ECG (Electrocardiogram): Kodi Kutsata Mtima Kumasonyeza Chiyani? Ndi Zimene Sizingatheke

Njira zazikulu

• Mwachangu komanso chosawononga: ECG yokhazikika yokhala ndi ma lead 12 imalembedwa kwa masekondi angapo ndipo siimayambitsa ululu.
• Ndi chithunzithunzi: ECG yachibadwa imafotokoza momwe mtima umagwirira ntchito pa masekondi amenewo okha.
• Sichijambula mitsempha yamagazi kapena ma valve: ECG imasonyeza zizindikiro zamagetsi, osati kuyenda kwa magazi, kutsekeka kapena kapangidwe ka valavu.
• Kutanthauzira kumafuna mfundo zofunika: Kutsata komweko kungakhale kwachibadwa mwa munthu mmodzi ndi kofunikira mwa wina.
• Zizindikiro zosalekeza zimaposa zotsatira zabwinobwino: Ngati kupweteka pachifuwa kapena kugunda kwa mtima kukupitirira, bwererani kwa dokotala wanu.

Pang'onopang'ono

Amadziwikanso monga

• ECG, EKG (kalembedwe kochokera ku Chijeremani, elektrokardiogramm)
• Electrocardiogram, electrocardiography
• "Kuyesa kwa ECG", "kutsata mtima", "kuyesa kwa chithunzi cha mtima", "ECG yotsogola 12"
• Chihindi/chiyankhulo chogwiritsa ntchito m'zipatala zaku India: "dil ka ECG", "dil ki jaanch wali machine"

Kodi ECG ndi chiyani

Kugunda kulikonse kwa mtima kumayamba ngati mphamvu yamagetsi mu sinus node, kufalikira kudzera mu atria, kudutsa atrioventricular node ndikulowa mu ventricles. ECG imatenga kusintha kwa magetsi kumeneku pamwamba pa khungu ndikusindikiza ngati mafunde: P wave (atrial activation), QRS complex (ventricular activation) ndi T wave (ventricular recovery). Ma electrode khumi amapanga "mawonekedwe" khumi ndi awiri amagetsi osiyanasiyana a mtima.

Makina a ECG ndi chipangizo chomvera. Sichimalowetsa mphamvu m'thupi.

Chifukwa chiyani ECG imachitidwa

• Kupweteka pachifuwa kapena kupanikizika pachifuwa: kuyang'ana njira za ischemia yoopsa kapena infarction, ndikuwongolera zisankho za chithandizo mwachangu.
• Kugunda kwa mtima, kuzimitsidwa kapena kutsala pang'ono kukomoka: kulemba kayendedwe ka thupi ngati chizindikirocho chilipo, ndikuyang'ana zolakwika zomwe zimayambitsa kufalikira kwa magazi kapena kubwereranso kwa magazi.
• Kupuma movutikira: monga gawo limodzi la kuwunika kwakukulu kwa mtima ndi kupuma.
• Matenda a mtima odziwika: kutsatiridwa kwa arrhythmia, infarction ya myocardial yapitayi, kulephera kwa mtima kapena cardiomyopathy.
• Kuyang'ana kwa pacemaker kapena ICD: pamodzi ndi mafunso ovomerezeka pa chipangizo.
• Kuyang'anira mankhwala ndi electrolyte: Mankhwala ena amakhudza nthawi ya QT; kusokonezeka kwa potaziyamu ndi calcium kumasintha mawonekedwe a mafunde.
• Musanachite opaleshoni kapena musanayambe chithandizo china, komwe mkhalidwe wachipatala umafuna.

Ndani ayenera kuchita mayesowa?

• Aliyense amene ali ndi ululu waukulu pachifuwa, kupanikizika, kapena ululu womwe umafalikira mpaka nsagwada, khosi kapena mkonoIzi zimafuna ECG yadzidzidzi, osati nthawi yokonzekera.
• Anthu omwe ali ndi vuto la mtima, kukomoka mosadziwa, kapena kugunda kwa mtima kosakhazikika.
• Anthu omwe ali ndi matenda odziwika bwino a mitsempha ya mtima, kulephera kwa mtima, matenda a valve kapena matenda a mtima a rheumatic monga momwe adalangizidwira ndi dokotala wawo wa mtima.
• Anthu omwe ali ndi matenda oopsa, matenda a shuga kapena matenda a impso osatha pamene dokotala akufufuza momwe mtima ulili.
• Anthu omwe amamwa mankhwala odziwika kuti amakhudza kayendedwe ka mtima kapena nthawi ya QT, pamene dokotala akulangiza kuti aziwunika.
• Othamanga ndi osewera opikisana komwe njira yowunikira imagwiritsidwa ntchito, komanso anthu omwe ali ndi mbiri ya banja lawo ya imfa yadzidzidzi ya mtima kapena matenda a mtima obadwa nawo.
• Anthu akuyesedwa asanachite opaleshoni yayikulu, kutengera zaka, zizindikiro ndi matenda ena m'malo motengera nthawi zonse kwa aliyense.

