I-ECG (i-Electrocardiogram): Lokho Okuboniswa Ukulandelela Inhliziyo? Nalokho Okungenakukwazi

Ukuthatha okhiye

• Okusheshayo futhi okungahlaseli: irekhodi elijwayelekile le-ECG elino-lead ongu-12 imizuzwana embalwa futhi alibangeli ubuhlungu.
• Kuyisithombe-skrini: I-ECG evamile ichaza umsebenzi kagesi wenhliziyo kuphela ngaleyo mizuzwana.
• Ayibonisi imithambo noma ama-valve: I-ECG ikhombisa izimpawu zikagesi, hhayi ukugeleza kwegazi, ukuvaleka noma isakhiwo se-valve.
• Umongo wezidingo zokuhumusha: ukulandelwa okufanayo kungaba okuvamile komunye umuntu futhi kube okubalulekile komunye.
• Izimpawu eziqhubekayo zidlula umphumela ojwayelekile: uma ubuhlungu besifuba noma ukushaya kwenhliziyo kuqhubeka, buyela kudokotela wakho.

Nge-shazi

Obeye aziwe njengo

• I-ECG, i-EKG (isipelingi esithathwe ngesiJalimane, i-electrocardiogramm)
• I-Electrocardiogram, i-electrocardiography
• "Ukuhlolwa kwe-ECG", "ukulandelela inhliziyo", "ukuhlolwa kwegrafu yenhliziyo", "i-ECG enama-lead angu-12"
• Ukusetshenziswa kwesi-Hindi/komdabu emitholampilo yaseNdiya: "dil ka ECG", "dil ki jaanch wali machine"

Iyini i-ECG

Ukushaya kwenhliziyo ngakunye kuqala njengomfutho kagesi ku-sinus node, kusakazeke ku-atria, kudlule i-atrioventricular node bese kuhamba kungene kuma-ventricles. I-ECG ithatha lezi zinguquko ze-voltage ebusweni besikhumba bese iziphrinta njengamagagasi: igagasi le-P (ukusebenza kwe-atrial), i-QRS complex (ukusebenza kwe-ventricular) kanye negagasi le-T (ukululama kwe-ventricular). Ama-electrode ayishumi akhiqiza "imibono" kagesi eyishumi nambili ehlukene yenhliziyo.

Umshini we-ECG uyithuluzi lokulalela. Awudlulisi ugesi emzimbeni.

Kungani kwenziwa i-ECG

• Ubuhlungu besifuba noma ukucindezeleka kwesifuba: ukubheka amaphethini e-acute ischemia noma i-infarction, kanye nokuqondisa izinqumo zokwelashwa ngokushesha.
• Ukushaya kwenhliziyo, ukuphelelwa amandla noma ukuphelelwa amandla: ukubhala phansi isigqi uma kukhona uphawu, kanye nokubheka ukukhubazeka okuyisisekelo kokuqhuba noma ukubuyiselwa kwe-repolarisation.
• Ukuphelelwa umoya: njengengxenye eyodwa yokuhlolwa okubanzi kwenhliziyo nokuphefumula.
• Isifo senhliziyo esaziwayo: ukulandelwa kwe-arrhythmia, i-myocardial infarction yangaphambilini, ukwehluleka kwenhliziyo noma i-cardiomyopathy.
• Ukuhlolwa kwe-Pacemaker noma i-ICD: kanye nokuphenywa kwedivayisi okusemthethweni.
• Ukuqapha imithi kanye ne-electrolyte: eminye imithi ithinta isikhawu se-QT; ukuphazamiseka kwe-potassium ne-calcium kushintsha ukuma kwamagagasi.
• Ngaphambi kokuhlinzwa noma ngaphambi kokuqala ukwelashwa okuthile, lapho isimo sezokwelapha sidinga khona lokho.

Ubani okufanele athole lolu vivinyo

• Noma ubani onesifo esibuhlungu esifubeni, ingcindezi, noma ubuhlungu obusakazekela emhlathini, entanyeni noma engalweniLokhu kudinga i-ECG ephuthumayo, hhayi i-aphoyintimenti ehleliwe.
• Abantu abanenhliziyo eshaya ngamandla, ukuquleka okungachazeki, noma ukushaya kwenhliziyo okungajwayelekile okubhalwe phansi.
• Abantu abanesifo semithambo yenhliziyo esaziwayo, ukwehluleka kwenhliziyo, isifo se-valve noma isifo senhliziyo esinama-rheumatic njengoba kuqondiswe udokotela wabo wenhliziyo.
• Abantu abanesifo somfutho wegazi ophakeme, isifo sikashukela noma isifo sezinso esingamahlalakhona lapho udokotela ehlola ukubandakanyeka kwenhliziyo.
• Abantu abasebenzisa imithi eyaziwa ngokuthi ithinta ukuhanjiswa kwenhliziyo noma isikhawu se-QT, lapho udokotela eluleka ukuqapha.
• Abadlali bezemidlalo kanye nabadlali abancintisanayo lapho kusebenza khona inqubo yokuhlola, kanye nabantu abanomlando womndeni wokufa kwenhliziyo ngokuzumayo noma isifo senhliziyo esizuzwe njengefa.
• Abantu abahlolwa ngaphambi kokuhlinzwa okukhulu, ngokusekelwe eminyakeni, izimpawu kanye nokugula okuhambisana nakho kunokuba kube njalo kuwo wonke umuntu.

