Electrocardiogram (ECG): Zimene Mayeso Amaonetsa, Zimene Amaphonya, ndi Momwe Mungawerengere Lipoti Lanu

Njira zazikulu

• Mwachangu komanso chosawononga: ECG yokhazikika ya 12-lead imatenga mphindi zochepa ndipo siigwiritsa ntchito ma radiation kapena jakisoni.
• Mphamvu yake ndi zochitika zamagetsi ndi izi: arrhythmias, kutsekeka kwa mtima ndi kusintha kwa gawo la ST la matenda a mtima omwe akusintha.
• Kuyeza ECG yabwinobwino n’kolimbikitsa koma sikutsimikizira izi: Anthu ambiri omwe ali ndi vuto la mtima wochepa kwambiri amakhala ndi vuto la kupuma bwino.
• Ndi chithunzithunzi: Kugunda kwa mtima kosalekeza kungafunike Holter kapena kuyang'anira kayendedwe ka mtima kwa nthawi yayitali.
• Kutanthauzira kumafuna mfundo zofunika: Kutsata komweko kungatanthauze zinthu zosiyana mwa wothamanga wazaka 20 ndi wazaka 65 yemwe ali ndi matenda a shuga.

Pang'onopang'ono

Amadziwikanso monga

• ECG (yogwiritsidwa ntchito ku India ndi ku Britain) ndi EKG (yochokera ku Chijeremani) Kadiyogramu yamagetsi, chofala ku US)
• ECG yokhala ndi lead 12, ECG yopumula
• "Kufufuza mtima", "Chithunzi cha mtima", "kuyesa kwa ECG"
• Kawirikawiri zimasokonezeka pokambirana ndi "echo test" (echocardiogram), yomwe ndi njira yosiyana yoyezera pogwiritsa ntchito ultrasound

Kodi electrocardiogram ndi chiyani?

Mtima umagunda chifukwa cha chizindikiro chamagetsi chomwe chimayambira mu node ya sinoatrial (SA), chimafalikira pa atria, chimayima kwakanthawi pa node ya atrioventricular (AV), kenako chimatsika mu dongosolo la conduction kupita ku ventricles. Mafunde awa amafika pamwamba pa khungu, komwe ma electrode amatha kuwatenga.

ECG yokhazikika yokhala ndi ma lead 12 imagwiritsa ntchito ma electrode khumi omata, asanu ndi limodzi pachifuwa ndi anayi pamiyendo, kuti apange "mawonekedwe" khumi ndi awiri amagetsi osiyanasiyana a mtima. Makinawa amasindikiza chithunzi chokhala ndi zigawo zodziwika bwino:

• P wave: kuyambitsa kwa magetsi kwa atria.
• QRS zovuta: kuyambitsa magetsi kwa ma ventricle.
• T wave: kubwezeretsa magetsi (repolarisation) kwa ma ventricles.
• Kusinthasintha (PR, nthawi ya QRS, QT): nthawi yomwe sitepe iliyonse imatenga, ndipo ndi pomwe kuchedwa kwa conduction ndi zotsatira zina za mankhwala zimawonekera.

ECG imalemba momwe magetsi amagwirira ntchito yokha. Electrocardiogram sijambula minofu ya mtima, ma valve kapena mitsempha yamagazi.

Chifukwa chiyani electrocardiogram imachitidwa

• Kupweteka pachifuwa kapena kusasangalala pachifuwa: kuyang'ana kusintha komwe kukusonyeza kuti pali vuto lalikulu la mtima, makamaka mkati mwa mphindi zochepa kuchokera pamene munthu wafika pamalo adzidzidzi.
• Kugunda kwa mtima, kugunda kwa mtima mofulumira kapena pang'onopang'ono: kuti mufotokoze nyimbo ngati ilipo panthawi yojambula.
• Kulephera kupuma, kuzimitsa kapena kutsala pang'ono kukomoka: kuyang'ana chotchinga cha conduction, mawonekedwe a pre-excitation, QT yayitali kapena umboni wa kupsinjika.
• Matenda a mtima odziwika: kutsatira kayendetsedwe ka kayendedwe ka mphamvu, kamvekedwe kake, ndi kubwereranso kwa mphamvu pakapita nthawi.
• Kuyang'anira mankhwala: mankhwala angapo a mtima, mankhwala ena oletsa matenda amisala, maantibayotiki ena ndi mankhwala ena oletsa emergency amakhudza nthawi ya QT kapena conduction.
• Mavuto a electrolyte ndi impso: Kusokonezeka kwakukulu kwa potaziyamu kapena calcium kungayambitse kusintha kwa magazi, ngakhale kuti ECG si njira yolowera m'malo mwa kuyezetsa magazi.
• Musanachite opaleshoni kapena opaleshoni: pamene ukalamba, zizindikiro kapena matenda a mtima omwe alipo apangitsa kuti zikhale zofunikira.
• Zoyambira musanalandire chithandizo china: mwachitsanzo musanayambe mankhwala omwe amadziwika kuti amawonjezera nthawi ya QT.

