mob, thiab nrhiav seb puas muaj qhov tsis zoo ntawm kev sib kis lossis kev hloov pauv ntawm lub suab.
• Ua tsis taus pa: ua ib feem ntawm kev ntsuam xyuas dav dua ntawm lub plawv thiab kev ua pa.
• Kab mob plawv uas paub lawm: kev saib xyuas ntawm arrhythmia, myocardial infarction yav dhau los, lub plawv tsis ua haujlwm lossis cardiomyopathy.
• Kev kuaj xyuas lub plawv dhia lossis ICD: nrog rau kev nug cov cuab yeej raug cai.
• Kev saib xyuas tshuaj thiab electrolyte: qee cov tshuaj cuam tshuam rau QT lub sijhawm; potassium thiab calcium cuam tshuam hloov cov duab nthwv dej.
• Ua ntej phais lossis ua ntej pib qee yam kev kho mob, qhov twg qhov xwm txheej kho mob tsim nyog nws.

Leej twg yuav tsum tau txais qhov kev xeem no

• Txhua tus neeg uas muaj mob hauv siab, mob siab, lossis mob kis mus rau lub puab tsaig, caj dab lossis caj npab: qhov no xav tau ECG thaum muaj xwm txheej ceev, tsis yog teem sijhawm teem tseg.
• Cov neeg uas muaj lub plawv dhia tsis xwm yeem, tsaus muag tsis paub meej, lossis lub plawv dhia tsis xwm yeem.
• Cov neeg uas paub tias muaj kab mob plawv coronary artery, lub plawv tsis ua haujlwm, kab mob valve lossis kab mob plawv rheumatic raws li lawv tus kws kho mob plawv tau hais.
• Cov neeg uas muaj mob ntshav siab, mob ntshav qab zib lossis mob raum ntev thaum tus kws kho mob soj ntsuam kev koom tes ntawm lub plawv.
• Cov neeg noj tshuaj uas paub tias cuam tshuam rau lub plawv dhia lossis QT lub sijhawm, thaum tus kws kho mob qhia kom saib xyuas.
• Cov neeg ncaws pob thiab cov neeg sib tw kis las qhov twg siv tau cov txheej txheem kuaj mob, thiab cov neeg uas muaj keeb kwm tsev neeg ntawm kev tuag sai sai ntawm lub plawv lossis kab mob plawv uas tau txais los ntawm noob caj noob ces.
• Cov neeg raug soj ntsuam ua ntej phais loj, raws li hnub nyoog, cov tsos mob thiab cov kab mob sib koom ua ke es tsis yog ib txwm muaj rau txhua tus neeg.

Kev siv ECG ib txwm rau ib tus neeg uas tsis muaj tsos mob thiab tsis muaj yam ua rau muaj kev pheej hmoo feem ntau ntxiv me ntsis thiab tuaj yeem ua rau muaj kev tshawb pom tsis tau zoo uas ua rau muaj kev kuaj ntxiv. Seb ECG puas muaj txiaj ntsig rau koj yog kev txiav txim siab hauv kev kho mob.

Qhov uas ECG tsis tuaj yeem ntes tau lossis tsis suav nrog

Qhov no yog qhov kev xeem uas nkag siab yuam kev tshaj plaws.

• Nws tsis tuaj yeem zam tau kab mob coronary artery. Feem ntau, kev ntsuas ECG thaum so yog ib qho zoo rau cov neeg uas muaj cov hlab ntsha hauv lub plawv nqaim heev. Kev ntsuas ECG tsis pom cov hlab ntsha hauv lub plawv li.
• Nws tsis tuaj yeem zam tau qhov mob plawv nres ntawm nws tus kheej. Thaum ntxov ntawm kev mob plawv nres, ECG yuav zoo li qub lossis ze li qub. Kev kuaj mob feem ntau yuav tsum tau ua ECG ntau zaus ntxiv rau lub plawv troponin thiab kev soj ntsuam hauv chaw kho mob.
• Nws tsis tuaj yeem ntes tau qhov mob arrhythmia tsis tu ncua. Yog tias lub plawv dhia tsis zoo li qub thaum ob peb feeb ntawd, qhov kev taug qab yuav zoo li qub. Yuav tsum tau saib xyuas kev taug kev.
• Nws tsis ntsuas qhov ua haujlwm ntawm lub twj tso kua mis. Cov lus nug txog kev kuaj mob plawv (echocardiography), tsis yog cov lus nug txog ECG.
• Nws tsis ntsuas ntshav siab, roj cholesterol lossis feem pua ​​​​​​ntawm kev txhaws.
• Nws tsis tuaj yeem kuaj mob ntsws lossis aorta xwm txheej ceev. Kev mob ntsws embolism thiab aortic dissection tej zaum yuav ua rau muaj kev hloov pauv ECG uas tsis tshwj xeeb lossis tsis muaj; yuav tsum tau kuaj duab.
• "ECG ib txwm muaj" txhais tau tias tsis muaj qhov txawv txav pom hauv cov ntaub ntawv kaw cia ntawd. Nws tsis zoo ib yam li "tsis suav nrog kab mob plawv". Yog tias koj cov tsos mob tseem muaj lossis rov qab los txawm tias ECG zoo li qub, rov qab mus ntsib koj tus kws kho mob.