I-ECG ejwayelekile kumuntu ongenazo izimpawu futhi ongenazo izinto eziyingozi ivame ukwengeza okuncane futhi ingaveza imiphumela engalindelekile eholela ekuhlolweni okwengeziwe. Ukuthi i-ECG iwusizo yini kuwe kuyisinqumo sezokwelapha.

Lokho i-ECG engenakukubona noma ukukukhipha

Lena yingxenye engaqondakali kahle kakhulu yokuhlolwa.

• Akukwazi ukuvimbela isifo semithambo yenhliziyo. I-ECG ephumulile ivame ukuba yinto evamile kubantu abanokuncipha okukhulu kwemithambo yenhliziyo. I-ECG ayiboni nhlobo imithambo yenhliziyo.
• Ayikwazi ukuvimbela ukuhlaselwa yinhliziyo ngokwayo. Ekuqaleni kwesifo sohlangothi, i-ECG ingase ibukeke ijwayelekile noma icishe ibe yinto evamile. Ukuxilongwa ngokuvamile kudinga ama-ECG alandelanayo kanye ne-cardiac troponin kanye nokuhlolwa kwezokwelapha.
• Ayikwazi ukubamba ngokuthembekile i-arrhythmia ngezikhathi ezithile. Uma isigqi esingajwayelekile singenzeki phakathi naleyo mizuzwana embalwa, ukulandelela kuzobukeka kujwayelekile. Kudingeka ukuqapha okuhamba kancane.
• Ayilinganisi umsebenzi wephampu. Ingxenyana yokukhipha umoya, ukuncishiswa noma ukuvuza kwe-valve, uketshezi lwe-pericardial kanye nama-clots kuyimibuzo ye-echocardiography, hhayi imibuzo ye-ECG.
• Ayikali umfutho wegazi, i-cholesterol noma iphesenti lokuvaleka.
• Ayikwazi ukuxilonga izimo eziphuthumayo zamaphaphu noma ze-aorta. I-pulmonary embolism kanye nokuhlukaniswa kwe-aorta kungase kubangele izinguquko ze-ECG ezingaqondile noma kungabi bikho; kudingeka izithombe.
• "I-ECG evamile" isho ukuthi akukho okungajwayelekile okutholakale kulokho kuqoshwa. Akufani nokuthi "isifo senhliziyo singafakwanga". Uma izimpawu zakho ziqhubeka noma zibuya naphezu kwe-ECG evamile, buyela kudokotela wakho.

Ukuhlolwa okuhlobene kodwa okuhlukile

Lezi zivivinyo ziphendula imibuzo ehlukene. Ukuthi yikuphi okuza kuqala kuncike ekubonisweni: ubuhlungu obukhulu besifuba obungazelelwe buholela ku-ECG kanye ne-troponin; ukushaya kwenhliziyo okuvamile kuholela ekuqaphelweni okuhambayo; ukuphelelwa umoya okune-murmur kuholela ku-echocardiography; ubuhlungu besifuba obuqhubekayo esigulini esizinzile bungase buholele ekuhlolweni kokucindezeleka noma ku-CT coronary angiography kuye ngengozi kanye nokutholakala kwendawo.

Ungalungiselela kanjani

Amayunithi amaningi awadingi ukulungiselela okukhethekile kwe-ECG yokuphumula. Izinqubo ziyahlukahluka phakathi kwezibhedlela nezikhungo zokuxilonga, futhi imiyalelo enikezwa yiyunithi yakho iza kuqala kunanoma yini ebhalwe lapha.

• Akukho ukuzila ukudla kuyadingeka ukuze kutholakale i-ECG ejwayelekile yokuphumula.
• Izingubo: Gqoka into evumela ukufinyelela esifubeni, ezihlakaleni nasemaqakaleni. Izingubo ezimbili zilula kunezingubo ezinesiqeshana esisodwa.
• Isikhumba: Gwema uwoyela, i-moisturiser noma i-talcum powder esifubeni ngalolo suku, njengoba lokhu kwenza buthaka ukuxhumana kwe-electrode. Amanye amadoda angadinga amabala amancane ezinwele zesifuba ezinqunyiwe.
• Imithi: Letha uhlu lwakho lwamanje. Ungayeki, weqe noma ushintshe noma yimuphi umuthi owunikezwe udokotela ngaphambi kwe-ECG ngaphandle kokuthi udokotela owunikezayo ekutshelile.
• Ukuzikhandla okukhulu kanye nezinto ezivuselelayo: Ukuvivinya umzimba ngamandla, inani elikhulu le-caffeine, ugwayi noma utshwala ngaphambi nje kokuhlolwa kungakhuphula izinga lokushaya kwenhliziyo futhi kwenze ukuhumusha kube nzima. Phumula imizuzu embalwa ngaphambi kokuqopha.
• Tshela abasebenzi uma une-pacemaker noma i-ICD, isimo sesikhumba noma ukungezwani komzimba okunamathelayo, ukubopha isifuba, noma uma ubuhlungu.

