I-Electrocardiogram (ECG): Lokho Okuboniswa Yisivivinyo, Lokho Okuphuthelwa Yiso, kanye Nendlela Yokufunda Umbiko Wakho

Ukuthatha okhiye

• Okusheshayo futhi okungahlaseli: I-ECG ejwayelekile enama-lead angu-12 ithatha imizuzu embalwa futhi ayibandakanyi imisebe futhi ayifaki imijovo.
• Imicimbi yesigqi kanye nogesi yiwona amandla ayo: ukungasebenzi kahle kwenhliziyo, ukuvinjwa kwenhliziyo kanye noshintsho lwesigaba se-ST sokuhlaselwa yinhliziyo okuguqukayo.
• I-ECG evamile iyaqinisekisa kodwa ayiqinisekisi: Abantu abaningi abanokuncipha okukhulu kwenhliziyo banokulandela okuvamile kokuphumula.
• Kuyisithombe-skrini: Ukushaya kwenhliziyo okungapheli kungadinga ukuqapha i-Holter noma isikhathi eside.
• Umongo wezidingo zokuhumusha: Ukulandelela okufanayo kungasho izinto ezahlukene kumdlali oneminyaka engu-20 ubudala kanye nomuntu oneminyaka engu-65 ubudala onesifo sikashukela.

Nge-shazi

Obeye aziwe njengo

• I-ECG (ukusetshenziswa kwamaNdiya naseBrithani) kanye ne-EKG (kusukela eJalimane I-Electrocardiogramm, okuvamile e-US)
• I-ECG enama-lead angu-12, i-ECG ephumuzayo
• "Ukulandelela inhliziyo", "igrafu yenhliziyo", "ukuhlolwa kwe-ECG"
• Ngokuvamile kudidaniswa engxoxweni "ne-echo test" (echocardiogram), okuwukuhlolwa okuhlukile kusetshenziswa i-ultrasound

Kuyini i-electrocardiogram

Inhliziyo ishaya ngenxa yesignali kagesi eqala ku-node ye-sinoatrial (SA), isakazeke ku-atria, ime isikhashana ku-node ye-atrioventricular (AV), bese ihamba phansi ohlelweni lokuhambisa umoya iye kuma-ventricles. Lawa maza afinyelela ebusweni besikhumba, lapho ama-electrode angawathatha khona.

I-ECG ejwayelekile enama-lead angu-12 isebenzisa ama-electrode ayishumi anamathelayo, ayisithupha esifubeni kanye namane emilenzeni, ukudala "imibono" kagesi eyishumi nambili ehlukene yenhliziyo. Umshini unyathelisa umkhondo onezingxenye ezibonakalayo:

• I-P wave: ukusebenza kukagesi kwe-atria.
• I-QRS complex: ukusebenza kukagesi kwama-ventricle.
• I-T wave: ukululama kukagesi (ukuvuselelwa kabusha kwe-ventricles).
• Izikhawu (i-PR, ubude be-QRS, i-QT): ukuthi isinyathelo ngasinye sithatha isikhathi esingakanani, okuyilapho ukubambezeleka kokuqhuba kanye nemiphumela ethile yemithi kuvela khona.

I-ECG iqopha ukuziphatha kukagesi kuphela. I-electrocardiogram ayibonisi imisipha yenhliziyo, ama-valve noma imithambo yegazi.