Ndani ayenera kuchita mayesowa?

ECG ndi yoyenera ngati dokotala ali ndi funso linalake lokhudza momwe mtima wanu umagwirira ntchito. Izi nthawi zambiri zimaphatikizapo anthu omwe:

• kukhala ndi ululu pachifuwa, kupanikizika, kapena ululu womwe umafika pa nsagwada, kumbuyo kapena mkono, mwachangu
• kukhala ndi mtima wogunda, kugunda kwa mtima kosasinthasintha, kapena kugunda kwa mtima kofulumira/kochedwa
• wakomoka, makamaka panthawi yochita masewera olimbitsa thupi, kapena ali ndi mbiri ya banja la wachibale wachinyamata yemwe wamwalira mwadzidzidzi chifukwa cha matenda a mtima
• kukhala ndi kupuma movutikira kapena kuchepa kwa kulekerera kuchita masewera olimbitsa thupi
• kukhala ndi matenda a kuthamanga kwa magazi, matenda a shuga, matenda osatha a impso, kapena matenda a mtima kapena a valvular omwe adadziwika, kuphatikizapo matenda a mtima a nyamakazi
• akumwa mankhwala omwe angakhudze kugunda kwa mtima kapena nthawi ya QT, monga momwe dokotala walangizira
• akuyesedwa asanachite opaleshoni, kapena ngati gawo la kuwunika masewera omwe asanachitike kutenga nawo mbali komwe malamulo am'deralo amafunikira

Kupumula kwa ECG mwa munthu wachinyamata wopanda zizindikiro komanso wopanda zoopsa nthawi zambiri sikubweretsa mavuto ambiri ndipo kungayambitse mafunso okhudza mitundu yosiyanasiyana yopanda vuto. Kusankha ngati ECG yowunikira ndi yothandiza ndi chisankho cha dokotala wanu, osati chowonjezera chachizolowezi. Zotsatira zimasiyana malinga ndi momwe matenda alili.

Zimene electrocardiogram singathe kuzizindikira kapena kuzichotsa

Iyi ndi gawo lokhalo lomwe silikumvetsetsedwa bwino kwambiri pa mayesowa.

• Sichikuwonetsa m'maganizo mitsempha ya mtima. Kuyeza kwa ECG kokhazikika sikuchotsa matenda a mitsempha ya mtima, ndipo sikukuuzani ngati mitsempha ya mtima yachepa.
• Sichiyesa mphamvu ya kupompa. Gawo lotulutsa magazi limachokera ku echocardiogram kapena MRI ya mtima, osati ECG.
• Sichiyesa ma valve. Kuchepa kapena kutayikira kwa valavu, kuphatikizapo matenda a rheumatic valve, kumafunika echocardiography. ECG ikhoza kuwonetsa mawonekedwe ena a chipinda, koma singathe kuwerengera valavu.
• Sizingatheke kuchotsa matenda a mtima modalirika. Kuthamanga kwa mtima msanga kapena kosakwera kwa ST kumatha kukhala ndi kutsata koyambirira kwabwinobwino kapena kofanana ndi kwabwinobwino. Ma ECG otsatizana komanso mayeso a magazi a troponin omwe ali ndi mphamvu yapamwamba amagwiritsidwa ntchito, chifukwa kutsata kamodzi kokha sikokwanira.
• Kawirikawiri imasowa ma arrhythmias osinthasintha. Kujambula kwa masekondi 10 kumagwira ntchito yokha panthawiyo. Ngati palpitations ikubwera ndikutha, ECG yabwinobwino sikutanthauza kuti palibe arrhythmia; Holter, extended patch kapena event monitoring ingafunike.
• Sizizindikira magazi oundana m'mapapo mwachindunji. Kutupa kwa m'mapapo kungayambitse zizindikiro zosonyeza kuti munthu ali ndi vuto, koma kuzindikira matendawa kumadalira kujambula zithunzi monga CT pulmonary angiography.
• Mawonekedwe okulitsa chipinda ndi osalunjika. Zizindikiro za ECG za hypertrophy ya ventricle yakumanzere sizimakhudza mtima kapena zimangokhudza mtima; echocardiography imayesa izi.
• Matenda ena a kapangidwe kake ndi majini amatha kukhala ndi ECG yabwinobwino, makamaka koyambirira.