Kuyeza ECG mwa munthu amene alibe zizindikiro kapena zinthu zoopsa nthawi zambiri sikuwonjezera zambiri ndipo kungapangitse kuti pakhale zotsatirapo zina zomwe zingamuthandize kuyezetsa matenda ena. Kudziwa ngati ECG ndi yothandiza kwa inu ndi lingaliro lachipatala.

Zimene ECG singathe kuzizindikira kapena kuzichotsa

Iyi ndi gawo losamvetsetseka bwino kwambiri la mayeso.

• Sizingathetse matenda a mitsempha ya mtima. ECG yopumula nthawi zambiri imakhala yachibadwa mwa anthu omwe ali ndi kuchepa kwakukulu kwa mitsempha ya mtima. ECG siiona konse mitsempha ya mtima.
• Sizingathetse vuto la mtima lokha. Kumayambiriro kwa infarction, ECG ingawoneke ngati yabwinobwino kapena yofanana ndi yabwinobwino. Kuzindikira matendawa nthawi zambiri kumafuna ma ECG otsatizana komanso troponin ya mtima ndi kuwunika kwachipatala.
• Sizingatheke kugonjetsa arrhythmia yokhazikika. Ngati kamvekedwe kachilendo kameneka sikakuchitika m'masekondi ochepa amenewo, kutsata kumeneku kudzawoneka bwino. Kuyang'anira mozungulira ndikofunikira.
• Sichiyesa ntchito ya pampu. Mafunso okhudza kutuluka kwa magazi, kuchepa kapena kutayikira kwa valavu, madzi a m'mimba ndi magazi oundana ndi mafunso okhudza echocardiography, osati mafunso okhudza ECG.
• Sichiyesa kuthamanga kwa magazi, cholesterol kapena kuchuluka kwa kutsekeka kwa magazi.
• Sizingazindikire zadzidzidzi za m'mapapo kapena aorta. Kutsekeka kwa mtsempha wa m'mapapo ndi kudulidwa kwa mtsempha wamagazi kungayambitse kusintha kwa ECG kosadziwika bwino kapena kusakhalapo; kujambula zithunzi ndikofunikira.
• "ECG yachibadwa" zikutanthauza kuti palibe vuto lililonse lomwe linapezeka mu cholembedwacho. Sizili ngati "matenda a mtima osaphatikizidwa". Ngati zizindikiro zanu zikupitirira kapena zikubwerera ngakhale ECG yachitika bwino, pitani kwa dokotala wanu.

Mayeso ofanana koma osiyana

Mayesowa amayankha mafunso osiyanasiyana. Kumene kumabwera poyamba kumadalira momwe wodwalayo amawonekera: kupweteka kwambiri pachifuwa mwadzidzidzi kumabweretsa ECG ndi troponin nthawi yomweyo; kupuma movutikira nthawi zina kumabweretsa kuyang'aniridwa; kupuma movutikira komanso kung'ung'udza kumabweretsa echocardiography; kupweteka pachifuwa komwe kumachitika nthawi zambiri kwa wodwala wodwala wodwala kungayambitse kuyezetsa kupsinjika maganizo kapena CT coronary angiography kutengera chiopsezo ndi kupezeka kwa wodwalayo.

Momwe mungakonzekerere

Mayunitsi ambiri safuna kukonzekera kwapadera kwa ECG yopumula. Ma protocol amasiyana pakati pa zipatala ndi malo oyezera matenda, ndipo malangizo operekedwa ndi chipinda chanu ndi omwe amaperekedwa patsogolo kuposa chilichonse cholembedwa pano.

• Palibe kusala kudya ndikofunikira pa ECG yopumula yokhazikika.
• zovala: Valani chinthu chomwe chimalola kuti chifuwa, manja ndi akakolo zilowe. Zovala za zidutswa ziwiri n'zosavuta kuposa chovala cha chidutswa chimodzi.
• Khungu: Pewani mafuta, mafuta odzola kapena ufa wa talcum pachifuwa tsiku limenelo, chifukwa izi zimafooketsa kukhudzana kwa ma electrode. Amuna ena angafunike kudula tsitsi la pachifuwa ndi tinthu tating'onoting'ono.
• Mankhwala: Bweretsani mndandanda wanu wa mankhwala omwe mukugwiritsa ntchito panopa. Musayimitse, kulumpha kapena kusintha mankhwala aliwonse omwe mwalandira musanachite ECG pokhapokha ngati dokotala amene mwalandirayo wakuuzani.
• Kuchita khama kwambiri ndi zinthu zolimbikitsa thupi: Kuchita masewera olimbitsa thupi mwamphamvu, kumwa caffeine wambiri, fodya kapena mowa nthawi yochepa mayeso asanachitike kungakweze kugunda kwa mtima ndikupangitsa kuti kutanthauzira kukhale kovuta. Pumulani kwa mphindi zochepa musanayambe kujambula.
• Uzani antchito ngati muli ndi pacemaker kapena ICD, vuto la khungu kapena vuto la zomatira, zomatira pachifuwa, kapena ngati mukumva kupweteka.