Uma ukhulelwe

I-ECG yokuphumula isetshenziswa ekukhulelweni uma kuboniswe ngokwezokwelapha. Akukho misebe. Isilinganiso senhliziyo sivame ukuba phezulu ekukhulelweni futhi kwenzeka izinguquko ezithile ze-axis kanye ne-repolarisation, ngakho-ke ukulandelwa kwezimpawu kufundwa ngokumelene nezindinganiso zokukhulelwa. Ukulala phansi kungase kungabi mnandi ekukhulelweni kamuva, tshela uchwepheshe, njengoba isikhundla esigobile singasetshenziswa.

Izingane

Ama-ECG ezingane asebenzisa ama-electrode amancane, futhi okubaluleke kakhulu, ukuhumusha ngokweminyaka. Amazinga okushaya kwenhliziyo, izikhawu kanye namaphethini wamagagasi ajwayelekile kosana olusanda kuzalwa kungaba okungajwayelekile kumuntu omdala. I-ECG yezingane kufanele ibikwe ngokumelene nezindinganiso zezingane.

Abantu abadala abadala

Izinguquko ezincane zokuqhuba kanye nokukhubazeka okungaqondile kuvamile ngokweminyaka futhi akuzona izifo ngokuzenzakalelayo. Ukuqhathaniswa ne-ECG yangaphambilini kuvame ukuba nolwazi oluningi kunokulandelela kuphela.

Abantu abanesifo sikashukela, i-CKD noma ukwehluleka kwenhliziyo

Akukho mkhawulo woketshezi noma wokuzila ukudla osebenza ku-ECG yokuphumula, ngakho-ke imiyalelo yala maqembu ayishintshi. Izimpawu ze-ischaemia zingase zibe buthuntu noma zingajwayelekile kusifo sikashukela esidala, ngakho-ke i-ECG ingacelwa ngezimpawu ezingacacile njengokukhathala okungavamile noma ukuphelelwa umoya. Ku-CKD kanye nokwehluleka kwenhliziyo, ukushintsha kwe-potassium kanye nokunye kwe-electrolyte kungashintsha i-ECG ngokuzimela kwenhliziyo uqobo.

I-Pacemaker noma idivayisi efakwe ngaphakathi

I-ECG ingaqoshwa ngokuphephile nge-pacemaker noma i-ICD endaweni yayo, futhi isiza ekuboniseni ukuthi idivayisi iyasebenza yini. Ayithathi indawo yokuphenywa kwedivayisi okusemthethweni yithimba le-cardiology.

Kwenzekani ngesikhathi se-ECG

• Isikhundla: ulala kusofa. Isifuba, izihlakala namaqakala kuvezwa uma kudingeka; ishidi noma ingubo isetshenziselwa ubumfihlo, futhi ungacela umnakekeli wesifazane.
• Ukubekwa kwe-Electrode: Ama-electrode ayishumi anamathiselwe ngama-gel noma ama-adhesive pad, ayisithupha esifubeni, elilodwa egatsheni ngalinye. Ukubekwa okunembile kubalulekile, ngoba ama-lead abekwe kabi akhiqiza ukulandelwa okudukisayo.
• Ukurekhoda: ucelwa ukuthi ulale unganyakazi, uphefumule ngendlela evamile futhi ungakhulumi imizuzwana embalwa. Ukunyakaza, ukuthuthumela nokukhuluma kudala into yobuciko.
• Ngemuva kwalokho: ama-electrode ahlutshiwe. Asikho isikhathi sokululama futhi ungabuyela emsebenzini ojwayelekile ngokushesha. Ijeli ingasulwa; isikhumba singase sibe pinki isikhashana lapho ama-pad enamathiselwe khona.

Inqubo ithatha isikhathi esingakanani

• Ukulandelela uqobo: ngokuvamile kuthatha cishe imizuzwana eyi-10 yokuqopha.
• Ekamelweni: ngokuvamile imizuzu emi-5-10 kufaka phakathi ukubeka kanye nokubekwa kwe-electrode.
• Ukuvakasha konke: ngokuvamile imizuzu eyi-15-20 ngokubhalisa nokulinda, yize lokhu kuncike ngokuphelele kuyunithi.
• Bika: Esimweni esiphuthumayo i-ECG ifundwa ngemizuzu embalwa eceleni kombhede. Ukuhlolwa kweziguli ezingalaliswa esibhedlela, isikhathi sokubika sincike ekusebenzeni kweyunithi, buza endaweni yokwamukela lapho ulanda khona.