"Sizikudziwika" sikutanthauza "kuchotsedwa". Ngati kupweteka pachifuwa panu, kupuma movutikira, kugunda kwa mtima kapena kukomoka kukupitirirabe ngakhale ECG yanu yakhala yachizolowezi, bwererani kwa dokotala wanu, musatenge lipoti lachizolowezi ngati fayilo yotsekedwa.

Mayeso ofanana koma osiyana

Palibe mayeso amodzi omwe ali "abwino" padziko lonse lapansi. Mayeso omwe amabwera poyamba amadalira vuto: kupweteka pachifuwa komwe kumapitirira mu dipatimenti yadzidzidzi kumayamba ndi ECG ndi troponin; kupuma mobwerezabwereza nthawi zambiri kumafuna kuyang'aniridwa kwa kayendedwe ka thupi; kulira kapena matenda okayikiridwa a valavu kumasonyeza echocardiography; kupweteka pachifuwa kokhazikika mwa munthu amene ali pachiwopsezo chapakati nthawi zambiri kumabweretsa CT coronary angiography kapena functional imaging, kutengera kupezeka ndi lingaliro la gulu lothandizira.

Momwe mungakonzekerere

Kukonzekera ECG yopumula sikokwanira, ndipo malangizo enieni amagwira ntchito ndipo amakhazikitsidwa ndi gulu lochita. Malangizo olembedwa a gulu lanu ndi ofunika kwambiri kuposa chilichonse chomwe mumawerenga pa intaneti.

• zovala: Valani chinthu chomwe chimatsegula kapena kukweza mosavuta pachifuwa; mungapemphedwe kuti muvale diresi.
• Khungu: Pewani mafuta, mafuta odzola, talc kapena lotion pachifuwa, m'manja ndi m'miyendo patsikulo, chifukwa izi zimachepetsa kukhudzana kwa ma electrode. Tsitsi pachifuwa lingafunike kudulidwa pamalo omwe ma electrode ali.
• Kusala kudya: Sikofunikira pa ECG yopumula yokhazikika. Ngati ECG ndi gawo la mayeso opsinjika kapena phukusi lalikulu, tsatirani njira yeniyeni yoyeserayo.
• Mankhwala: Bweretsani mndandanda wa mankhwala omwe muli nawo panopa. Musayimitse, kuyamba kapena kusintha mankhwala aliwonse omwe mwapatsidwa poyesa, kuphatikizapo beta blockers, antiarrhythmics kapena mankhwala a chithokomiro, pokhapokha ngati dokotala amene wakupatsani mankhwalawo wakuuzani.
• Zolimbikitsa: Pa ECG yopuma, caffeine ndi nikotini si zotchinga zenizeni, koma zimatha kukweza kugunda kwa mtima ndikuwonjezera kugunda kwa ectopic. Ngati mayesowa akuchitika makamaka kuti awone kugunda kwa mtima kapena mayeso a kupsinjika, tsatirani malangizo a chipangizocho.
• Uzani antchito Ngati muli ndi pacemaker kapena defibrillator yoyikidwa, matenda a mtima kapena opaleshoni ya bypass, mabala pachifuwa kapena ma dressing, kapena ngati munayesedwapo kale, kufufuza komwe kunachitidwa kale ndikofunikira poyerekeza.

Pregnancy

ECG siigwiritsa ntchito ma radiation ndipo imagwiritsidwa ntchito pa mimba ngati dokotala wanena. Malo angasinthidwe, kugona chagada pambuyo pa mimba kungayambitse mutu wopepuka, kotero nthawi zambiri amagwiritsidwa ntchito poyenda kumanzere kapena pang'ono. Kusintha kwina kwa ECG, kuphatikizapo kusintha kwa axis ndi kusintha pang'ono kwa T-wave, kumachitika nthawi zambiri pa mimba ndipo kumafunika kutanthauzira ndi dokotala wodziwa za mimbayo.

ana

Ma ECG a ana amagwiritsa ntchito ma electrode ang'onoang'ono, ndipo chofunika kwambiri, miyezo yachibadwa yokhudzana ndi zaka, miyezo ya akuluakulu imasokoneza kutsata kwa ana. Kufotokozera zomatazo pasadakhale kumathandiza; kuyenda ndi kulira nthawi zambiri zimayambitsa zinthu zakale, kotero kujambula mobwerezabwereza kungafunike.

Okalamba ndi anthu omwe ali ndi vuto losayenda bwino

Khungu lofooka kapena lopyapyala likhoza kukhudzidwa ndi guluu, ndipo kugwedezeka kapena matenda a Parkinson zingapangitse chinthu choyambirira. Uzani katswiri ngati kugona pansi kuli kovuta; kujambula pang'ono kogona pansi kungathe kufotokozedwa.