Kungani kwenziwa i-electrocardiogram

• Ubuhlungu besifuba noma ukungakhululeki kwesifuba: ukubheka izinguquko ezisikisela isigameko esibi senhliziyo, okungcono kakhulu kungakapheli imizuzu yokufika endaweni ephuthumayo.
• Ukushaya kwenhliziyo okusheshayo noma okuhamba kancane: ukuchaza isigqi uma sikhona ngesikhathi sokurekhoda.
• Ukuphelelwa umoya, ukuphelelwa umoya noma ukuphelelwa umoya: ukubheka i-conduction block, amaphethini angaphambi kokuvusa, i-QT ende noma ubufakazi bokucindezeleka.
• Isifo senhliziyo esaziwayo: ukulandelela ukuqhutshwa, isigqi kanye nokuphindaphinda ngokuhamba kwesikhathi.
• Ukuqapha imithi: imithi eminingana yenhliziyo, eminye imithi yokwelapha izifo zengqondo, eminye imithi elwa namagciwane kanye neminye imithi yokwelapha ukugabha ithinta isikhathi noma ukuqhutshwa kwe-QT.
• Izinkinga ze-electrolyte nezinso: Ukuphazamiseka okuphawulekayo kwe-potassium noma i-calcium kungashintsha ukulandelela, yize i-ECG ingeyona indawo yokuhlolwa kwegazi.
• Ngaphambi kokuhlinzwa noma i-anesthesia: lapho ubudala, izimpawu noma isifo senhliziyo esikhona senza kube yinto ebalulekile.
• Isisekelo ngaphambi kokwelashwa okuthile: isibonelo ngaphambi kokuqala izidakamizwa ezaziwa ukuthi zandisa isikhathi se-QT.

Ubani okufanele athole lolu vivinyo

I-ECG ifanelekile uma udokotela enombuzo othize mayelana nokusebenza kukagesi kwenhliziyo yakho. Lokho kuvame ukuhlanganisa abantu aba:

• ukuba nobuhlungu esifubeni, ingcindezi, noma ubuhlungu obuphuma emhlathini, emhlane noma engalweni, ngokushesha
• ukuba nokushaya kwenhliziyo okungavamile, ukushaya kwenhliziyo okungajwayelekile, noma ukushaya kwenhliziyo okusheshayo/okuhamba kancane okubhalwe phansi
• uke waquleka, ikakhulukazi ngesikhathi sokuzikhandla, noma unomlando womndeni wokushona kwenhliziyo ngokuzumayo esihlotsheni esisesincane
• ukuba nokuphefumula okungachazeki noma ukuncipha kokubekezelela ukuzivocavoca
• baphila nomfutho wegazi ophakeme, isifo sikashukela, isifo sezinso esingamahlalakhona, noma isifo senhliziyo noma se-valvular esivele sikhona, okuhlanganisa nesifo senhliziyo esinama-rheumatic
• uphuza imithi engathinta isigqi senhliziyo noma isikhawu se-QT, njengoba kuceliwe ngudokotela
• zihlolwa ngaphambi kokuhlinzwa, noma njengengxenye yokuhlolwa kwezemidlalo kwangaphambi kokubamba iqhaza okuhlelekile lapho inqubo yendawo idinga khona

I-ECG ephumulile kumuntu osemusha ongenazo izimpawu futhi ongenazo izici eziyingozi ivame ukwengeza okuncane futhi ingaphakamisa imibuzo mayelana nezinhlobo eziyingozi. Ukuthi ukuhlolwa kwe-ECG kuwusizo yini kuyisinqumo sikadokotela wakho, hhayi isengezo esivamile. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.

Lokho i-electrocardiogram engenakukubona noma ukukukhipha

Lena yingxenye eyodwa engaqondakali kakhulu yokuhlolwa.

• Ayiboni ngeso lengqondo imithambo yenhliziyo. I-ECG evamile yokuphumula ayikuvimbeli ukugula kwemithambo yenhliziyo, futhi ayikutsheli ukuthi umthambo unciphile yini.
• Akulinganisi amandla okupompa. Ingxenye yokukhipha igazi ivela ku-echocardiogram noma ku-MRI yenhliziyo, hhayi ku-ECG.
• Ayihloli ama-valve. Ukuncipha noma ukuvuza kwevalvu, okuhlanganisa nesifo sevalvu yamathambo, kudinga i-echocardiography. I-ECG ingabonisa amaphethini egumbi lesibili, kodwa ayikwazi ukulinganisa ivalvu.
• Akunakwenzeka ukuthi kususwe ngokuthembekile ukuhlaselwa yinhliziyo. Ukuhlaselwa yinhliziyo okusheshayo noma okungaphakeme kwe-ST kungaba nokulandelela kokuqala okuvamile noma okucishe kube okuvamile. Kusetshenziswa ama-ECG alandelanayo kanye nokuhlolwa kwegazi kwe-troponin okuzwela kakhulu, ngoba ukulandelela okukodwa akwanele.
• Ngokuvamile ayizwani nokuphazamiseka kwe-arrhythmias ngezikhathi ezithile. Ukuqoshwa kwemizuzwana eyi-10 kubamba isigqi kuphela ngaleso sikhathi. Uma ukushaya kwenhliziyo kufika futhi kudlule, i-ECG evamile ayikukhiphi ukungasebenzi kahle kwenhliziyo; i-Holter, i-patch ende noma ukuqapha umcimbi kungadingeka.
• Ayihlolisisi ngqo amahlule egazi emaphashini. I-pulmonary embolism ingase iveze amaphethini abonisa ukusikisela, kodwa ukuxilongwa kuncike ekuthathweni kwezithombe njenge-CT pulmonary angiography.
• Amaphethini okukhulisa ikamelo awaqondile. Izindlela ze-ECG zokwenyuka kwe-ventricular kwesobunxele azibucayi futhi aziqondile; i-echocardiography iyayilinganisa.
• Ezinye izimo zesakhiwo kanye nezakhi zofuzo zingaba ne-ECG evamile, ikakhulukazi ekuqaleni.