Ngati muli ndi pakati

ECG yopumula imagwiritsidwa ntchito pa mimba ngati yasonyezedwa kuchipatala. Palibe kuwala kwa dzuwa. Nthawi zambiri kugunda kwa mtima kumakhala kwakukulu pa mimba ndipo kusintha kwina kwa axis ndi repolarisation kumachitika, kotero kutsata kumeneku kumawerengedwa motsutsana ndi malamulo a mimba. Kugona chagada kungakhale kovuta pa mimba yotsatira, uzani katswiri, chifukwa malo opendekeka angagwiritsidwe ntchito.

ana

Ma ECG a ana amagwiritsa ntchito ma electrode ang'onoang'ono, ndipo chofunika kwambiri, kutanthauzira malinga ndi zaka. Kugunda kwa mtima, nthawi ndi mafunde zomwe zimakhala zachilendo mwa mwana wakhanda sizingakhale zachilendo kwa munthu wamkulu. ECG ya ana iyenera kunenedwa motsutsana ndi malamulo a ana.

Achikulire achikulire

Kusintha pang'ono kwa kayendedwe ka magazi ndi zinthu zina zosafunikira kwenikweni zimakhala zofala ndi ukalamba ndipo sizimangochitika zokha. Kuyerekeza ndi ECG yoyambirira nthawi zambiri kumakhala kothandiza kwambiri kuposa kufufuza kokha.

Anthu omwe ali ndi matenda a shuga, CKD kapena kulephera kwa mtima

Palibe choletsa chamadzimadzi kapena kusala kudya chomwe chimagwiritsidwa ntchito pa ECG yopuma, kotero malangizo a magulu awa sasintha. Zizindikiro za ischemia zitha kukhala zosamveka bwino kapena zosazolowereka kwa anthu omwe akhala ndi matenda a shuga kwa nthawi yayitali, kotero ECG ikhoza kupemphedwa kuti igwiritsidwe ntchito pa zizindikiro zosamveka bwino monga kutopa kosazolowereka kapena kusowa mpweya. Mu CKD ndi kulephera kwa mtima, potaziyamu ndi kusintha kwina kwa ma electrolyte kumatha kusintha ECG popanda kudalira mtima wokha.

Chothandizira pacemaker kapena chipangizo choyikidwa

ECG ikhoza kujambulidwa mosamala ndi pacemaker kapena ICD, ndipo imathandiza kusonyeza ngati chipangizocho chikuyenda bwino. Sichilowa m'malo mwa mafunso ovomerezeka a chipangizocho ndi gulu la akatswiri a mtima.

Zomwe zimachitika pa ECG

• Kuyika: Mumagona pa sofa. Chifuwa, manja ndi akakolo zimaonekera ngati pakufunika kutero; nsalu kapena diresi imagwiritsidwa ntchito podzisungira, ndipo mungapemphe womusamalira wamkazi.
• Kuyika kwa Electrode: Ma electrode khumi amamangiriridwa ndi gel kapena ma glue pad, asanu ndi limodzi pachifuwa, limodzi pa nthambi iliyonse. Kuyika bwino ndikofunikira, chifukwa ma lead olakwika amatulutsa zizindikiro zosokeretsa.
• Kujambula: Mumapemphedwa kuti mugone pansi, mupume bwino komanso musalankhule kwa masekondi angapo. Kusuntha, kunjenjemera ndi kulankhula zimapanga zinthu zakale.
• Pambuyo pake: Ma electrode amachotsedwa. Palibe nthawi yochira ndipo mutha kubwerera kuntchito yanu yachizolowezi nthawi yomweyo. Gel ikhoza kupukutidwa; khungu likhoza kukhala la pinki kwakanthawi komwe ma pads adalumikizidwa.

Kodi njirayi imatenga nthawi yayitali bwanji

• Kutsata kokha: nthawi zambiri kujambula kumatenga pafupifupi masekondi 10.
• M'nyumba: nthawi zambiri mphindi 5-10 kuphatikizapo malo ndi malo ogwiritsira ntchito ma elekitirodi.
• Ulendo wonse: nthawi zambiri mphindi 15-20 ndi kulembetsa ndi kudikira, ngakhale izi zimadalira kwathunthu chipangizocho.
• Lipoti: Pakagwa mwadzidzidzi, ECG imawerengedwa mkati mwa mphindi zochepa pambali pa bedi. Pa mayeso akunja kwa odwala, nthawi yopereka malipoti imadalira momwe chipangizocho chikuyendera, funsani ku phwando mukatenga.