Anthu omwe ali ndi makina oletsa kupanikizika kapena zipangizo zoyimitsidwa

ECG ndi yotetezeka ndi makina oyeretsera mtima ndi makina oyeretsera mtima omwe amaikidwa m'thupi ndipo nthawi zambiri amagwiritsidwa ntchito molondola kuti aone momwe chipangizocho chimagwirira ntchito. Nthawi zonse tchulani chipangizocho, chifukwa kufufuzako kumatanthauziridwa mosiyana. Kufunsidwa kwapadera ndi gulu la akatswiri a mtima kumapereka chidziwitso chomwe ECG ya pamwamba singathe.

Matenda a shuga, matenda a impso osatha komanso kulephera kwa mtima

Palibe kukonzekera kwapadera komwe kumafunika pa ECG yopuma, ndipo palibe malire a madzi kapena kusala kudya omwe amagwiritsidwa ntchito. Ngati ECG yanu ndi gawo la mayeso opsinjika, malangizo osala kudya ndi mankhwala a mayesowo angakhudze anthu omwe akumwa insulin kapena mankhwala ena ochepetsa shuga m'magazi, anthu omwe akumwa mankhwala oletsa madzi m'thupi, komanso anthu omwe ali ndi matenda a impso kapena kulephera kwa mtima, funsani dokotala amene wakupemphani malangizo anu musanadye kapena kusiya kumwa mankhwalawo.

Zomwe zimachitika pa electrocardiogram

• Kuyika: Mumagona pa sofa ndipo mumaonetsa chifuwa, manja ndi akakolo. Mungathe kupempha zachinsinsi komanso munthu woti akuthandizeni.
• Kuyika kwa Electrode: Ma electrode khumi omatira amaikidwa pamalo odziwika bwino a thupi. Kuyika kolondola n'kofunika; ma lead otayika ndi omwe amachititsa kuti zinthu zisamawoneke zachilendo.
• Kujambula: Mumagona chete, mumapuma bwino ndipo mumapewa kulankhula kwa masekondi angapo pamene makina akujambula. Kunjenjemera, kukhosomola kapena kuyenda kungalepheretse kutsata kwa wodwala, ndipo katswiriyo angabwerezenso.
• Pambuyo pake: Ma electrode amachotsedwa. Kufiira pang'ono pakhungu kapena kumamatira pang'ono n'kofala. Kuchita zinthu mwachizolowezi, kudya ndi kuyendetsa galimoto kungayambirenso nthawi yomweyo, pokhapokha ngati chifukwa cha mayesowo chikupereka malamulo.

Kodi njirayi imatenga nthawi yayitali bwanji

Kujambula kwamagetsi nthawi zambiri kumakhala pafupifupi masekondi 10. Kuyika kwa ma electrode, malo ake ndi kuvula/kuvala kumatanthauza kuti nthawi zambiri kumatenga mphindi 5-10, komanso kupitirira apo ngati pakufunika kubwerezabwereza, ngati tsitsi la pachifuwa liyenera kudulidwa, kapena kwa ana. Mu dipatimenti yadzidzidzi yokhala ndi ululu pachifuwa, cholinga chake ndikutenga kufufuza ndikuwunikanso mkati mwa mphindi zochepa kuchokera pamene munthu wafika. Pa nthawi yofulumira, dokotala amawunikanso kufufuzako nthawi yomweyo; pa mayeso achizolowezi akunja, nthawi yopereka malipoti imadalira momwe chipangizocho chikuyendera.

Kumvetsetsa lipoti lanu la ECG

Lipoti la ECG nthawi zambiri limakhala ndi magawo atatu: kutsata kosindikizidwa, seti ya miyeso yopangidwa ndi makina, ndi kutanthauzira kwa anthu.

• Kugunda kwa mtima: Kugunda kwa thupi komwe kumanenedwa mu mphindi imodzi. Kugunda kwa thupi komwe kumachepera kapena kupitirira muyeso wa akuluakulu sikwachilendo, othamanga ophunzitsidwa nthawi zambiri amakhala ndi kupuma pang'onopang'ono, ndipo nkhawa, malungo, ululu, kuchepa kwa magazi m'thupi kapena kutaya madzi m'thupi nthawi zambiri zimakweza kuchuluka kwa thupi.
• Rhythm: "sinus rhythm" amatanthauza kuti kugwedezeka kwa mtima kumayamba pamalo abwinobwino. Kugwedezeka kwa mtima, kugwedezeka kwa mtima, tachycardia ya supraventricular ndi kugwedezeka kwa mtima kwa ventricular zimafotokozedwa ndi mayina.
• Nthawi: Nthawi ya PR (kuyendetsa kwa AV), nthawi ya QRS (kuyendetsa kwa ventricular, komwe kumapitilira mu bundle branch block), ndi QT/QTc (kubwezeretsa mphamvu, komwe kumagwirizana ndi mankhwala ena ndi matenda obadwa nawo).
• Axis ndi ma voltages: Kuwongolera ndi kukula kwa mphamvu zamagetsi. Zizindikiro za mphamvu zamagetsi zomwe zimasonyeza hypertrophy sizodalirika zokha ndipo zimakhudzidwa ndi kapangidwe ka thupi, makulidwe a khoma pachifuwa ndi malo omwe lead imayikidwa.
• Gawo la ST ndi mafunde a T: Kukwera kwa ST kapena kupsinjika maganizo ndi kusintha kwa T-wave kungasonyeze kufooka kwa magazi kapena kuvulala, komanso kumachitika ndi pericarditis, myocarditis, kusokonezeka kwa electrolyte, bundle branch block, early repolarisation variants ndi left ventricular hypertrophy.
• Mafunde a Q: zingasonyeze matenda a mtima akale, ochiritsidwa, kapena zingakhale zosayenera komanso zosavulaza.