Ukuqonda umbiko wakho we-ECG

Umbiko we-ECG uvame ukuba nezingxenye ezintathu: izinombolo ezilinganisiwe, incazelo eyenziwe ngekhompyutha, kanye nokufunda kukadokotela ngokwakhe. Ukufunda kukadokotela yikho okubalulekile. Ukuhumusha okuzenzakalelayo kuvame ukuba yiphutha, kanye nokuphazamiseka okungaphezu kwalokho okushiwoyo ikakhulukazi.

Imigomo ongayibona:

• Isigqi se-sinus esijwayelekile: i-pulse iqala endaweni evamile futhi ihamba ngendlela evamile.
• I-Sinus tachycardia / i-sinus bradycardia: isigqi esivamile esisheshayo noma esihamba kancane kunokujwayelekile. Zombili zinezimbangela eziningi ezingenacala, ukukhathazeka, umkhuhlane, ubuhlungu, ukuphelelwa amanzi emzimbeni, i-anemia, isifo se-thyroid, izinga lokufaneleka komzimba noma imithi.
• I-Atrial fibrillation: isigqi esingajwayelekile esivela ku-atria, esibalulekile ngenxa yengozi yokushaywa yisifo sohlangothi futhi ngoba sivame ukudinga ukwelashwa okukhethekile.
• Ukushaya kwe-Ectopic / ukushaya kwangaphambi kwesikhathi: ukushaya okwengeziwe. Ngokuvamile kungabonakali, kodwa i-ectopy noma i-ectopy evame ukuba nezimpawu ihlolwa kabanzi.
• Ibhulokhi ye-AV yezinga lokuqala, ibhulokhi yegatsha lesikhwama sokudla, i-RBBB engaphelele: amaphethini okuqhuba angaba uhlobo olujwayelekile kwabanye abantu futhi abaluleke kwabanye.
• Ibhulokhi yegatsha le-bundle lesobunxele, ukuphakama okusha kwe-ST noma ukucindezeleka, ukuguqulwa kwe-T-wave, amaza e-Q: amaphethini adinga ukuhambisana okusheshayo kwezokwelapha kanye nokuqhathaniswa nanoma iyiphi i-ECG yangaphambilini.
• I-hypertrophy ye-ventricular yesobunxele "ngokwemigomo ye-voltage": isiphakamiso sikagesi semisipha ejiyile, hhayi isilinganiso. I-Echocardiography ihlola lokhu kahle.
• I-QT ende noma emfushane: ezihlobene nengozi ye-arrhythmia kanye nemithi ethile. Xoxa nodokotela, futhi ungayeki umuthi wedwa.
• "Izinguquko ze-ST-T ezingaqondile": isisho esivame kakhulu esisho ukuthi ukulandelela akujwayelekile encwadini kodwa akubonisi noma yikuphi ukuxilongwa okukodwa. Kodwa akuvamile ukuba yimbangela yokwethuka; kumuntu onezimpawu kushukumisela ukuhlolwa okwengeziwe.

Ngamabomu, azikho izikhawu zokubhekisela zezinombolo ezibhalwe kuleli khasi. Izinga elijwayelekile lokushaya kwenhliziyo kanye nezikhawu ze-PR, i-QRS kanye ne-QT lincike eminyakeni, ubulili, izinga lokushaya kwenhliziyo, indawo yomzimba, imithi kanye nendlela yokulinganisa esetshenzisiwe, futhi zisetshenziswa udokotela obikayo. Inombolo eyodwa ngaphandle kobubanzi bencwadi ayiyona inkinga yokuxilonga. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye, futhi i-ECG yakho kumele ihunyushwe ngokomongo ngudokotela oyicelile.

Uma imiphumela ye-ECG ingadukisa

Okutholakele okungabonakala kungajwayelekile ngokungeyikho

• Ukubekwa kabi komthofu noma ukugoba kwemilenze okubuyiselwe emuva: ingalingisa ukushaqeka, ukuphambuka kwe-axis noma ukungasebenzi kahle kwesigqi.
• Ukunyakaza, ukuthuthumela, ukuthuthumela noma ukukhuluma: izinto ezidaliwe zingalingisa i-arrhythmia. Ukuthuthumela kwe-Parkinsonian kanye nokuphazamiseka kukagesi kuyizimbangela ezivamile.
• Ukukhathazeka, ubuhlungu, umkhuhlane, ukuzikhandla noma izinto ezivuselelayo muva nje: kwandisa izinga futhi kungabangela izinguquko ze-ST-T.
• Ukujwayela komzimba, izicubu zebele, i-emphysema noma usayizi womzimba omkhulu: shintsha ubukhulu besiginali futhi ingasikisela ngokungeyikho, noma ifihle, i-hypertrophy.
• Izinhlobo ezijwayelekile: Ukubuyela emuva kwe-polarization kusenesikhathi kanye namaphethini e-T-wave asebasha kubantu abasebasha, abaphilile noma abasubathi bavame ukufundwa ngokweqile njenge-ischaemia.
• Ukuhumusha ngekhompyutha: ama-algorithms avame ukubika ngokweqile ukungalingani, futhi igama eliphrintiwe njengelithi "infarct" emgqeni aliyona inkinga yokuxilonga.