Kev ntsuam xyuas sib txuas tab sis sib txawv

Cov kev kuaj no teb cov lus nug sib txawv. Qhov twg los ua ntej nyob ntawm seb qhov kev mob tshwm sim li cas: mob hauv siab sai sai ua rau muaj ECG thiab troponin tam sim ntawd; lub plawv dhia tsis tu ncua ua rau muaj kev soj ntsuam kev taug kev; ua tsis taus pa nrog lub suab nrov ua rau muaj echocardiography; mob hauv siab thaum ua haujlwm hnyav rau tus neeg mob uas ruaj khov yuav ua rau muaj kev kuaj mob siab lossis CT coronary angiography nyob ntawm seb muaj kev pheej hmoo thiab qhov chaw muaj.

Yuav npaj li cas

Feem ntau cov chav kuaj mob tsis tas yuav npaj tshwj xeeb rau kev kuaj ECG thaum so. Cov txheej txheem sib txawv ntawm cov tsev kho mob thiab cov chaw kuaj mob, thiab cov lus qhia uas koj lub chav kuaj mob muab yuav tseem ceeb dua txhua yam uas sau ntawm no.

• Tsis txhob yoo mov xav tau rau tus qauv ECG so.
• Khaub ncaws: hnav ib yam dab tsi uas tso cai rau kev nkag mus rau hauv lub hauv siab, dab teg thiab pob luj taws. Khaub ncaws ob daim yooj yim dua li khaub ncaws ib daim.
• Daim tawv nqaij: Tsis txhob siv roj, tshuaj pleev kom noo noo lossis hmoov talcum rau ntawm lub hauv siab hnub ntawd, vim tias cov no ua rau lub electrode tsis muaj zog. Ib txhia txiv neej yuav xav tau txiav cov plaub hau hauv siab me me.
• Cov tshuaj kho mob: Nqa koj daim ntawv teev tshuaj tam sim no tuaj. Tsis txhob tsum, hla dhau lossis hloov cov tshuaj uas tau muab rau koj ua ntej kuaj ECG tshwj tsis yog tus kws kho mob tau hais kom koj ua.
• Kev ua haujlwm hnyav thiab cov tshuaj stimulants: Ua ntej yuav kuaj, ua kom lub plawv dhia ceev thiab txhais lus nyuaj dua. So ob peb feeb ua ntej yuav kaw.
• Qhia rau cov neeg ua haujlwm yog tias koj muaj lub tshuab pacemaker lossis ICD, mob tawv nqaij lossis ua xua rau cov nplaum, cov ntaub qhwv hauv siab, lossis yog tias koj mob.

Yog koj xeeb tub

Siv ECG so thaum cev xeeb tub thaum pom tias muaj mob. Tsis muaj hluav taws xob. Lub plawv dhia feem ntau siab dua thaum cev xeeb tub thiab qee qhov kev hloov pauv ntawm axis thiab repolarisation tshwm sim, yog li qhov kev taug qab raug nyeem tawm tsam cov qauv cev xeeb tub. Pw tiaj tus yuav tsis xis nyob thaum cev xeeb tub tom qab, qhia rau tus kws kho mob, vim tias qhov chaw tilted yuav siv tau.

Cov me nyuam

Cov ECG rau menyuam yaus siv cov electrodes me dua thiab, qhov tseem ceeb, kev txhais lus raws li hnub nyoog. Lub plawv dhia, lub sijhawm sib txawv thiab cov qauv nthwv dej uas yog ib txwm muaj rau menyuam mos yuav tsis zoo li qub rau cov neeg laus. Yuav tsum tshaj tawm ECG rau menyuam yaus uas tsis raws li cov qauv rau menyuam yaus.

Cov laus

Kev hloov pauv me me ntawm lub plawv thiab qhov tsis zoo uas tsis tshwj xeeb yog qhov tshwm sim nrog lub hnub nyoog thiab tsis yog tus kab mob uas cia li tshwm sim. Kev sib piv nrog ECG ua ntej feem ntau muaj txiaj ntsig ntau dua li kev taug qab ib leeg.