Mawu opangidwa ndi makina okha pamwamba pa chosindikizira, mawu monga "abnormal ECG", "possible old infarct", "non-specific T-wave abnormality" kapena "ganizirani za left ventricular hypertrophy", ndi lingaliro la kompyuta, osati matenda. Kuwerenga kokha nthawi zambiri kumapitirira muyeso ndipo nthawi zambiri kumakonzedwa ndi dokotala wopereka malipoti. Musachitepo kanthu pa mawu osindikizidwa dokotala asanatanthauzire kutsata malinga ndi zizindikiro zanu, mayeso anu, zoopsa zomwe muli nazo komanso ma ECG am'mbuyomu. Kuyerekeza ndi kutsata kwakale nthawi zambiri kumasintha tanthauzo lonse: kupeza kokhazikika sikukudetsa nkhawa kwambiri kuposa kwatsopano.

Pamene zotsatira za ECG zingakhale zosokeretsa

Zotsatira zomwe zingawoneke zachilendo

• Kutayika kwa zingwe za mkuwa kapena kusinthana kwa zingwe za mkuwa akhoza kutsanzira matenda akale a mtima, kusintha kwa axis kapena ngakhale kusonyeza dextrocardia.
• Kusuntha, kunjenjemera, kugwedezeka kapena ma electrode otayirira akhoza kutsanzira arrhythmia kapena kupanga chiyambi cha kuyendayenda.
• Kusokonezedwa kwamagetsi kuchokera ku zipangizo zapafupi zingathe kuphimba zinthu zomwe zimafanana ndi flutter kapena fibrillation.
• Mitundu yachizolowezi monga kubwereranso msanga kwa ubongo, kusinthasintha kwa mtima chifukwa cha kupuma, ndi kusintha kwa thupi komwe kumachitika chifukwa cha othamanga nthawi zambiri zimaonedwa kuti ndi "zachilendo" ndi mapulogalamu.
• Kukhazikika kwa thupi, minofu ya m'mawere, kunenepa kwambiri, kukwera kwa mpweya m'mapapo kapena kutupa kusintha ma voltage ndi mawonekedwe a ST-T.
• Bundle branch block, speeding ndi pre-excitation kusokoneza magawo a ST, zomwe zimapangitsa kuti kuwunika kwa ischemia kusadalire pogwiritsa ntchito ECG yokha pamwamba.
• Kusokonezeka kwa electrolyte ndi kagayidwe kachakudya: kusokonekera kwa potaziyamu, calcium ndi magnesium, ndipo mankhwala ena amatha kuyambitsa kusintha kwa ST-T ndi QT kosagwirizana ndi matenda a mtima.

Zomwe zapezeka zomwe zingawoneke ngati zachilendo kapena zolimbikitsa

• Matenda a mtima oyambirira: Kufufuza koyamba kungakhale kwabwinobwino. Kubwerezabwereza ma ECG ndi kuyezetsa troponin ndikofunikira ngati zizindikiro zikusonyeza matenda a mtima oopsa.
• Kutsekeka kwa gawo lakumbuyo kapena lakumbali ikhoza kukhala yocheperako pa ma lead 12 wamba.
• Kusakhazikika kwa mtima zimasowa pakati pa magawo, kotero kuti kutsata komwe kumatsalira kumawoneka bwino.
• Matenda a mtima okhazikika nthawi zambiri imapanga ECG yopumula bwino ngakhale itakhala yochepa kwambiri.
• Kusakhazikika kwa kayendedwe ka ... akhoza kubisa kusintha kwatsopano kwa ischemic.

Pachifukwa ichi, dokotala amayesa ECG ndi nkhani yanu. Zizindikiro zomwe zikupitirira kapena zikuipiraipira zimaposa zizindikiro zachibadwa.