Kumvetsetsa lipoti lanu la ECG

Lipoti la ECG nthawi zambiri limakhala ndi magawo atatu: manambala oyezedwa, kutanthauzira kopangidwa ndi kompyuta, ndi kuwerenga kwa dokotala mwiniwake. Kuwerenga kwa dokotala ndiko komwe kumafunikira. Kutanthauzira kodziyimira pawokha nthawi zambiri kumakhala kolakwika, komanso makamaka zolakwika zochulukirapo.

Malamulo omwe mungawone:

• Kuyenda kwa sinus kwabwinobwino: chikokacho chikuyamba pamalo abwinobwino ndikuyenda bwino.
• Sinus tachycardia / sinus bradycardia: Kuthamanga kwabwinobwino komwe kumakhala kofulumira kapena kochedwa kuposa masiku onse. Zonsezi zili ndi zifukwa zambiri zosalakwa, nkhawa, malungo, kupweteka, kusowa madzi m'thupi, kuchepa kwa magazi m'thupi, matenda a chithokomiro, kuchuluka kwa mphamvu kapena mankhwala.
• Kusokonezeka kwa mtima: Kusinthasintha kwa kayendedwe ka atria, komwe ndikofunikira chifukwa cha chiopsezo cha sitiroko komanso chifukwa nthawi zambiri kumafuna chithandizo chapadera.
• Kugunda kwa ectopic / kugunda kwa msanga: Kugunda kowonjezera. Nthawi zambiri kumakhala kofatsa, koma kawirikawiri ectopy kapena ectopy yokhala ndi zizindikiro imafufuzidwanso.
• Chipika cha AV cha digiri yoyamba, chipika cha nthambi ya kumanja, RBBB yosakwanira: machitidwe oyendetsera omwe angakhale osiyana mwa anthu ena ndi ofunika mwa ena.
• Chipika cha nthambi cha kumanzere, kukwera kwatsopano kwa ST kapena kutsika, kusintha kwa T-wave, mafunde a Q: njira zomwe zimafuna kulumikizana mwachangu kwachipatala ndikuyerekeza ndi ECG iliyonse yoyambirira.
• Hypertrophy ya ventricle yakumanzere "ndi njira zamagetsi": chizindikiro chamagetsi cha minofu yokhuthala, osati muyeso. Echocardiography imayesa izi moyenera.
• QT yayitali kapena yaifupi: zokhudzana ndi chiopsezo cha arrhythmia ndi mankhwala ena. Kambiranani ndi dokotala, ndipo musasiye kumwa mankhwala nokha.
• "Zosintha za ST-T zosalunjika": Mawu ofala kwambiri omwe amatanthauza kuti kutsata matendawa sikwabwinobwino koma sikukutanthauza matenda amodzi okha. Paokha si chinthu chodetsa nkhawa; mwa munthu amene ali ndi zizindikiro, kumalimbikitsa kuwunika kwina.

Mwadala, palibe nthawi zowerengera za manambala zomwe zalembedwa patsamba lino. Nthawi zodziwika bwino za kugunda kwa mtima komanso nthawi za PR, QRS ndi QT zimadalira zaka, jenda, kugunda kwa mtima, momwe thupi limakhalira, mankhwala ndi njira yoyezera yomwe imagwiritsidwa ntchito, ndipo zimagwiritsidwa ntchito ndi dokotala wopereka malipoti. Nambala imodzi kunja kwa mndandanda wa mabuku si matenda. Zotsatira zimasiyana malinga ndi matenda, ndipo ECG yanu iyenera kutanthauziridwa malinga ndi momwe dokotalayo adaifunira.

Pamene zotsatira za ECG zingakhale zosokeretsa

Zotsatira zomwe zingawoneke zachilendo

• Kutayika kwa mtolo kapena kusinthidwa kwa nthambi: akhoza kutsanzira infarction, axis deviation kapena rhythm abnormality.
• Kuyenda, kunjenjemera, kunjenjemera kapena kulankhula: Zinthu zakale zimatha kutsanzira arrhythmia. Kugwedezeka kwa Parkinsonian ndi kusokonezeka kwa magetsi ndizomwe zimayambitsa vutoli.
• Nkhawa, ululu, malungo, kuchita masewera olimbitsa thupi kapena zinthu zina zotsitsimula thupi zomwe zachitika posachedwapa: kukweza chiŵerengero ndipo kungayambitse kusintha kwa ST-T.
• Kukhazikika kwa thupi, minofu ya m'mawere, emphysema kapena kukula kwa thupi: kusintha kukula kwa chizindikiro ndipo kungasonyeze molakwika, kapena kubisa, hypertrophy.
• Mitundu yachizolowezi: Kubwerera m'mbuyo msanga ndi machitidwe a T-wave a achinyamata mwa anthu achichepere, olimba thupi kapena othamanga nthawi zambiri amawerengedwa mopitirira muyeso ngati ischemia.
• Kutanthauzira kwa kompyuta: Ma algorithms nthawi zambiri amanena mopitirira muyeso za vuto, ndipo mawu osindikizidwa ngati "infarct" pamzerewu si matenda.