Cov neeg uas muaj mob ntshav qab zib, CKD lossis mob plawv tsis ua haujlwm

Tsis muaj kev txwv dej lossis kev yoo mov siv rau ECG so, yog li cov lus qhia rau cov pab pawg no tsis hloov pauv. Cov tsos mob ntawm ischemia tej zaum yuav tsis meej lossis tsis zoo li qub hauv cov ntshav qab zib ntev, yog li ECG tuaj yeem thov rau cov tsos mob tsis meej xws li qaug zog lossis ua pa tsis taus. Hauv CKD thiab lub plawv tsis ua haujlwm, potassium thiab lwm yam electrolyte hloov pauv tuaj yeem hloov ECG yam tsis muaj lub plawv nws tus kheej.

Lub tshuab pacemaker lossis lub cuab yeej implanted

Ib qho ECG tuaj yeem kaw tau zoo nrog lub tshuab pacemaker lossis ICD, thiab pab qhia seb lub cuab yeej puas ua haujlwm. Nws tsis hloov qhov kev nug txog lub cuab yeej raug cai los ntawm pab pawg kws kho mob plawv.

Muaj dab tsi tshwm sim thaum lub sijhawm ECG

• Txoj Haujlwm: koj pw saum lub rooj zaum. Lub hauv siab, dab teg thiab pob luj taws raug nthuav tawm raws li qhov xav tau; ib daim ntaub lossis ib lub tsho hnav pw raug siv rau kev ntiag tug, thiab koj tuaj yeem thov tus poj niam pabcuam.
• Electrode qhov chaw: kaum lub electrodes raug txuas nrog cov gel lossis cov nplaum nplaum, rau ntawm lub hauv siab, ib qho ntawm txhua ceg. Kev tso kom raug yog qhov tseem ceeb, vim tias cov xov hlau tsis raug tso ua rau muaj cov kab tsis tseeb.
• Cov ntaubntawv: Lawv hais kom koj pw twj ywm, ua pa li qub thiab tsis txhob hais lus ob peb feeb. Kev txav mus los, kev tshee hnyo thiab kev hais lus tsim cov khoom cuav.
• Tom qab: cov electrodes raug tev tawm. Tsis muaj lub sijhawm rov zoo thiab koj tuaj yeem rov qab mus ua haujlwm li qub tam sim ntawd. Cov gel tuaj yeem so tawm; daim tawv nqaij yuav liab ib pliag qhov twg cov ntaub qhwv tau txuas.

Cov txheej txheem siv sijhawm ntev npaum li cas

• Kev taug qab nws tus kheej: feem ntau yog li ntawm 10 vib nas this ntawm kev kaw.
• Hauv chav: feem ntau yog 5-10 feeb suav nrog kev tso thiab kev tso electrode.
• Tag nrho kev mus ntsib: feem ntau yog 15-20 feeb nrog rau kev sau npe thiab tos, txawm hais tias qhov no nyob ntawm chav tsev tag nrho.
• Tshaj tawm: Thaum muaj xwm txheej ceev, ECG yuav raug nyeem hauv ob peb feeb ntawm lub txaj pw. Rau kev kuaj mob sab nraud, lub sijhawm tshaj tawm nyob ntawm qhov ua haujlwm ntawm chav kho mob, nug ntawm lub chaw txais tos thaum tuaj tos.

Nkag siab txog koj daim ntawv qhia ECG

Feem ntau daim ntawv qhia ECG muaj peb ntu: cov lej ntsuas, kev txhais lus los ntawm lub khoos phis tawj, thiab kev nyeem ntawv ntawm tus kws kho mob. Kev nyeem ntawv ntawm tus kws kho mob yog qhov tseem ceeb. Kev txhais lus tsis siv neeg feem ntau yuam kev, thiab tshwj xeeb tshaj yog qhov tsis zoo ntawm kev hu xov tooj dhau.

Cov lus uas koj yuav pom:

• Lub suab nrov ntawm lub sinus ib txwm muaj: lub siab xav pib nyob rau hauv qhov chaw ib txwm thiab mus ncig ua si li qub.
• Sinus tachycardia / sinus bradycardia: ib lub suab paj nruag ib txwm uas sai dua lossis qeeb dua li niaj zaus. Ob qho tib si muaj ntau yam ua rau tsis muaj laj thawj, xws li kev ntxhov siab, kub taub hau, mob, qhuav dej, ntshav tsis txaus, kab mob thyroid, qib kev noj qab haus huv lossis tshuaj.
• Atrial fibrillation: lub plawv dhia tsis xwm yeem los ntawm lub atria, tseem ceeb vim muaj feem yuav mob stroke thiab vim tias nws feem ntau xav tau kev kho mob tshwj xeeb.
• Ectopics / lub plawv dhia ua ntej lub sijhawm: lub plawv dhia ntau dhau. Feem ntau tsis ua teeb meem, tab sis feem ntau yog mob ectopy lossis mob ectopy nrog cov tsos mob yuav raug soj ntsuam ntxiv.
• First-degree AV block, right bundle branch block, incomplete RBBB: cov qauv conduction uas tej zaum yuav yog qhov sib txawv ib txwm muaj rau qee tus neeg thiab tseem ceeb rau lwm tus.
• Kev thaiv ceg sab laug, qhov siab tshiab ntawm ST lossis kev nyuaj siab, kev tig rov qab ntawm T-wave, Q waves: cov qauv uas xav tau kev sib raug zoo thiab kev sib piv sai nrog txhua ECG ua ntej.
• Sab laug ventricular hypertrophy "los ntawm cov qauv voltage": ib qho kev qhia txog hluav taws xob ntawm cov leeg nqaij tuab, tsis yog kev ntsuas. Echocardiography ntsuas qhov no kom raug.
• QT ntev los yog luv: muaj feem cuam tshuam rau kev pheej hmoo ntawm kev mob plawv dhia tsis xwm yeem thiab rau qee yam tshuaj. Tham nrog tus kws kho mob, thiab tsis txhob tsum tshuaj ntawm koj tus kheej.
• "Kev hloov pauv ST-T uas tsis tshwj xeeb": ib kab lus uas siv ntau heev uas txhais tau tias kev taug qab tsis yog ib txwm muaj hauv phau ntawv tab sis tsis taw qhia rau ib qho kev kuaj mob twg. Nws tus kheej nws tsis tshua ua rau muaj kev txhawj xeeb; rau ib tus neeg uas muaj cov tsos mob nws yuav ua rau muaj kev ntsuam xyuas ntxiv.

Txhob txwm ua, tsis muaj cov lej siv rau ntawm nplooj ntawv no. Cov qib ib txwm rau lub plawv dhia thiab rau PR, QRS thiab QT nyob ntawm hnub nyoog, poj niam txiv neej, lub plawv dhia, kev coj cwj pwm ntawm lub cev, tshuaj thiab txoj kev ntsuas siv, thiab raug siv los ntawm tus kws kho mob qhia. Ib tus lej sab nraud ntawm phau ntawv kawm tsis yog kev kuaj mob. Cov txiaj ntsig sib txawv nyob ntawm tus kheej qhov xwm txheej, thiab koj tus kws kho mob uas tau thov nws yuav tsum txhais cov ntsiab lus hauv cov ntsiab lus.

Thaum cov txiaj ntsig ECG tuaj yeem ua rau yuam kev

Cov kev tshawb pom uas yuav zoo li tsis zoo li qub

• Cov xov hlau tsis raug qhov chaw lossis cov xov hlau ceg tig rov qab: tuaj yeem ua raws li infarction, axis deviation lossis rhythm abnormality.
• Kev txav mus los, tshee hnyo, tshee hnyo lossis hais lus: cov khoom cuav tuaj yeem ua raws li lub plawv dhia tsis xwm yeem. Parkinsonian tremor thiab electrical interference yog cov neeg ua txhaum feem ntau.
• Kev ntxhov siab, mob, kub taub hau, kev tawm dag zog tsis ntev los no lossis cov tshuaj txhawb zog: nce tus nqi thiab tej zaum yuav ua rau muaj kev hloov pauv ST-T.
• Kev nyob ib puag ncig lub cev, cov nqaij ntawm lub mis, mob ntsws o lossis lub cev loj: hloov qhov loj ntawm lub teeb liab thiab tuaj yeem qhia tsis tseeb, lossis zais, hypertrophy.
• Cov kev hloov pauv ib txwm muaj: Kev rov ua dua tshiab thaum ntxov thiab cov qauv T-wave rau cov tub ntxhais hluas, cov neeg muaj zog lossis cov neeg ua kis las feem ntau raug nyeem ntau dhau li ischaemia.
• Kev txhais lus hauv computer: Cov algorithms feem ntau qhia ntau dhau txog qhov tsis zoo, thiab lo lus luam tawm zoo li "infarct" ntawm daim kab xev tsis yog kev kuaj mob.

Cov kev tshawb pom uas zoo li qub lossis ua rau neeg ntseeg siab tsis tseeb

• Mob myocardial infarction thaum ntxov heev: Cov ECG yuav tsis muaj dab tsi txawv txav hauv thawj ob peb teev; cov kev rov ua dua feem ntau hloov pauv.
• Kab mob plawv ruaj khov: feem ntau tsim cov ECG so ib txwm muaj.
• Kev mob arrhythmia ib ntus: tsis pom tshwj tsis yog tias nws tshwm sim thaum lub sijhawm kaw.
• Mob plawv sab laug uas twb muaj lawm, mob plawv dhia ceev ceev lossis mob plawv qub: tuaj yeem npog cov kev hloov pauv ischemic tshiab.
• Kev mob plawv tom qab lossis thaj chaw cais tawm: tej zaum yuav tsis zoo sawv cev rau ntawm cov qauv coj.
• Cov teebmeem tshuaj: qee cov tshuaj ua rau qeeb qeeb lossis hloov pauv kev coj ua, ua rau cov kev tshawb pom mos muag.