Zoopsa ndi chitetezo

ECG yopumula yokhala ndi lead 12

ECG yopumula imalemba zizindikiro zamagetsi; sipereka mphamvu m'thupi, sigwiritsa ntchito kuwala kwa dzuwa ndipo sifunikira jakisoni. Mavuto enieni ndi ang'onoang'ono: kufiira kwa khungu kapena kuyabwa chifukwa cha zomatira, kusasangalala pang'ono pamene mapepala achotsedwa, kusasangalala chifukwa cha tsitsi lodulidwa pachifuwa, komanso kawirikawiri zomwe zimachitika pakhungu. Chiwopsezo chachikulu cha matenda si chakuthupi koma kutanthauzira, kusanthula molakwika kapena kutanthauzira mopitirira muyeso kungayambitse nkhawa zosafunikira ndi mayeso ena, kapena kutsimikizira zabodza.

Kuchita masewera olimbitsa thupi (kupsinjika maganizo) ECG

ECG yokhudza kupsinjika imakhala ndi chiopsezo chosiyana komanso chachikulu, chifukwa imawonjezera dala ntchito ya mtima. Zochitika zosazolowereka koma zodziwika bwino zimaphatikizapo kupweteka pachifuwa, kusakhazikika kwa mtima, kusintha kwakukulu kwa kuthamanga kwa magazi, kukomoka, komanso, nthawi zina, zochitika zazikulu zamtima. Imachitika ndi kuyang'aniridwa ndi dokotala komanso malo opumulirako, ndipo si yoyenera aliyense, mwachitsanzo mu matenda a mtima omwe akuganiziridwa kuti ndi acute coronary syndrome, severe aortic stenosis kapena kusakhazikika kwa mtima kosalamulirika. Malangizo achitetezo a ECG yopumula sapita ku mayeso a kupsinjika.

Kuyang'anira Holter ndi ambulatory

Zoopsa zake zimakhala zochepa chifukwa cha kuyabwa pakhungu chifukwa cha kukhudzana kwa nthawi yayitali ndi electrode komanso kusokonezeka kogwiritsa ntchito chipangizocho. Kuchuluka kwa matenda kumadalira kuchuluka kwa zizindikiro zomwe zimachitika panthawi yowunikira.

Zinthu zapadera

Pregnancy

Kugunda kwa mtima ndi kupuma movutikira n’kofala kwambiri pa nthawi ya mimba, ndipo ECG ndi sitepe yoyamba yoyenera, yopanda kuwala kwa dzuwa. Kusintha kwa thupi kumasinthasintha momwe magazi amayendera, kotero kutanthauzira koyenera kwa mimba n’kofunika. Matenda a rheumatic valve omwe amapezeka koyamba pa nthawi ya mimba ndi ofunika kwambiri ku India, ndipo nthawi zambiri amafunika echocardiography osati ECG yokha.

Ana ndi achinyamata

Zotsatira za ana ziyenera kuwerengedwa molingana ndi zaka zawo. Kufufuza n'kofunikira ngati munthu wakomoka panthawi yochita masewera olimbitsa thupi, kugunda kwa mtima chifukwa cha kugwa, kapena mbiri ya banja ya imfa yadzidzidzi mwa wachibale wake wachinyamata. Kuwunika matenda a mtima obadwa nawo kumadalira echocardiography, ndi ECG ngati mayeso othandizira.

Achikulire achikulire

Matenda a mtima otchedwa Atrial fibrillation ndi conduction disease amakhala ofala kwambiri akamakula, ndipo matenda a mtima nthawi zambiri amapezeka popanda kupweteka pachifuwa, komanso kupuma movutikira, kusokonezeka kapena kutopa. Kutsatira zizindikiro zakale nthawi zambiri kumasonyeza zinthu zingapo zomwe zimachitika nthawi imodzi, kotero kufananiza ndi ma ECG akale n'kothandiza kwambiri.

shuga

Matenda a mtima amatha kukhala ochulukirapo komanso osawonetsa zizindikiro zambiri mwa anthu omwe ali ndi matenda a shuga kwa nthawi yayitali, kotero ECG yachibadwa siyenera kutengedwa ngati njira yochotsera zizindikiro. Kambiranani ndi dokotala wanu za zizindikiro zilizonse zolimbitsa thupi, ngakhale zitakhala zochepa.

Matenda a impso osatha komanso dialysis

Kusintha kwa potaziyamu ndi calcium panthawi ya dialysis kungapangitse kuti magazi ayambe kuyenda bwino, ndipo kuchuluka kwa magazi m'magazi kumanzere n'kofala. Kusintha kwa ECG kumasonyeza koma sikulowa m'malo mwa mayeso a biochemical kuti aone ngati pali vuto la electrolyte.