Zomwe zapezeka zitha kuwoneka zachilendo kapena zolimbikitsa molakwika

• Kuyamba kwa matenda a mtima: ECG siingakhale yodabwitsa m'maola oyamba; kubwerezabwereza kwa zizindikiro nthawi zambiri kumasintha.
• Matenda a mtima okhazikika: nthawi zambiri amapanga ECG yopumula bwino.
• Kusakhazikika kwa mtima (arrhythmia): zosaoneka pokhapokha ngati zitachitika panthawi yojambulira.
• Chipolopolo cha nthambi ya kumanzere chomwe chilipo kale, kamvekedwe ka kayendedwe ka thupi kapena kugwedezeka kwa mtima: akhoza kubisa kusintha kwatsopano kwa ischemic.
• Kugwa kwa malo akutali kapena opatulidwa: akhoza kuimiridwa molakwika pa ma lead wamba.
• Zotsatira zamankhwala: Mankhwala ena amachepetsa liwiro kapena kusintha kayendedwe ka mpweya, zomwe zimapangitsa kuti zotsatira zake zisakhale zofewa.

Chifukwa cha zolakwika zonse ziwiri, ECG imawerengedwa pamodzi ndi zizindikiro zanu, mayeso, zotsatira zomwe mudapeza kale, komanso, ngati pakufunika, mayeso a magazi ndi zithunzi.

Zoopsa ndi chitetezo

ECG yopumula yokhala ndi lead 12

Kulemba ECG yopumula ndi njira yochepetsera chiopsezo. Palibe kuwala kwa dzuwa, singano, kapena magetsi omwe amaperekedwa m'thupi. Mavuto enieni ndi kuyabwa pang'ono pakhungu kapena kufiira chifukwa cha zomatira, kusasangalala ngati tsitsi la pachifuwa ladulidwa, komanso kutayika kwa chinsinsi kwakanthawi panthawi yoyika ma electrode.

Kuwunika kwa ambulatory (Holter, patch, event monitor)

Mavuto akuluakulu ndi kuyabwa pakhungu chifukwa cha ma electrode omwe akhala akutha nthawi yayitali, kuyabwa, komanso zoletsa kusamba pamene chipangizocho chili cholumikizidwa. Tsatirani malangizo a chipangizocho pa chipangizocho.

Kupsinjika maganizo (kuchita masewera olimbitsa thupi) ECG

ECG yopsinjika imakhala ndi chiopsezo chosiyana komanso chachikulu kuposa ECG yopumula, chifukwa mtima umapanikizika mwadala. Zoopsa zomwe sizimadziwika koma zomwe zimazindikirika zimaphatikizapo kupweteka pachifuwa, kusakhazikika kwa mtima, kusintha kwakukulu kwa kuthamanga kwa magazi, kukomoka, komanso, nthawi zina, zochitika zazikulu zamtima. Imachitika ndi malo oyang'aniridwa ndi othandizira othandizira, ndipo sikoyenera kwa aliyense, mwachitsanzo, panthawi yomwe akuganiziridwa kuti ali ndi matenda a mtima kapena matenda ena oopsa a valve. Dokotala amene akupempha izi amaganizira zinthu izi payekhapayekha.

Malamulo a chitetezo cha mtundu umodzi wa ECG sayenera kugwiritsidwa ntchito pa gulu lonse la mayeso.

Zinthu zapadera

Pregnancy

Kugunda kwa mtima ndi kupuma movutikira n’kofala kwambiri pa nthawi ya mimba ndipo ECG nthawi zambiri ndiyo mayeso oyamba. Ndikotetezeka pankhani ya kuwala kwa dzuwa. Kutanthauzira kuyenera kuwerengera kusintha kwa mafunde a T okhudzana ndi mimba. Zizindikiro zatsopano zofunika pa nthawi ya mimba kapena nthawi yobereka ziyenera kufufuzidwa mwachangu m'malo motsimikiziridwa.