Vim yog ob qho kev qhia ntawm qhov yuam kev, ECG raug nyeem ua ke nrog koj cov tsos mob, kev kuaj mob, cov kev taug qab yav dhau los thiab, yog tias xav tau, kev kuaj ntshav thiab kev thaij duab.

Kev Pheej Hmoo thiab Kev Nyab Xeeb

Kev so ECG 12-lead

Kev kaw cov ECG so yog ib qho txheej txheem uas muaj kev pheej hmoo tsawg heev. Tsis muaj hluav taws xob, tsis muaj koob thiab tsis muaj hluav taws xob xa mus rau lub cev. Cov teeb meem tiag tiag yog qhov khaus me me ntawm daim tawv nqaij lossis liab los ntawm cov ntaub nplaum, tsis xis nyob yog tias cov plaub hau hauv siab raug txiav, thiab poob qhov kev ceev ntiag tug luv luv thaum tso lub electrode.

Kev saib xyuas kev mob nkeeg (Holter, patch, event monitor)

Cov teeb meem tseem ceeb yog khaus tawv nqaij nyob rau hauv qab cov electrodes uas siv ntev, khaus, thiab txwv tsis pub da dej thaum lub cuab yeej txuas nrog. Ua raws li cov lus qhia ntawm lub cuab yeej rau lub cuab yeej tshwj xeeb.

Kev Nyuaj Siab (kev tawm dag zog) ECG

Ib qho ECG uas muaj kev ntxhov siab muaj qhov sib txawv thiab muaj kev pheej hmoo siab dua li ECG thaum so, vim tias lub plawv raug ntxhov siab. Cov kev pheej hmoo uas tsis tshua muaj tab sis paub zoo suav nrog mob hauv siab, arrhythmia, ntshav siab hloov pauv, tsaus muag thiab, tsis tshua muaj, cov teeb meem plawv loj. Nws ua tiav nrog kev saib xyuas thiab cov chaw cawm siav, thiab nws tsis tsim nyog rau txhua tus, piv txwv li, thaum muaj kev xav tias muaj mob plawv lossis qee yam kab mob valve loj. Tus kws kho mob thov kom nws ntsuas cov yam no ib tus zuj zus.

Cov lus qhia txog kev nyab xeeb rau ib hom ECG yuav tsum tsis txhob siv rau tag nrho tsev neeg ntawm kev kuaj.

Cov xwm txheej tshwj xeeb

Cev xeeb tub

Kev dhia ceev thiab ua tsis taus pa feem ntau tshwm sim thaum cev xeeb tub thiab ECG feem ntau yog thawj qhov kev kuaj. Nws muaj kev nyab xeeb nrog rau kev siv hluav taws xob. Kev txhais lus yuav tsum suav nrog kev hloov pauv ntsig txog kev cev xeeb tub hauv tus nqi, axis thiab T nthwv dej. Cov tsos mob tshiab tseem ceeb thaum cev xeeb tub lossis lub sijhawm tom qab yug menyuam tsim nyog tau txais kev ntsuam xyuas sai dua li kev ntseeg siab.

Cov menyuam yaus thiab tub ntxhais hluas

Yuav tsum nyeem cov ECGs rau menyuam yaus nrog rau cov qauv hnub nyoog. Yog tias cov neeg laus pom tias qhov tshwm sim tsis zoo, tej zaum yuav yog qhov ib txwm muaj rau menyuam yaus. Kev tsaus muag thaum ua si, kev tsaus muag vim ntshai lossis suab nrov, lossis keeb kwm tsev neeg ntawm kev tuag tam sim ntawd ntawm ib tug txheeb ze hluas yog cov laj thawj tshwj xeeb uas yuav tsum nrhiav kev pab los ntawm kws kho mob plawv rau menyuam yaus.

Cov laus

Cov tsos mob ntawm lub plawv dhia tsis xwm yeem thiab kev hloov pauv ntawm lub plawv dhia tsis xwm yeem feem ntau yuav tshwm sim thaum muaj hnub nyoog ntau. Cov tsos mob ntawm ischemia tej zaum yuav tsis zoo li qub, qaug zog, tsis meej pem lossis ua tsis taus pa dua li mob hauv siab ib txwm muaj.

Cov neeg mob ntshav qab zib uas tab tom kho mob kom txo cov piam thaj

Tsis tas yuav tsum yoo mov rau kev kuaj ECG thaum so, yog li noj mov thiab tshuaj kho mob ntshav qab zib txuas ntxiv mus raws li tau sau tseg. Kev mob ntshav qab zib uas ntsiag to lossis tsis zoo li qub feem ntau tshwm sim ntau dua, uas ua rau qhov kev kuaj mob qis dua.