Ukuthi “akubonakali” akufani nokuthi “akufakiwe”. Uma ubuhlungu besifuba sakho, ukuphelelwa umoya, ukushaya kwenhliziyo noma ukuquleka kuqhubeka naphezu kwe-ECG evamile, buyela kudokotela wakho, ungaphathi umbiko ojwayelekile njengefayela elivaliwe.

Ukuhlolwa okuhlobene kodwa okuhlukile

Akukho ukuhlolwa okukodwa "okungcono" kuyo yonke indawo. Ukuthi yikuphi ukuhlolwa okuza kuqala kuncike enkingeni: ubuhlungu besifuba obuqhubekayo endaweni ephuthumayo buqala nge-ECG kanye ne-troponin; ukushaya kwenhliziyo okuphindaphindiwe kuvame ukudinga ukuqapha isigqi; ukukhononda noma isifo se-valve esisolwayo kukhomba i-echocardiography; ubuhlungu besifuba obuzinzile kumuntu osengozini ephakathi buvame ukuholela ku-CT coronary angiography noma ku-functional imaging, kuye ngokutholakala kanye nokwahlulela kwethimba elilaphayo.

Ungalungiselela kanjani

Ukulungiselela i-ECG yokuphumula kuncane kakhulu, futhi imiyalelo ethile iyasebenza futhi ibekwa yiyunithi eqhubayo. Imiyalelo ebhaliwe yeyunithi yakho iza kuqala kunanoma yini oyifunda ku-inthanethi.

• Izingubo: gqoka into evuleka noma ephakama kalula esifubeni; ungase ucelwe ukuthi ugqoke ingubo.
• Isikhumba: Gwema uwoyela, i-moisturiser, i-talc noma i-lotion esifubeni, ezingalweni nasemilenzeni ngosuku, njengoba lokhu kunciphisa ukuthintana kwe-electrode. Izinwele zesifuba zingadinga ukunqunywa ezindaweni ze-electrode.
• Ukuzila ukudla: Akudingeki kwi-ECG ejwayelekile yokuphumula. Uma i-ECG iyingxenye yokuhlolwa kokucindezeleka noma iphakheji ebanzi, landela inqubo ethile yalolo vivinyo.
• Imithi: Letha uhlu lwakho lwemithi yamanje. Ungayeki, uqalise noma ushintshe noma yimuphi umuthi owunikezwe ukuhlolwa, okuhlanganisa ama-beta blockers, ama-antiarrhythmics noma umuthi we-thyroid, ngaphandle kokuthi udokotela okunike wona ekutshela ukuthi wenze kanjalo.
• Izikhuthazi: Ukuze uthole i-ECG yokuphumula, i-caffeine ne-nicotine akuzona izithiyo eziphelele, kodwa zingakhuphula izinga lokushaya kwenhliziyo futhi zengeze ukushaya kwe-ectopic. Uma ukuhlolwa kwenziwa ngqo ukuhlola ukushaya kwenhliziyo noma ukuhlolwa kokucindezeleka, landela isiqondiso seyunithi.
• Tshela abasebenzi Uma une-pacemaker noma i-defibrillator efakwe, ukuhlaselwa yinhliziyo noma ukuhlinzwa kwe-bypass ngaphambilini, amanxeba esifubeni noma amabhandeshi, noma uma uke waba nokuhlolwa okufanayo ngaphambili, ukulandelela kwangaphambilini kubalulekile ukuze kuqhathaniswe.