Ana ndi achinyamata

Ma ECG a ana ayenera kuwerengedwa motsatira miyezo ya zaka. Kupeza komwe kumaonedwa kuti ndi kosazolowereka malinga ndi miyezo ya akuluakulu kungakhale kwachibadwa kwa mwana. Kukomoka panthawi yochita masewera olimbitsa thupi, kukomoka chifukwa cha mantha kapena phokoso, kapena mbiri ya banja ya imfa yadzidzidzi mwa wachibale wachinyamata ndi zifukwa zenizeni zofunsira thandizo kwa dokotala wa mtima wa ana.

Achikulire achikulire

Matenda a mtima otchedwa Atrial fibrillation ndi conduction disorders zimafala kwambiri ndi ukalamba. Zizindikiro za ischemia zitha kukhala zachilendo, kutopa, kusokonezeka kapena kupuma movutikira m'malo mopweteka pachifuwa.

Anthu omwe ali ndi matenda a shuga akuyamba kulandira chithandizo chochepetsa shuga m'magazi

Palibe kusala kudya kofunikira pa ECG yopuma, kotero chakudya ndi mankhwala a matenda ashuga amapitirira monga momwe adalangizidwira. Kusakhazikika kwa magazi m'thupi kapena kosazolowereka kumachitika kawirikawiri mu matenda a shuga omwe akhalapo kwa nthawi yayitali, zomwe zimachepetsa nthawi yoyezetsa.

Matenda a impso osatha komanso dialysis

Kusokonezeka kwa potaziyamu ndi calcium kumasintha kwambiri ECG, nthawi zina moopsa, ndipo kufufuza kungasinthe nthawi isanayambe komanso itatha dialysis. Kusintha kwa ECG apa kumatanthauziridwa pamodzi ndi kapangidwe ka magazi.

Kulephera kwa mtima

ECG imathandiza kuzindikira mavuto a rhythm, kuchedwa kwa conduction ndi infarction isanachitike, komanso imaphunzitsa zisankho zokhudzana ndi chithandizo cha chipangizocho. Sichiyesa gawo la ejection, echocardiography imatero.

Othamanga

Ochita masewera olimbitsa thupi ophunzitsidwa nthawi zambiri amawonetsa kupuma pang'onopang'ono, kubwereranso msanga kwa magazi komanso kuchuluka kwa mphamvu zamagetsi zomwe zimakhala za thupi. Kusiyanitsa mtima wa wochita masewera ndi matenda a mtima kumafuna kutanthauzira kwa katswiri, ndipo nthawi zina kuyesedwa kwa mtima kapena kuyesedwa kwina.

ECG mu nkhani ya ku India

• Matenda a coronary kwa ana aang'ono: Kafukufuku wa zachipatala ndi za matenda m'madera akumwera kwa Asia nthawi zonse wanena kuti matenda a mtima a ischemic adayamba msanga kuposa m'madera ambiri akumadzulo, ndichifukwa chake kupweteka pachifuwa kwa munthu wazaka 40 ku India kumaonedwa ngati nkhani yaikulu m'malo monyalanyazidwa ndi zaka zokha.
• Chiwopsezo cha kagayidwe kachakudya pa BMI yotsika: Anthu aku South Asia amakhala ndi matenda a shuga komanso chiopsezo chachikulu cha matenda a mtima ndi kugunda kwa mtima m'thupi lawo poyerekeza ndi anthu aku Europe. Kuoneka bwino sikutanthauza kuti ali ndi chiopsezo chochepa.
• Matenda a mtima otchedwa rheumatic adakali ofunika. Kwa anthu omwe ali ndi mbiri ya matenda a nyamakazi ali ana, ECG ingasonyeze kuti pali vuto la atrial fibrillation kapena kukula kwa chipinda, koma matenda a valve okha amawunikidwa pogwiritsa ntchito echocardiography. ECG ndi echo ndi zogwirizana, sizingasinthidwe.
• Anemia: Kusowa kwa magazi m'thupi chifukwa cha kusowa kwa iron kwafala kwambiri ku India ndipo nthawi zambiri kumayambitsa tachycardia ndipo nthawi zina kusintha kwa ST-T komwe sikunatchulidwe kwenikweni, komwe kungasokonezedwe ndi ischemia.
• Matenda a chithokomiro ndi chinthu china chomwe chimayambitsa kusakhazikika kwa liwiro ndi kamvekedwe ka thupi komwe kumapezeka pa ma ECG achizolowezi.
• Kutchula: Malipoti ndi mankhwala aku India amagwiritsa ntchito "ECG" pafupifupi padziko lonse; "EKG" imawonekera makamaka pazida zotumizidwa kunja. TMT (mayeso a treadmill) ndi mawu ofala kwambiri a ECG yopsinjika, ndi "mayeso a echo" a echocardiography, awa ndi mayeso osiyana ndi ECG yopumula.
• Kufikira: Makina a ECG okhala ndi njira imodzi ndi 12-lead amapezeka kwambiri kuphatikizapo pamlingo wa chisamaliro chapadera, ndipo ntchito za tele-ECG zimatumiza njira zotsatirira matenda kuti zipereke malipoti akutali. Ngati muli ndi ECG yosindikizidwa pakati pa zipatala, sungani yoyambirira, kuyerekeza ndi njira yakale yotsatirira matenda ndikofunika kwambiri.
• Data: Lipoti lililonse la digito la ECG, pulogalamu kapena fomu yosungitsira pa intaneti imakhudza deta yaumoyo waumwini, yomwe imayendetsedwa ku India motsatira Digital Personal Data Protection Act, 2023. Funsani momwe kutsata ndi lipoti lanu kumasungidwira ndikugawidwa.