Kab mob raum ntev thiab kev ntxuav ntshav

Kev cuam tshuam ntawm cov potassium thiab calcium hloov ECG ntau heev, qee zaum txaus ntshai, thiab qhov kev taug qab yuav hloov pauv ua ntej thiab tom qab kev ntxuav ntshav. Cov kev hloov pauv ECG ntawm no raug txhais ua ke nrog cov tshuaj lom neeg hauv cov ntshav.

Lub plawv tsis ua haujlwm

Daim ECG pab txheeb xyuas cov teeb meem ntawm lub plawv dhia, kev ncua sij hawm ntawm kev ua pa thiab kev raug mob yav dhau los, thiab qhia txog kev txiav txim siab txog kev kho mob nrog cov cuab yeej. Nws tsis ntsuas qhov feem pua ​​​​​​ntawm kev ejection, echocardiography ua tau.

Ncaws pob

Cov neeg ncaws pob uas tau kawm tiav feem ntau qhia tias lawv lub plawv so qeeb qeeb, rov ua dua tshiab thaum ntxov thiab muaj hluav taws xob ntau ntxiv uas yog vim li cas. Kev paub qhov txawv ntawm lub plawv ntawm cov neeg ncaws pob thiab cardiomyopathy xav tau kev txhais lus tshwj xeeb, thiab qee zaum echocardiography lossis kev kuaj ntxiv.

ECG hauv Is Nrias teb

• Kab mob plawv thaum yau: Cov kev tshawb fawb kho mob thiab kev tshawb fawb txog kab mob hauv cov pej xeem South Asian tau tshaj tawm tias muaj kab mob plawv ischaemic ua ntej ntau tus pej xeem Western, yog vim li cas mob hauv siab rau tus neeg muaj hnub nyoog 40 xyoo hauv Is Nrias teb thiaj li raug saib xyuas hnyav dua li tsis quav ntsej los ntawm hnub nyoog xwb.
• Kev pheej hmoo ntawm kev hloov pauv ntawm lub cev thaum BMI qis dua: Cov neeg Esxias Qab Teb muaj mob ntshav qab zib thiab muaj feem yuav mob plawv yog tias lawv lub cev hnyav thiab lub duav qis dua li cov neeg European. Yog lawv lub cev zoo li qub tsis tau txhais hais tias yuav muaj feem yuav mob tsawg.
• Kab mob plawv rheumatic tseem ceeb heev. Rau cov neeg uas muaj keeb kwm mob rheumatic fever thaum yau, ECG yuav qhia tau tias muaj atrial fibrillation lossis lub plawv loj hlob, tab sis tus kab mob valve nws tus kheej raug soj ntsuam los ntawm echocardiography. ECG thiab echo yog sib pab, tsis sib pauv tau.
• Anaemia: Kab mob ntshav tsis txaus hlau yog qhov tshwm sim ntau hauv Is Nrias teb thiab feem ntau ua rau lub plawv dhia ceev thiab qee zaum tsis yog qhov tshwj xeeb ST-T hloov pauv, uas tuaj yeem yuam kev rau ischemia.
• Mob qog noj ntshav yog lwm qhov uas ua rau muaj teeb meem ntawm tus nqi thiab lub plawv dhia uas pom muaj nyob rau ntawm ECGs ib txwm muaj.
• Lub npe: Cov ntawv ceeb toom thiab cov ntawv sau tshuaj hauv Is Nrias teb siv "ECG" yuav luag thoob plaws; "EKG" feem ntau tshwm sim ntawm cov khoom siv xa tuaj. TMT (kev kuaj treadmill) yog cov lus hauv zos rau kev ntxhov siab ECG, thiab "echo test" rau echocardiography, cov no yog kev kuaj mob sib txawv ntawm ECG so.
• Kev Nkag: Cov tshuab ECG ib txoj kab thiab 12-lead muaj ntau yam suav nrog rau theem kev kho mob thawj zaug, thiab cov kev pabcuam tele-ECG xa cov ntaub ntawv rau kev tshaj tawm deb. Yog tias koj nqa ECG luam tawm ntawm cov tsev kho mob, khaws cov qub, kev sib piv nrog cov ntaub ntawv qub yog qhov muaj txiaj ntsig tiag tiag.
• Cov ntaub ntawv: Txhua daim ntawv qhia txog ECG digital, app lossis daim ntawv teev npe online muaj cov ntaub ntawv kev noj qab haus huv tus kheej, uas tau tswj hwm hauv Is Nrias teb raws li Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023. Nug seb koj qhov kev taug qab thiab daim ntawv qhia khaws cia thiab sib qhia li cas.