ukukhulelwa

I-ECG ayibandakanyi imisebe futhi isetshenziswa ekukhulelweni uma kuboniswe ngokwezokwelapha. Indawo ingalungiswa, ukulala phansi ngomhlane ekukhulelweni kamuva kungabangela ikhanda elikhanyayo, ngakho-ke indawo ebheke ngakwesobunxele noma eqonde kancane ivame ukusetshenziswa. Ezinye izinguquko ze-ECG, okuhlanganisa ukushintsha kwe-axis kanye nezinguquko ezincane ze-T-wave, zenzeka ngokuvamile ekukhulelweni futhi zidinga ukuchazwa udokotela owaziyo ngokukhulelwa.

Izingane

Ama-ECG ezingane asebenzisa ama-electrode amancane, futhi okubaluleke kakhulu, amanani ajwayelekile ngokweminyaka, izindlela zabantu abadala aziqondi kahle izindlela izingane ezilandelela ngazo. Ukuchaza izitika kusengaphambili kuyasiza; ukunyakaza nokukhala kuvame ukubangela izinto ezidaliwe, ngakho-ke kungadingeka ukuqopha okuphindaphindiwe.

Abantu abadala kanye nabantu abangakwazi ukuhamba kahle

Isikhumba esibuthakathaka noma esincane singase sisabela ekunamatheni, futhi ukuthuthumela noma isifo sikaParkinson kungadala into yokuqala. Tshela uchwepheshe uma ukulala phansi kunzima; ukuqoshwa okugobile kancane kungachazwa.

Abantu abane-pacemaker noma amadivayisi afakwe

I-ECG iphephile ngama-pacemaker kanye nama-defibrillator afakwa emzimbeni futhi ivame ukusetshenziswa ngokunembile ukuhlola ukuziphatha kwedivayisi. Njalo khuluma ngedivayisi, njengoba ukulandelela kuhunyushwa ngendlela ehlukile. Ukuphenywa kwedivayisi ethile yithimba le-cardiology kunikeza ulwazi olungenakukwazi ukuhlinzekwa yi-ECG engaphezulu.

Isifo sikashukela, isifo sezinso esingamahlalakhona kanye nokwehluleka kwenhliziyo

Akukho ukulungiselela okukhethekile okudingekayo ukuze uthole i-ECG yokuphumula, futhi akukho mkhawulo woketshezi noma wokuzila ukudla osebenzayo. Uma i-ECG yakho iyingxenye yokuhlolwa kokucindezeleka, imiyalelo yokuzila ukudla kanye nemithi yalolo vivinyo ingathinta abantu abasebenzisa i-insulin noma eminye imithi yokwehlisa ushukela, abantu abasebenzisa imikhawulo yoketshezi, kanye nabantu abanesifo sezinso esithuthukile noma ukwehluleka kwenhliziyo, cela udokotela ocelayo ukuthi akunike imiyalelo yomuntu ngamunye ngaphambi kokuthi uzile ukudla noma weqe umthamo.

Kwenzekani ngesikhathi se-electrocardiogram

• Isikhundla: Ulala kusofa bese uveza isifuba, izihlakala namaqakala. Ubumfihlo kanye nomphelezeli kungacelwa.
• Ukubekwa kwe-Electrode: Ama-electrode anamathelayo ayishumi abekwa ezindaweni ezithile zomzimba. Ukubekwa okunembile kubalulekile; izintambo ezilahlekile ziyimbangela evamile yokulandelwa okungavamile.
• Ukurekhoda: ulala unganyakazi, uphefumula ngendlela evamile futhi ugweme ukukhuluma imizuzwana embalwa ngenkathi umshini uqopha. Ukuqhaqhazela, ukukhwehlela noma ukunyakaza kungafiphaza umkhondo, futhi uchwepheshe angase akuphinde lokho.
• Ngemva kwalokho: Ama-electrode ayasuswa. Ukubomvu kwesikhumba okufushane noma ukunamathela okuncane kuvamile. Umsebenzi ojwayelekile, ukudla nokushayela kungaqhubeka ngokushesha, ngaphandle kokuthi isizathu sokuhlolwa ngokwaso sibeka imingcele.