Okutholakele okungabonakala kujwayelekile noma kududuza ngamanga

• Ukuhlaselwa yinhliziyo okusheshayo kakhulu: I-ECG ingaba yinto engavamile emahoreni okuqala; ukulandelwa okuphindaphindiwe kuvame ukushintsha.
• Isifo senhliziyo esizinzile: ngokuvamile kukhiqiza i-ECG yokuphumula evamile ngokuphelele.
• I-arrhythmia engapheli: okungabonakali ngaphandle kokuthi kwenzeke ngesikhathi sokuqopha.
• Ibhulokhi legatsha lesobunxele elikhona kakade, isigqi esisheshayo noma ukuphazamiseka okudala: ingafihla izinguquko ezintsha ze-ischemic.
• Ukuhlaselwa yisifo sendawo engemuva noma ehlukanisiwe: kungase kungavezwa kahle kuma-lead ajwayelekile.
• Imiphumela yomuthi: eminye imithi yehlisa izinga noma ishintshe ukuhanjiswa, ithambise imiphumela.

Ngenxa yezindlela zombili zamaphutha, i-ECG ifundwa kanye nezimpawu zakho, ukuhlolwa, ukulandelwa kwangaphambilini, kanye nokuhlolwa kwegazi kanye nezithombe lapho kudingeka khona.

Izingozi nokuphepha

I-ECG yokuphumula enama-lead angu-12

Ukuqopha i-ECG yokuphumula kuyinqubo enobungozi obuphansi kakhulu. Akukho misebe, akukho naliti futhi akukho mandla alethwa emzimbeni. Izinkinga ezingokoqobo ukucasuka okuncane kwesikhumba noma ukubomvu okuvela kuma-adhesive pads, ukungakhululeki uma izinwele zesifuba zinqunyiwe, kanye nokulahlekelwa ubumfihlo isikhashana ngesikhathi sokufakwa kwe-electrode.

Ukuqapha okuhambahambayo (i-Holter, i-patch, i-event monitor)

Izinkinga eziyinhloko ukucasuka kwesikhumba ngaphansi kwama-electrode agugile isikhathi eside, ukulunywa, kanye nemikhawulo yokugeza ngenkathi idivayisi ixhunyiwe. Landela imiyalelo yeyunithi yedivayisi ethile.

Ukucindezeleka (ukuzivocavoca) i-ECG

I-ECG yokucindezeleka inephrofayili ehlukile nephezulu yengozi kune-ECG yokuphumula, ngoba inhliziyo icindezelekile ngamabomu. Izingozi ezingavamile kodwa eziqashelwayo zifaka phakathi ubuhlungu besifuba obubangelwa yisifo, ukungalingani kwenhliziyo, ushintsho oluphawulekayo lomfutho wegazi, ukuquleka kanye, okungajwayelekile, nemicimbi yenhliziyo engathi sína. Kwenziwa ngokuqapha kanye nezindawo zokuvuselela ezitholakalayo, futhi akufanele wonke umuntu, isibonelo, ngesikhathi sokusolwa kwe-acute coronary syndrome noma kwezinye izinhlobo zesifo se-valve esinzima. Udokotela ocela lokhu ulinganisa lezi zici ngazinye.

Izitatimende zokuphepha zohlobo olulodwa lwe-ECG akufanele zisetshenziswe kuwo wonke umndeni wezivivinyo.

Izimo ezikhethekile

ukukhulelwa

Ukushaya kwenhliziyo nokuphelelwa umoya kuvamile ekukhulelweni futhi i-ECG ivame ukuba ukuhlolwa kokuqala. Kuphephile maqondana nemisebe. Ukuchazwa kumele kubhekele izinguquko ezihlobene nokukhulelwa kumazinga, i-axis kanye namagagasi e-T. Izimpawu ezintsha ezibalulekile ekukhulelweni noma esikhathini sokubeletha zidinga ukuhlolwa okusheshayo kunokuqinisekiswa.

Izingane kanye nentsha

Ama-ECG ezingane kumele afundwe ngokwemigomo ethile yobudala. Ukutholakele okubizwa ngokuthi akujwayelekile ngokwemigomo yabantu abadala kungaba yinto evamile enganeni. Ukuquleka ngesikhathi sokuzivocavoca, ukuquleka okubangelwa ukwesaba noma umsindo, noma umlando womndeni wokushona ngokuzumayo esihlotsheni esisesincane kuyizizathu ezithile zokufuna usizo lwezokwelapha inhliziyo yezingane.