Tus nqi thiab kev pov hwm hauv Is Nrias teb

Ib qho ECG 12-lead uas so yog ib qho ntawm cov kev kuaj mob plawv uas pheej yig tshaj plaws hauv Is Nrias teb, feem ntau yog ob peb puas rupees hauv feem ntau qhov chaw, thaum kev saib xyuas kev taug kev, kev kuaj kev ntxhov siab thiab echocardiography raug nqi ntau dua. Cov nqi sib txawv thiab hloov pauv raws sijhawm, yog li paub meej tias tus nqi tam sim no nrog lub chaw ua ntej kuaj. Txhua tus nqi uas tau hais hauv online tsuas yog qhia xwb thiab tsis yog ib qho lus hais.

Cov yam uas cuam tshuam rau tus nqi:

• Hom kev kuaj: ECG thaum so piv rau kev ntxhov siab ECG/TMT piv rau Holter lossis kev saib xyuas txuas ntxiv.
• Qhov chaw: tsev kho mob tsoomfwv, chaw kho mob thawj zaug, chaw kuaj mob ib leeg, tsev kho mob tuam txhab lossis kev pabcuam mus ntsib tsev.
• Lub nroog thiab thaj chaw nyob, thiab seb qhov kev xeem puas ua thaum lub sijhawm ua haujlwm ib txwm lossis ua xwm txheej ceev lossis kev pabcuam hmo ntuj.
• Txawm yog tus kws kho mob plawv tshaj tawm lossis sab laj nrog.
• Cov nqi sau ntawv hauv tsev lossis sau ntawv ntawm txaj, thiab lub sijhawm saib xyuas rau kev kawm Holter.
• Txawm yog ECG yog ib feem ntawm pob khoom kuaj mob lossis ua raws li kev tshawb nrhiav ib leeg xwb.

Kev Pov Hwm: ECG uas tau ua thaum lub sijhawm nkag mus rau hauv tsev kho mob lossis kev saib xyuas menyuam feem ntau yuav raug them rov qab ua ib feem ntawm cov nqi tshawb nrhiav. Kev kuaj mob sab nraud thiab kev kuaj mob tiv thaiv ECG feem ntau tsis raug them tshwj tsis yog tias koj daim ntawv pov hwm suav nrog OPD lossis kev pab kuaj mob. Cov phiaj xwm ntawm tsoomfwv xws li Ayushman Bharat PM-JAY npog kev tshawb nrhiav hauv kev kho mob hauv tsev kho mob uas tau ntim rau hauv cov tsev kho mob uas tau teeb tsa. Tshawb xyuas koj cov lus tshwj xeeb ntawm daim ntawv pov hwm, cov kev txwv me me thiab cov kev cai tso cai ua ntej nrog koj tus neeg pov hwm lossis lub rooj pov hwm ntawm tsev kho mob.

Cov lus dab neeg thiab qhov tseeb

Lus nug cov lus nug

Puas siv tau ECG los nrhiav tau cov hlab ntsha uas raug thaiv?

Tsis yog. Lub ECG sau cov hluav taws xob ua haujlwm thiab tsis tuaj yeem qhia cov hlab ntsha hauv lub plawv lossis ntsuas qhov nqaim. Nws yuav qhia tau cov kev hloov pauv uas qhia tias cov leeg nqaij plawv tsis muaj ntshav txaus, tshwj xeeb tshaj yog thaum mob tas li, tab sis kev taug qab ib txwm tsis suav nrog kev thaiv. CT coronary angiography lossis invasive angiography teb cov lus nug ntawd.

Kuv daim ntawv qhia ECG hais tias "kev hloov pauv ST-T uas tsis tshwj xeeb". Kuv puas yuav tsum txhawj?

Qhov no yog ib kab lus uas siv ntau heev uas txhais tau tias kev taug qab tsis yog ib txwm muaj hauv phau ntawv tab sis qhia tias tsis muaj ib qho kev kuaj mob. Ua rau muaj xws li kev sawv ntsug, kev ntxhov siab, ntshav tsis txaus, kev hloov pauv electrolyte, tshuaj thiab kev hloov pauv ib txwm muaj. Nws qhov tseem ceeb nyob ntawm koj cov tsos mob thiab cov yam ntxwv txaus ntshai, yog li tham txog daim ntawv qhia nrog tus kws kho mob uas tau xaj nws.

Qhov txawv ntawm ECG thiab echo test yog dab tsi?

Lub ECG kaw cov teeb liab hluav taws xob los ntawm cov electrodes ntawm daim tawv nqaij thiab ntsuas lub suab nrov, kev sib kis thiab cov qauv ischaemic. Ib qho echocardiogram siv ultrasound los saib qhov loj ntawm lub chamber, kev ua haujlwm ntawm lub valve thiab lub zog ntawm lub twj tso kua mis. Ob qho tib si hloov lwm qhov, thiab lub suab rov qab so kuj tsis pom cov hlab ntsha hauv lub plawv.

Puas mob ECG, thiab puas muaj hluav taws xob?