Inqubo ithatha isikhathi esingakanani

Ukuqoshwa kwangempela kukagesi kuvame ukuba yimizuzwana eyi-10. Ukubekwa kwe-electrode, ukubeka kanye nokukhumula/ukugqoka kusho ukuthi i-aphoyintimenti ivame ukuthatha imizuzu emi-5-10, futhi isikhathi eside uma kudingeka ukulandelwa okuphindaphindiwe, uma izinwele zesifuba kufanele zinqunywe, noma ezinganeni. Emnyango ophuthumayo onezinhlungu zesifuba, inhloso iwukuba kuthathwe ukulandelwa futhi kubuyekezwe zingakapheli imizuzu yokufika. Esimweni esiphuthumayo udokotela ubuyekeza ukulandelwa ngokushesha; ukuze kuhlolwe njalo iziguli zangaphandle, isikhathi sokubika sincike ekusebenzeni kweyunithi.

Ukuqonda umbiko wakho we-ECG

Umbiko we-ECG uvame ukuba nezingxenye ezintathu: ukulandelela okuphrintiwe, isethi yezilinganiso ezenziwe ngomshini, kanye nokuchazwa komuntu.

• Isilinganiso senhliziyo: Kubikwa ngama-beats ngomzuzu. Amanani angaphansi noma angaphezu kwebanga elivamile labantu abadala awavamile ngokuzenzakalelayo, abasubathi abaqeqeshwe bavame ukuba namazinga okuphumula kancane, kanti ukukhathazeka, umkhuhlane, ubuhlungu, i-anemia noma ukuphelelwa amanzi emzimbeni kuvame ukuphakamisa izinga.
• Isigqi: "isigqi se-sinus" sisho ukuthi i-pulse iqala endaweni evamile. I-Atrial fibrillation, i-atrial flutter, i-supraventricular tachycardia kanye ne-ventricular arrhythmias zichazwa ngamagama.
• Izikhawu: Isikhawu se-PR (ukuhanjiswa kwe-AV), ubude besikhathi se-QRS (ukuhanjiswa kwe-ventricular, okuqhubeka isikhathi eside ku-bundle branch block), kanye ne-QT/QTc (ukubuyiselwa kwe-polarization, okuhambisana nemithi ethile kanye nezimo ezizuzwe njengefa).
• I-axis nama-voltage: isiqondiso kanye nosayizi wamandla kagesi. Izindlela zokulinganisa i-voltage ze-hypertrophy azithembekile zodwa futhi zithonywa ukwakheka komzimba, ukujiya kodonga lwesifuba kanye nokubekwa komthofu.
• Ingxenye ye-ST kanye namagagasi e-T: Ukuphakama kwe-ST noma ukucindezeleka kanye nokuguqulwa kwe-T-wave kungabonisa i-ischaemia noma ukulimala, kodwa futhi kwenzeka nge-pericarditis, i-myocarditis, ukuphazamiseka kwe-electrolyte, i-bundle branch block, i-early repolarisation variants kanye ne-left ventricular hypertrophy.
• Amagagasi e-Q: kungase kubonise ukuhlaselwa yinhliziyo okudala, okuphulukisiwe, noma kungase kube nesimo futhi kungabi nangozi.

Isitatimende somshini esizenzakalelayo phezulu kokuphrinta, imishwana efana nokuthi "i-ECG engavamile", "i-infarct endala engenzeka", "i-T-wave engavamile" noma "cabanga nge-left ventricular hypertrophy", iyisiphakamiso sekhompyutha, hhayi ukuxilongwa. Ukufundwa okuzenzakalelayo kuvame ukubizwa ngokweqile futhi kuvame ukulungiswa ngudokotela obikayo. Ungathathi isinyathelo esitatimendeni esishicilelwe ngaphambi kokuba udokotela achaze ukulandelela ngokwesimo sezimpawu zakho, ukuhlolwa, izici eziyingozi kanye nama-ECG angaphambilini. Ukuqhathaniswa nokulandelela okudala kuvame ukushintsha incazelo ngokuphelele: okutholakele okuzinzile akukhathazi kakhulu kunentsha.