Abantu abadala abadala

Ukuphazamiseka kwe-atrial fibrillation kanye nokuphazamiseka kokuhamba kwegazi kuba yinto evamile njengoba umuntu ekhula. Izimpawu ze-ischaemia zingaba ukungajwayelekile, ukukhathala, ukudideka noma ukuphelelwa umoya kunokuba kube ubuhlungu besifuba obuvamile.

Abantu abanesifo sikashukela baphathwa ngokwehlisa ushukela wegazi

Akukho ukuzila ukudla okudingekayo ukuze kuhlolwe i-ECG yokuphumula, ngakho-ke ukudla kanye nemithi yesifo sikashukela kuyaqhubeka njengoba kuyalelwe. I-ischemia ethule noma engavamile ivame kakhulu kwisifo sikashukela esesihlale isikhathi eside, okwehlisa umkhawulo wokuhlolwa.

Isifo sezinso esingamahlalakhona kanye ne-dialysis

Ukuphazamiseka kwe-potassium ne-calcium kushintsha kakhulu i-ECG, ngezinye izikhathi ngendlela eyingozi, futhi ukulandelela kungase kushintshe ngaphambi nangemva kweseshini yokuhlanza igazi. Izinguquko ze-ECG lapha zihunyushwa kanye ne-chemistry yegazi.

Ukuhluleka kwenhliziyo

I-ECG isiza ekuboneni izinkinga zesigqi, ukubambezeleka kokuqhuba kanye nokuphazamiseka kwangaphambi kwesikhathi, futhi inika ulwazi ngezinqumo mayelana nokwelashwa kwedivayisi. Ayikali ingxenye yokukhipha, i-echocardiography iyakwenza.

Abadlali

Abasubathi abaqeqeshwe bavame ukubonisa amazinga okuphumula kancane, ukubuyiselwa emuva kwe-polarization kusenesikhathi kanye nokwanda kwamandla kagesi angokomzimba. Ukuhlukanisa inhliziyo yomsubathi ne-cardiomyopathy kudinga ukuchazwa kochwepheshe, futhi ngezinye izikhathi i-echocardiography noma ukuhlolwa okwengeziwe.

I-ECG kumongo waseNdiya

• Isifo se-Coronary ezinganeni: Umsebenzi wezokwelapha kanye nowezifo kubantu baseNingizimu Asia ubike njalo ukuthi isifo senhliziyo esibangelwa yi-ischemic sivela kusenesikhathi kunakwabantu abaningi baseNtshonalanga, yingakho ubuhlungu besifuba kumuntu oneminyaka engu-40 eNdiya buthathwa njengento ebalulekile kunokuba bunganakwa ngenxa yobudala kuphela.
• Ingozi ye-metabolic ku-BMI ephansi: Abantu baseNingizimu Asia bathola isifo sikashukela kanye nengozi embi ye-cardiometabolic emzimbeni ngesisindo somzimba esiphansi kanye nobubanzi besinqe kunemingcele etholakala kubantu baseYurophu. Ukwakheka okubukeka kujwayelekile akusho ukuthi kunengozi ephansi.
• Isifo senhliziyo esibizwa nge-rheumatic sihlala sibalulekile. Kubantu abanomlando womkhuhlane wamathambo ebuntwaneni, i-ECG ingabonisa i-atrial fibrillation noma amaphethini okukhulisa ikamelo, kodwa isifo se-valve ngokwaso sihlolwa nge-echocardiography. I-ECG kanye ne-echo kuyahambisana, akushintsheki.
• I-anemia: I-anemia yokuntuleka kwensimbi isakazeke kakhulu eNdiya futhi ivame ukubangela i-tachycardia kanye nezinguquko ze-ST-T ezingaqondile, okungaphanjaniswa ne-ischaemia.
• Isifo sendlala yegilo kungenye into evame ukubangela ukungalingani kwesilinganiso kanye nesigqi okutholakala kuma-ECG ajwayelekile.
• Ukuqamba: Imibiko nemithi kadokotela yaseNdiya isebenzisa igama elithi "ECG" cishe yonke indawo; elithi "EKG" livela kakhulu emishinini engenisiwe. Igama elithi TMT (ukuhlolwa kwe-treadmill) liyigama elivamile lendawo le-ECG yokucindezeleka, kanye nelithi "echo test" le-echocardiography, lezi yizivivinyo ezihlukile kwele-ECG ephumulile.
• Ukufinyelela: Imishini ye-ECG enesiteshi esisodwa kanye nemishini engu-12 eholayo itholakala kabanzi kufaka phakathi izinga lokunakekelwa okuyisisekelo, kanye nezinsizakalo ze-tele-ECG ezithumela umkhondo wokubika kude. Uma uphethe i-ECG ephrintiwe phakathi kwezibhedlela, gcina eyangempela, ukuqhathanisa nokulandelela okudala kubaluleke kakhulu.
• idatha: Noma yimuphi umbiko we-ECG wedijithali, uhlelo lokusebenza noma ifomu lokubhukha ku-inthanethi lihilela idatha yezempilo yomuntu siqu, elawulwa eNdiya ngaphansi koMthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, ka-2023. Buza ukuthi ukulandelela kwakho kanye nombiko wakho kugcinwa futhi kwabelwane kanjani.