Kulephera kwa mtima

ECG imathandiza kuzindikira mavuto a rhythm ndi kuchedwa kwa conduction monga kuletsa nthambi ya left bundle, zomwe zimakhudza chisankho cha chipangizo ndi chithandizo. Sichiyesa gawo la ejection; echocardiography ndi natriuretic peptide testing zimakwaniritsa cholinga chimenecho.

Othamanga

Maphunziro amapangitsa kusintha kwa ECG kudziwika, kuphatikizapo liwiro lochepa komanso kuchuluka kwa ma voltage, zomwe si matenda. Kusiyanitsa izi ndi matenda a mtima kapena channelopathy kumafuna njira zina zodziwira akatswiri komanso nthawi zambiri kujambula zithunzi zina.

Katswiri wa zamagetsi mu India

• kupezeka: Makina a ECG ndi ena mwa zipangizo zodziwira matenda zomwe zimafalitsidwa kwambiri ku India, zomwe zimapezeka m'zipatala za m'maboma, m'zipatala zazing'ono, m'ma laboratories odziwira matenda komanso m'malo ambiri azaumoyo. Izi zimapangitsa ECG kukhala njira yoyamba yowunikira magetsi m'mizinda ndi m'midzi.
• Chilankhulo ndi mayina: Odwala nthawi zambiri amagwiritsa ntchito "ECG" ndi "echo test" mosinthana, koma awa ndi mayeso osiyana, ECG imalemba magetsi, echo imagwiritsa ntchito ultrasound pa kapangidwe ka chithunzi ndi ntchito yake. Fotokozani chomwe chapemphedwa.
• Matenda a mtima a rheumatic Ku India, makamaka achinyamata, ndi chifukwa chachikulu chomwe chimayambitsa matenda a valve. Zingasonyeze kufooka kwa mtima kapena kukula kwa chipinda pa ECG, koma kuzindikira ndi kuyika chizindikiro kumafuna echocardiography.
• Matenda a coronary ali aang'ono: Anthu aku South Asia nthawi zambiri amadwala matenda a mitsempha ya mtima msanga komanso ali ndi thupi lochepa kuposa anthu ena ambiri. Ukalamba wokha suyenera kuchepetsa kukayikira, ndipo ECG yopumula bwino siyenera kuphimba mbiri ya zizindikiro zomveka bwino.
• Kuchepa kwa magazi m'thupi, Kuphatikizapo kuchepa kwa magazi m'thupi chifukwa cha kusowa kwa iron ndi thalassemia, kuli ponseponse ndipo kungayambitse kugunda kwa mtima, kusowa mpweya komanso kugunda kwa mtima mwachangu, zizindikiro zomwe zingayambitse ECG. Kuyezetsa magazi kumafunika pamodzi.
• Matenda a chithokomiro ndi chifukwa chofala komanso chochiritsika cha atrial fibrillation kapena sinus tachycardia chomwe chimapezeka pa ECG.
• Tele-ECG ndi maunyolo otumizira: Malo ambiri ang'onoang'ono amatumiza zithunzi kuti akapereke malipoti akutali. Nyamulani chithunzi choyambirira kapena chithunzi chowonekera bwino mukapita kukafunsana kulikonse, kufananiza kotsatizana kumasinthadi tanthauzo.
• Maphukusi oyezetsa thanzi Nthawi zambiri amaphatikiza ECG yopumula. Mawu osadziwika ochokera m'maphukusi awa ndi chifukwa chofala cha nkhawa; pita ndi dokotala kuti akafufuze matendawa m'malo mofufuza mawuwo pa intaneti.
• Zinsinsi za data: Kutsata ndi malipoti a ECG ndi deta yaumoyo wa munthu. Motsatira Digital Personal Data Protection Act, 2023, fomu iliyonse ya digito, portal kapena pulogalamu yomwe imasonkhanitsa tsatanetsatane wanu iyenera kukuuzani zomwe zasonkhanitsidwa ndi chifukwa chake, ndikupempha chilolezo chanu.

Mtengo ndi inshuwalansi, ndi zomwe zimakhudza mtengo ku India

Kupumula kwa ECG yokhala ndi lead 12 ndi imodzi mwa kafukufuku wotsika mtengo wa mtima womwe ulipo ku India, nthawi zambiri umawononga ndalama zochepa kuposa echocardiogram, mayeso oyeserera kupsinjika kwa treadmill kapena CT coronary angiography. Mitengo imasiyana kwambiri pakati pa chipatala chaching'ono, unyolo wodziwitsa matenda ndi chipatala chachikulu chachitatu, komanso pakati pa mizinda.