Uma imiphumela ye-ECG ingadukisa

Okutholakele okungabonakala kungajwayelekile ngokungeyikho

• Ukubekwa kabi komthofu noma ukushintshaniswa kwama-lead ezitho ingalingisa i-infarction yakudala, i-axis shift noma iphakamise ngisho ne-dextrocardia.
• Ukunyakaza, ukuthuthumela, ukuthuthumela noma ama-electrode axegayo ingalingisa i-arrhythmia noma ikhiqize isisekelo sokuzulazula.
• Ukuphazamiseka kukagesi kusuka emishinini eseduze kungambozwa izinto zobuciko ezifana nokuphaphazela noma i-fibrillation.
• Izinhlobo ezijwayelekile njengokuphindeka kwe-polarization kusenesikhathi, i-sinus arrhythmia ngokuphefumula, kanye nezinguquko ezihlobene nabadlali zivame ukubizwa ngokuthi "ezingavamile" yisoftware.
• Ukujwayela komzimba, izicubu zebele, ukukhuluphala, ukwehla okukhulu kwamaphaphu noma i-edema ukushintsha ama-voltage kanye nokubonakala kwe-ST-T.
• Ibhulokhi yegatsha elihlanganisiwe, ukuhamba ngesivinini kanye nokuvuselela ngaphambi kosuku ukuhlanekezela izingxenye ze-ST, okwenza ukuhlolwa kwe-ischemia kungathembeki nge-ECG engaphezulu kuphela.
• Ukuphazamiseka kwe-electrolyte kanye ne-metabolic: ukungalingani kwe-potassium, i-calcium kanye ne-magnesium, kanti eminye imithi ingadala izinguquko ze-ST-T kanye ne-QT ezingahlobene nesifo senhliziyo.

Okutholakele okungabonakala kujwayelekile noma kuqinisekisayo

• Ukuhlaselwa yinhliziyo kwasekuqaleni: Ukulandelela kokuqala kungaba okuvamile. Ukuhlolwa kwe-ECG okuphindaphindiwe kanye nokuhlolwa kwe-troponin kubalulekile uma izimpawu zibonisa ukuthi une-acute coronary syndrome.
• Ukuhlaselwa kwendawo yangemuva noma ehlangothini kungaba lula kuma-lead ajwayelekile angu-12.
• Ukuphazamiseka kwe-arrhythmia okungavamile zinyamalale phakathi kweziqephu, ukuze umkhondo wokuphumula ubonakale ujwayelekile ngokuphelele.
• Isifo senhliziyo esizinzile ivame ukukhiqiza i-ECG evamile yokuphumula ngisho noma kunokuncipha okukhulu.
• Ukungajwayelekile kokuqhuba kwesisekelo noma isigqi esisheshayo ingafihla izinguquko ezintsha ze-ischemic.

Ngenxa yalokhu, udokotela ulinganisa i-ECG nendaba yakho. Izimpawu eziqhubekayo noma eziya ziba zimbi kakhulu kunezimpawu ezijwayelekile.

Izingozi nokuphepha

I-ECG yokuphumula enama-lead angu-12

I-ECG ephumulile iqopha izimpawu zikagesi; ayilethi ugesi emzimbeni, ayisebenzisi imisebe futhi ayidingi umjovo. Izinkinga ezingokoqobo zincane: ukubomvu kwesikhumba okudlulayo noma ukulunywa okubangelwa yiglu, ukungakhululeki okuncane lapho kususwa amaphedi, ukungakhululeki ngenxa yokugunda izinwele zesifuba, kanye nokusabela kwesikhumba kwendawo okungavamile. Ingozi enkulu yezokwelapha akuyona engokomzimba kodwa echazayo, ukulandelela okungalungile noma okuhunyushwe ngokweqile kungaholela ekukhathazekeni okungadingekile nasekuhlolweni okwengeziwe, noma ekuqinisekisweni okungamanga.