Kev kuaj ECG thaum so tsis tas siv koob, tsis muaj hluav taws xob thiab tsis muaj hluav taws xob nkag mus rau hauv lub cev. Cov neeg feem coob tsuas hnov ​​​​​​cov gel txias lossis cov ntaub nplaum xwb. Cov tawv nqaij liab me me lossis khaus tuaj yeem tshwm sim tom qab tshem cov ntaub nplaum, thiab qee cov plaub hau hauv siab yuav tsum tau txiav kom zoo.

Vim li cas kuv tus kws kho mob thiaj li tau xaj Holter monitor tom qab ECG ib txwm muaj?

Vim tias ECG ib txwm kaw tsuas yog ob peb vib nas this xwb. Yog tias koj lub plawv dhia ceev, kiv taub hau lossis lub plawv dhia tsis xwm yeem, Holter lossis daim ntawv ntsuas kev kaw suab ntau tshaj ib hnub lossis ntau dua yuav pom tau lub plawv dhia tsis xwm yeem thaum koj ua tej yam niaj hnub.

Kev ntxhov siab lossis haus tshuaj yej puas tuaj yeem hloov kuv lub ECG?

Yog, rau qee qhov. Kev ntxhov siab, mob, caffeine, haus luam yeeb, kub taub hau thiab kev tawm dag zog tsis ntev los no tuaj yeem ua rau lub plawv dhia ceev thiab qee zaum ua rau muaj kev hloov pauv me me ntawm ST-T. So ntsiag to ob peb feeb ua ntej kaw suab pab tau. Cov kev cuam tshuam no cuam tshuam rau kev txhais lus tab sis tsis ua rau muaj kab mob plawv.

Yuav tsum tau ua ECG ntau zaus npaum li cas?

Tsis muaj ib lub sijhawm teem tseg xwb. Qhov zaus siv nyob ntawm koj cov tsos mob, kev kuaj mob, cov tshuaj thiab qhov laj thawj ntawm kev saib xyuas. Ib tug neeg uas muaj mob plawv dhia tsis xwm yeem lossis noj tshuaj uas cuam tshuam rau QT yuav xav tau kev kuaj mob ntau zaus; ib tug neeg uas tsis muaj tsos mob thiab tsis muaj yam txaus ntshai yuav tsis xav tau dab tsi li. Koj tus kws kho mob txiav txim siab.

Puas muaj kev nyab xeeb rau kev kuaj ECG thaum cev xeeb tub?

Siv lub ECG so thaum cev xeeb tub thaum xav tau thiab tsis tas siv hluav taws xob. Kev cev xeeb tub nws tus kheej hloov pauv lub plawv dhia thiab qee cov qauv nthwv dej, yog li qhov kev taug qab raug txhais raws li kev cia siab tshwj xeeb rau cev xeeb tub. Qhia rau tus kws kho mob yog tias pw tiaj tiaj tsis xis nyob, vim tias lwm txoj hauv kev tuaj yeem siv tau.

Lub tshuab ECG tau luam tawm ib qho kev kuaj mob uas txhawj xeeb rau ntawm daim kab xev. Qhov ntawd puas yog daim ntawv qhia zaum kawg?

Tsis yog. Kev txhais lus tsis siv neeg yog tsim los ntawm software thiab feem ntau hu xov tooj ntau dhau, tshwj xeeb tshaj yog rau cov neeg mob hluas, kis las lossis ntxhov siab. Daim ntawv qhia tseem ceeb yog daim uas tau tshuaj xyuas thiab kos npe los ntawm tus kws kho mob, nyeem ua ke nrog koj cov tsos mob thiab txhua yam kev kuaj mob yav dhau los.

Qhov chaw

• Lub Koom Haum American Heart Association / Lub Tsev Kawm Ntawv Qib Siab American College of Cardiology / Lub Koom Haum Heart Rhythm, cov lus qhia rau kev ua kom raug thiab kev txhais lus ntawm electrocardiogram (cov lus tshaj tawm ntau ntu).
• European Society of Cardiology, cov lus qhia txog cov kab mob plawv loj heev, supraventricular tachycardia, atrial fibrillation thiab syncope (saib cov ntawv tshaj tawm tam sim no rau ECG-raws li kev kuaj mob).
• Lub Koom Haum Cardiological Society ntawm Is Nrias teb thiab Indian College of Cardiology, cov lus hais txog txoj haujlwm thiab cov ntaub ntawv qhia txog kab mob plawv hauv cov neeg mob Is Nrias teb.
• Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb thiab qhov kev pab cuam Global Burden of Disease, cov ntaub ntawv txog kev mob plawv rau Is Nrias teb.
• Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023 (Tsoomfwv Is Nrias teb), kev tswj hwm cov ntaub ntawv kev noj qab haus huv tus kheej thiab cov ntawv qhia digital.