Mtengo ndi inshuwalansi ku India

Kuyeza ECG yokhala ndi lead 12 ndi imodzi mwa mayeso otsika mtengo kwambiri a mtima ku India, nthawi zambiri kumakhala ma rupees ochepa m'malo ambiri, pomwe kuyang'anira matenda a mtima, kuyesa kupsinjika maganizo ndi echocardiography kumawononga ndalama zambiri. Mitengo imasiyana kwambiri ndipo imasintha pakapita nthawi, choncho tsimikizirani ndalama zomwe mumagwiritsa ntchito kuchipatala musanayese. Chiwerengero chilichonse chomwe chatchulidwa pa intaneti ndi chongowonetsa chabe ndipo si mtengo.

Zinthu zomwe zimakhudza mtengo:

• Mtundu wa mayeso: ECG yopumula motsutsana ndi ECG/TMT yopsinjika motsutsana ndi Holter kapena kuyang'anira kwa nthawi yayitali kwa patch.
• Malo: chipatala cha boma, chipatala chachikulu, labotale yodziyimira payokha yoyezera matenda, chipatala chamakampani kapena chithandizo choyendera anthu kunyumba.
• Mzinda ndi dera, komanso ngati mayesowa amachitika nthawi yanthawi zonse kapena ngati chithandizo chadzidzidzi kapena chausiku.
• Kaya malipoti ovomerezeka kapena uphungu wa dokotala wa mtima uli mkati.
• Ndalama zosonkhanitsira kunyumba kapena zojambulira pafupi ndi bedi, komanso nthawi yowunikira maphunziro a Holter.
• Kaya ECG ndi gawo la phukusi lowunikira thanzi kapena lachitidwa ngati kafukufuku wodziyimira pawokha.

Inshuwalansi: ECG yomwe imachitidwa panthawi yolowera kuchipatala kapena yosamalira ana masana nthawi zambiri imabwezeredwa ngati gawo la ndalama zofufuzira. Kuzindikira matenda akunja ndi ma ECG oteteza thanzi nthawi zambiri saphimbidwa pokhapokha ngati ndondomeko yanu ikuphatikiza OPD kapena phindu la cheke chaumoyo. Mapulani aboma monga Ayushman Bharat PM-JAY amaphimba kafukufuku mkati mwa chisamaliro chachipatala chophatikizidwa m'zipatala zokhazikika. Yang'anani mawu enieni a ndondomeko yanu, malire ang'onoang'ono, ndi zofunikira zovomerezeka pasadakhale ndi kampani yanu ya inshuwaransi kapena ofesi ya inshuwaransi ya chipatala.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi ECG imatha kuzindikira mtsempha wotsekeka?

Ayi. ECG imalemba momwe mitsempha ya mtima imagwirira ntchito ndipo singathe kuwonetsa mitsempha ya mtima kapena kuchepa kwa muyeso. Ikhoza kuwonetsa kusintha komwe kumasonyeza kuti minofu ya mtima ilibe magazi okwanira, makamaka panthawi ya ululu wopitirira, koma kufufuza bwino sikuchotsa kutsekeka. CT coronary angiography kapena invasive angiography imayankha funso limenelo.

Lipoti langa la ECG limati "kusintha kwa ST-T komwe sikunatchulidwe kwenikweni". Kodi ndiyenera kuda nkhawa?

Iyi ndi mawu ofala kwambiri omwe amatanthauza kuti kutsata sikwabwinobwino koma kumasonyeza kuti palibe matenda amodzi. Zifukwa zake ndi monga kaimidwe ka thupi, nkhawa, kuchepa kwa magazi m'thupi, kusintha kwa ma electrolyte, mankhwala ndi kusintha kwabwinobwino. Kufunika kwake kumadalira zizindikiro zanu ndi zoopsa zanu, choncho kambiranani ndi dokotala amene analamula lipotilo.

Kodi kusiyana pakati pa ECG ndi mayeso a echo ndi kotani?