Ukuzivocavoca (ukucindezeleka) i-ECG

I-ECG yokucindezeleka inephrofayili ehlukile nephezulu yengozi, ngoba yandisa ngamabomu umthwalo womsebenzi wenhliziyo. Izehlakalo ezingavamile kodwa eziqashelwayo zifaka phakathi ubuhlungu besifuba, ukungalingani kwenhliziyo, ushintsho oluphawulekayo lomfutho wegazi, ukuquleka kanye, okungajwayelekile, nezehlakalo ezinkulu zenhliziyo. Yenziwa ngokuqapha kwezokwelapha kanye nezindawo zokuvuselela ezitholakalayo, futhi ayifanele wonke umuntu, isibonelo ku-acute coronary syndrome okusolwayo, i-aortic stenosis enzima noma i-arrhythmia engalawulwa. Izitatimende zokuphepha ze-ECG yokuphumula azidluliseli ekuhlolweni kokucindezeleka.

Ukuqapha kwe-Holter kanye nokuhamba ngezinyawo

Izingozi zikhawulelwe ekucasukeni kwesikhumba ngenxa yokuxhumana kwe-electrode isikhathi eside kanye nokuphazamiseka kokugqoka idivayisi. Umphumela wokuxilonga uncike ekutheni izimpawu zenzeka kangaki ngesikhathi sokuqapha.

Izimo ezikhethekile

ukukhulelwa

Ukushaya kwenhliziyo nokuphelelwa umoya kuvamile ekukhulelweni, futhi i-ECG iyisinyathelo sokuqala esinengqondo, esingenamisebe. Izinguquko zomzimba zishintsha umkhondo, ngakho-ke ukuhumusha okuqaphela ukukhulelwa kubalulekile. Isifo se-rheumatic valve esiqala ukukhulelwa sibalulekile eNdiya, futhi ngokuvamile sidinga i-echocardiography kune-ECG yodwa.

Izingane kanye nentsha

Ukulandelela kwezingane kumele kufundwe ngokwesilinganiso sobudala. Uphenyo luyadingeka uma umuntu equleka ngesikhathi sokuzivocavoca, ukushaya kwenhliziyo okubangelwa ukuwa, noma umlando womndeni wokushona ngokuzumayo esihlotsheni esisesincane. Ukuhlolwa kwesifo senhliziyo esizalwa naso kuncike ku-echocardiography, kanye ne-ECG njengesivivinyo esisekelayo.

Abantu abadala abadala

Isifo se-atrial fibrillation kanye nesifo sokuhambisa igazi siba sivame kakhulu ngokweminyaka, futhi ukuhlaselwa yinhliziyo kuvame ukuba khona ngaphandle kobuhlungu besifuba obuvamile, kanye nokuphelelwa umoya, ukudideka noma ukukhathala esikhundleni salokho. Ukulandelela okudala kuvame ukukhombisa ukukhubazeka okuningana okuhambisanayo, ngakho-ke ukuqhathanisa nama-ECG angaphambilini kuyasiza kakhulu.

Diabetes

Isifo senhliziyo singaba sibi kakhulu futhi singabi nazimpawu kubantu abanesifo sikashukela esidala, ngakho-ke i-ECG evamile akufanele ithathwe njengokuphuma kwaso. Xoxa nodokotela wakho nganoma yisiphi isibonakaliso sokuzikhandla, noma ngabe sincane.

Isifo sezinso esingamahlalakhona kanye ne-dialysis

Ukushintsha kwe-potassium ne-calcium ezungeze i-dialysis kungashintsha umkhondo, futhi i-hypertrophy ye-ventricular yesobunxele ivamile. Izinguquko ze-ECG ziyasikisela kodwa azithathi indawo yokuhlolwa kwamakhemikhali kokuphazamiseka kwe-electrolyte.

Ukuhluleka kwenhliziyo

I-ECG isiza ekuboneni izinkinga zesigqi kanye nokubambezeleka kokuqhuba njengokuvimba kwegatsha lesobunxele, okuthonya izinqumo zedivayisi kanye nokwelashwa. Ayilinganisi ingxenye yokukhipha; i-echocardiography kanye nokuhlolwa kwe-natriuretic peptide kufeza leyo njongo.