Izindleko kanye nomshuwalense eNdiya

I-ECG ephumuzayo enama-lead angu-12 iphakathi kokuhlolwa kwenhliziyo okungabizi kakhulu eNdiya, ngokuvamile ibiza ama-rupee angamakhulu ambalwa ezindaweni eziningi, kuyilapho ukuqapha ukuhamba, ukuhlolwa kokucindezeleka kanye ne-echocardiography kubiza kakhulu. Amanani ayahlukahluka kakhulu futhi ayashintsha ngokuhamba kwesikhathi, ngakho-ke qinisekisa inkokhelo yamanje nesikhungo ngaphambi kokuhlolwa. Noma yiliphi inani elicashunwe ku-inthanethi liyinkomba kuphela futhi aliyona ikhotheshini.

Izici ezithinta izindleko:

• Uhlobo lokuhlolwa: i-ECG yokuphumula uma kuqhathaniswa ne-ECG/TMT yokucindezeleka uma kuqhathaniswa ne-Holter noma ukuqapha okunwetshiwe kwe-patch.
• Indawo: isibhedlela sikahulumeni, isikhungo sezempilo esiyinhloko, ilabhorethri yokuxilonga ezimele, isibhedlela senkampani noma isevisi yokuvakasha ekhaya.
• Idolobha nendawo, nokuthi ngabe ukuhlolwa kwenziwa ngezikhathi ezijwayelekile noma njengesevisi ephuthumayo noma yasebusuku.
• Ukuthi ukubika okusemthethweni noma ukubonisana kukadokotela wenhliziyo kuhlanganisiwe yini.
• Izindleko zokuqoqa ekhaya noma zokurekhoda eceleni kombhede, kanye nobude bokuqapha izifundo zikaHolter.
• Ukuthi i-ECG iyingxenye yephakheji yokuhlola impilo noma yenziwa njengophenyo oluzimele.

Umshwalense: i-ECG eyenziwa ngesikhathi sokungeniswa esibhedlela okumboziwe noma inqubo yokunakekelwa kwasemini ivame ukubuyiselwa njengengxenye yezindleko zophenyo. Ukuxilongwa kweziguli zangaphandle kanye nama-ECG okuhlola impilo okuvimbelayo avame ukungambozwa ngaphandle kokuthi inqubomgomo yakho ifaka i-OPD noma inzuzo yokuhlola impilo. Izinhlelo zikahulumeni ezifana ne-Ayushman Bharat PM-JAY zimboza uphenyo ngaphakathi kokunakekelwa kwesibhedlela okuhlanganisiwe ezibhedlela ezihlanganisiwe. Hlola amagama akho enqubomgomo, imikhawulo engaphansi kanye nezidingo zokugunyazwa kusengaphambili nomshwalense wakho noma ideski lomshwalense wesibhedlela.

Izinganekwane namaqiniso

Imibuzo ejwayelekile ukubuzwa

Ingabe i-ECG ingayibona imithambo yegazi evalekile?

Cha. I-ECG iqopha umsebenzi kagesi futhi ayikwazi ukubonisa imithambo yenhliziyo noma ukulinganisa ukuncipha. Ingase iveze izinguquko ezibonisa ukuthi imisipha yenhliziyo ayitholi igazi eliningi, ikakhulukazi ngesikhathi sobuhlungu obuqhubekayo, kodwa ukulandelela okuvamile akukuvimbeli ukuvaleka. I-CT coronary angiography noma i-invasive angiography iyaphendula lowo mbuzo.

Umbiko wami we-ECG uthi "izinguquko ze-ST-T ezingaqondile". Ingabe kufanele ngikhathazeke?

Lesi isisho esivame kakhulu esisho ukuthi ukulandelela akujwayelekile encwadini kodwa kukhomba ukuthi akukho ukuxilongwa okukodwa. Izimbangela zifaka phakathi ukuma komzimba, ukukhathazeka, i-anemia, ukushintshashintsha kwe-electrolyte, imithi kanye nokushintshashintsha okuvamile. Ukubaluleka kwayo kuncike ezimpawini zakho kanye nezici eziyingozi, ngakho xoxa ngombiko nodokotela owu-ode.