Zinthu zomwe zimakhudza zomwe mumalipira:

• Mtundu wa malo, labotale yodziyimira payokha, nyumba yosungira okalamba, chipatala chamakampani kapena bungwe la boma
• Mzinda ndi dera
• Kaya ECG ndi yodziyimira payokha kapena yolumikizidwa mu phukusi la kuyezetsa thanzi kapena phukusi la opaleshoni
• Kaya ndalama zina zolipirira dokotala wa mtima zimalipidwa kuwonjezera pa kujambula
• Kaya mayesowa amachitika mu dipatimenti yothandiza anthu mwadzidzidzi kapena ngati wodwala m'chipatala, komwe angakhale gawo la phukusi lalikulu la chisamaliro
• Ntchito za ECG zakunja kwa nthawi yogwira ntchito, pafupi ndi bedi kapena zotolera kunyumba
• Zowonjezera monga kubwerezabwereza kapena kutsata kwa serial, rhythm strips kapena Holter monitoring yotsatira

Pa inshuwaransi: mayeso ozindikira matenda akunja nthawi zambiri saphimbidwa ndi inshuwaransi yazaumoyo yokhazikika pokhapokha ngati ndondomekoyi ikuphatikiza OPD kapena phindu la kuyezetsa thanzi. ECG ikachitidwa panthawi yovomerezedwa kuchipatala, nthawi zambiri imakhala gawo la zomwe zapemphedwa. Ma ECG asanafike pantchito, inshuwaransi, zamankhwala, komanso satifiketi yolimbitsa thupi nthawi zambiri amalipidwa ndi wofunsira ntchito kapena wolemba ntchito. Tsimikizirani za inshuwaransi ndi kampani yanu ya inshuwaransi kapena ofesi ya inshuwaransi ya chipatala musanayese mayeso.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi ECG ingakhale yabwinobwino ngakhale nditakhala ndi mtsempha wotsekeka?

Inde. ECG yopumula siimawonetsa mitsempha ya mtima, ndipo anthu ambiri omwe ali ndi kuchepa kwakukulu amakhala ndi kutsata kwabwinobwino pakati pa zochitika. Ngati muli ndi vuto la chifuwa kapena kupuma movutikira, dokotala wanu angakulangizenibe kuti muyesedwe bwino kapena CT coronary angiography ngakhale kuti ECG yanu ndi yachibadwa.

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

Mawu awa amatanthauza kuti njira yobwezeretsanso mphamvu ya magazi si yachibadwa koma sikutanthauza matenda enaake. Zomwe zimayambitsa matendawa ndi monga kupangika kwa thupi, malo oikamo lead, kusintha kwa ma electrolyte, mankhwala ndi mitundu ina yachibadwa. Imafunika kuunikiridwa pamodzi ndi zizindikiro zanu, zinthu zomwe zimayambitsa matenda ndi zizindikiro zilizonse zomwe zapezeka kale, m'malo mongotanthauzira mwapadera.

Kodi kusiyana pakati pa ECG ndi Holter monitor ndi kotani?

ECG yokhazikika imalemba pafupifupi masekondi khumi a rhythm, kotero imangojambula zomwe zikuchitika panthawiyo. Chowunikira cha Holter kapena patch chimalemba mosalekeza kwa tsiku limodzi mpaka milungu ingapo, zomwe zimakhala bwino kwambiri pakugunda kwa mtima, kuzimitsa kwa magetsi kapena kusakhazikika kwa mtima komwe kumabwera ndi kupita.

Kodi nthawi yonse yokumana ndi ECG imatenga nthawi yayitali bwanji?

Kujambula kwamagetsi kokha kumatenga masekondi khumi. Kuyika ma electrode, malo ake ndi kuvala nthawi zambiri zimapangitsa kuti ulendo wonse uchitike kwa mphindi zisanu mpaka khumi. Zingatenge nthawi yayitali kwa ana, ngati pakufunika kubwerezabwereza chifukwa cha zinthu zomwe zachitika, kapena ngati tsitsi pachifuwa likufunika kudulidwa kaye.

Kodi ECG imapweteka kapena imagwiritsa ntchito radiation?

ECG yopumula siigwiritsa ntchito kuwala kwa dzuwa, singano kapena kusiyana kulikonse. Ma electrode amangomamatira pakhungu. Anthu ambiri samamva chilichonse kupatula kukoka pang'ono pamene ma glue pad achotsedwa, ndipo nthawi zina khungu limafiira pang'ono kapena kuyabwa pamalo omwe ma electrode amaonekera.

Kodi ECG ndi yotetezeka ngati ndili ndi pacemaker?

Inde, ndipo nthawi zambiri izi zimachitika makamaka kuti muwone momwe pacemaker ikugwirira ntchito. Uzani katswiri za chipangizo chilichonse choyikidwa, chifukwa kutsata kwa kayendedwe ka mtima kumawerengedwa mosiyana. Kufunsa kwa chipangizocho ndi gulu la akatswiri a mtima kumapereka chidziwitso cha ECG pamwamba.