ECG imalemba zizindikiro zamagetsi kudzera mu ma electrode a khungu ndikuwunika momwe thupi limagwirira ntchito, momwe limagwirira ntchito, komanso momwe limagwirira ntchito. Echocardiogram imagwiritsa ntchito ultrasound kuti ione kukula kwa chipinda, ntchito ya valavu komanso mphamvu ya kupompa. Palibe chomwe chimalowa m'malo mwa china, ndipo echo yopumula siiwonetsanso mitsempha ya mtima.

Kodi ECG imapweteka, ndipo kodi pali ma radiation aliwonse?

ECG yopumula siigwiritsa ntchito singano, palibe kuwala kwa dzuwa komanso palibe magetsi olowa m'thupi. Anthu ambiri amamva gel yozizira kapena mapepala omatira okha. Kufiira pang'ono pakhungu kapena kukwiya kumatha kuchitika mapadi atachotsedwa, ndipo tsitsi lina pachifuwa lingafunike kudulidwa kuti likhudze bwino.

N’chifukwa chiyani dokotala wanga walamula Holter monitor pambuyo pa ECG yachibadwa?

Chifukwa ECG yokhazikika imalemba masekondi ochepa okha. Ngati kugunda kwa mtima kwanu, chizungulire kapena kugunda kwa mtima kosasinthasintha kumabwera ndikuchoka, kujambula kwa Holter kapena patch monitor kwa tsiku limodzi kapena kuposerapo kungakhale kosavuta kujambula kamvekedwe kachilendo pamene mukuchita zinthu zachizolowezi.

Kodi nkhawa kapena kumwa tiyi kungasinthe ECG yanga?

Inde, mpaka pamlingo winawake. Nkhawa, ululu, caffeine, fodya, malungo ndi kuchita zinthu zomwe zachitika posachedwapa zimatha kukweza kugunda kwa mtima ndipo nthawi zina zimayambitsa kusintha pang'ono kwa ST-T. Kupuma chete kwa mphindi zochepa musanajambule kumathandiza. Izi zimakhudza kutanthauzira koma sizimayambitsa matenda a mtima.

Kodi ECG iyenera kubwerezedwa kangati?

Palibe nthawi imodzi yokha. Kuchuluka kwa matendawa kumadalira zizindikiro zanu, matenda omwe mukupeza, mankhwala ndi chifukwa chowunikira. Munthu amene ali ndi vuto la arrhythmia kapena amene akumwa mankhwala omwe amakhudza QT angafunike kutsatiridwa pafupipafupi; munthu amene alibe zizindikiro komanso amene alibe zoopsa sangafunike kutsatiridwa. Dokotala wanu akusankha.

Kodi ECG ndi yotetezeka panthawi ya mimba?

ECG yopumula imagwiritsidwa ntchito pa nthawi ya mimba ikafunika ndipo siigwiritsa ntchito kuwala kwa dzuwa. Mimba yokha imasintha kugunda kwa mtima ndi mafunde ena, kotero kutsata kumeneku kumatanthauzidwa motsutsana ndi zomwe zimayembekezeredwa pa nthawi ya mimba. Uzani katswiri ngati kugona pansi sikukusangalatsa, chifukwa malo ena angagwiritsidwe ntchito.

Makina a ECG adasindikiza matenda odetsa nkhawa pa mzerewo. Kodi imeneyo ndi lipoti lomaliza?

Ayi. Kutanthauzira kodziyimira pawokha kumapangidwa ndi mapulogalamu ndipo nthawi zambiri kumabweretsa zovuta zambiri, makamaka kwa odwala achichepere, othamanga kapena oda nkhawa. Lipotilo lofunika ndi lomwe limawunikidwanso ndikusainidwa ndi dokotala, werengani pamodzi ndi zizindikiro zanu ndi zizindikiro zilizonse zomwe mudakumana nazo kale.

magwero

• Bungwe la American Heart Association / American College of Cardiology / Heart Rhythm Society, malangizo okhudza kukhazikika ndi kutanthauzira kwa electrocardiogram (mawu asayansi ambiri).
• European Society of Cardiology, malangizo okhudza matenda a mtima oopsa, supraventricular tachycardia, atrial fibrillation ndi syncope (onani makope aposachedwa kuti mudziwe njira zodziwira matenda pogwiritsa ntchito ECG).
• Cardiological Society of India ndi Indian College of Cardiology, mawu a udindo ndi zinthu zophunzitsira za matenda a mtima mwa odwala aku India.
• Bungwe la Zaumoyo Padziko Lonse ndi pulogalamu ya Global Burden of Disease, deta ya matenda a mtima ndi mitsempha ya mtima ku India.
• Lamulo la Chitetezo cha Deta Yaumwini pa Intaneti, 2023 (Boma la India), kusamalira deta yaumoyo wa munthu ndi malipoti a digito.