Uyini umehluko phakathi kwe-ECG kanye nokuhlolwa kwe-echo?

I-ECG iqopha izimpawu zikagesi ngama-electrode esikhumba futhi ihlola isigqi, ukuhanjiswa kanye namaphethini e-ischemic. I-echocardiogram isebenzisa i-ultrasound ukubheka usayizi wegumbi, umsebenzi we-valve kanye namandla okupompa. Akukho okunye okuthatha indawo yomunye, futhi i-echo yokuphumula ayibonisi imithambo yenhliziyo.

Ingabe i-ECG iyabuhlungu, futhi ingabe ikhona imisebe?

I-ECG yokuphumula ayibandakanyi izinaliti, akukho misebe futhi akukho mandla angena emzimbeni. Iningi labantu lizwa kuphela ijeli epholile noma amaphedi okunamathela. Ukubomvu okuncane kwesikhumba noma ukucasuka kungenzeka ngemva kokususwa kwamaphedi, futhi ezinye izinwele zesifuba zingadinga ukunqunywa ukuze zithinteke kahle.

Kungani udokotela wami e-ode i-Holter monitor ngemuva kwe-ECG evamile?

Ngoba i-ECG ejwayelekile iqopha imizuzwana embalwa kuphela. Uma ukushaya kwenhliziyo, isiyezi noma ukushaya kwenhliziyo okungajwayelekile kufika futhi kudlule, ukuqopha kwe-Holter noma i-patch monitor ngosuku olulodwa noma ngaphezulu kungenzeka kakhulu ukuthi kubambe isigqi esingajwayelekile ngenkathi wenza imisebenzi evamile.

Ingabe ukukhathazeka noma ukuphuza itiye kungashintsha i-ECG yami?

Yebo, ngezinga elithile. Ukukhathazeka, ubuhlungu, i-caffeine, ugwayi, umkhuhlane kanye nokuzikhandla kwamuva nje kungakhuphula izinga lokushaya kwenhliziyo futhi ngezinye izikhathi kubangele izinguquko ezincane ze-ST-T. Ukuphumula buthule imizuzu embalwa ngaphambi kokuba ukuqoshwa kusize. La mathonya athinta ukuhumusha kodwa awadali isifo senhliziyo esakhiweni.

I-ECG kufanele iphindwe kangaki?

Akukho simiso esisodwa. Ukuvama kuncike ezimpawini zakho, ekuxilongweni, emithini kanye nesizathu sokuqapha. Umuntu one-arrhythmia noma osebenzisa umuthi othinta i-QT angadinga ukulandelwa njalo; umuntu ongenazo izimpawu futhi ongenazo izici eziyingozi angase adinge lutho. Udokotela wakho okwelaphayo unquma.

Ingabe i-ECG iphephile ngesikhathi sokukhulelwa?

I-ECG yokuphumula isetshenziswa ekukhulelweni uma kudingeka futhi ayibandakanyi imisebe. Ukukhulelwa ngokwako kushintsha ukushaya kwenhliziyo kanye namaphethini athile amagagasi, ngakho-ke ukulandelela kuchazwa ngokuphambene nokulindela okuqondene nokukhulelwa. Tshela uchwepheshe uma ukulala phansi kungakhululeki, njengoba kungasetshenziswa enye indlela.

Umshini we-ECG uphrinte ukuxilongwa okukhathazayo emgqeni. Ingabe lowo ngumbiko wokugcina?

Cha. Ukuhumusha okuzenzakalelayo kudalwa yisofthiwe futhi kuvame ukwenza izinto ezingajwayelekile, ikakhulukazi ezigulini ezisencane, ezemidlalo noma ezikhathazekile. Umbiko obalulekile yilowo obuyekezwe futhi wasayinwa udokotela, ofundwa kanye nezimpawu zakho kanye nanoma yikuphi ukulandelwa kwangaphambilini.

Imithombo

• I-American Heart Association / I-American College of Cardiology / I-Heart Rhythm Society, izincomo zokwenziwa kube yi-standard kanye nokuchazwa kwe-electrocardiogram (isitatimende sesayensi esinezingxenye eziningi).
• I-European Society of Cardiology, iziqondiso ze-acute coronary syndromes, i-supraventricular tachycardia, i-atrial fibrillation kanye ne-syncope (bheka izinhlelo zamanje ukuze uthole izindlela zokuxilonga ezisekelwe ku-ECG).
• I-Cardiological Society of India kanye ne-Indian College of Cardiology, izitatimende zezikhundla kanye nezinto zemfundo ngezifo zenhliziyo ezigulini zaseNdiya.
• I-World Health Organization kanye nohlelo lwe-Global Burden of Disease, idatha yomthwalo wezifo zenhliziyo nemithambo yegazi eNdiya.
• Umthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, 2023 (Uhulumeni waseNdiya), ukuphathwa kwedatha yezempilo yomuntu siqu kanye nemibiko yedijithali.