Abadlali

Ukuqeqeshwa kuveza izinguquko ze-ECG eziqashelwayo, okuhlanganisa izinga eliphansi kanye nokwanda kwamandla kagesi, okungesona isifo. Ukuhlukanisa lokhu ku-cardiomyopathy noma i-channelopathy kudinga izindlela ezithile zomdlali kanye nokuthwebula izithombe okwengeziwe.

I-electrocardiogram kumongo waseNdiya

• Ukutholakala: Imishini ye-ECG iphakathi kwamadivayisi okuxilonga asatshalaliswa kakhulu eNdiya, akhona ezibhedlela zesifunda, emitholampilo emincane, emalabhorethri okuxilonga kanye nasezikhungweni eziningi zezempilo eziyisisekelo. Lokhu kwenza i-ECG ibe ukuhlolwa kokuqala kukagesi okusebenzayo kokubili ezindaweni zasemadolobheni nezasemakhaya.
• Ulimi kanye nokuqanjwa kwamagama: Iziguli zivame ukusebenzisa i-"ECG" kanye ne-"echo test" ngokushintshana, kodwa lokhu kuyizivivinyo ezahlukene, i-ECG iqopha ugesi, i-echo isebenzisa i-ultrasound ukuze ihlele isithombe kanye nomsebenzi waso. Cacisa ukuthi yisiphi esiceliwe.
• Isifo senhliziyo esibuhlungu Kusalokhu kuyimbangela ebalulekile yesifo se-valve eNdiya, ikakhulukazi kubantu abadala abasebasha. Kungase kubonise i-atrial fibrillation noma amaphethini okukhulisa ikamelo ku-ECG, kodwa ukuxilongwa kanye nokuhlolwa kudinga i-echocardiography.
• Isifo se-Coronary esemncane: Abantu baseNingizimu Asia bavame ukuba nesifo semithambo yenhliziyo kusenesikhathi futhi ngesisindo somzimba esiphansi kunabanye abantu abaningi. Ubudala bodwa akufanele bunciphise izinsolo, futhi i-ECG evamile yokuphumula akufanele idlule umlando wezimpawu ezikholisayo.
• I-anemia, kufaka phakathi i-anemia yokuntuleka kwensimbi kanye nesici se-thalassemia, kusakazeke kabanzi futhi kungabangela ukushaya kwenhliziyo okusheshayo, ukuphelelwa umoya kanye nokushaya kwenhliziyo okusheshayo, izimpawu ezingase zibangele i-ECG. Ukuhlolwa kwegazi kuyadingeka kanye.
• Izinkinga ze-thyroid ziyimbangela evamile neyelaphekayo ye-atrial fibrillation noma i-sinus tachycardia etholakala ku-ECG.
• I-Tele-ECG kanye neziteshi zokudlulisela: Izikhungo eziningi ezincane zithumela umkhondo wokubika kude. Phatha okuphrintiwe kokuqala noma isithombe esicacile kuyo yonke ingxoxo, ukuqhathanisa okulandelanayo kushintsha ngempela incazelo.
• Amaphakheji okuhlolwa kwempilo ngokuvamile ukubopha i-ECG ephumulile. Izitatimende zomshini ezingalindelekile ezivela kula maphakheji ziyisizathu esivamile sokukhathazeka; thatha umkhondo uwuyise kudokotela kunokuba useshe umusho ku-inthanethi.
• Ubumfihlo bedatha: Ukulandelela kanye nemibiko ye-ECG kuyidatha yezempilo yomuntu siqu. Ngaphansi koMthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, ka-2023, noma yiliphi ifomu ledijithali, iphothali noma uhlelo lokusebenza oluqoqa imininingwane yakho kufanele likutshele ukuthi yini eqoqwe nokuthi kungani, futhi lufune imvume yakho.

Izindleko kanye nomshuwalense, nokuthi yini ethinta intengo eNdiya

I-ECG ephumuzayo enama-lead angu-12 ingenye yezindlela zokuhlola inhliziyo ezingabizi kakhulu ezitholakala eNdiya, ngokuvamile ezibiza kancane kakhulu kune-echocardiogram, ukuhlolwa kokucindezeleka kwe-treadmill noma i-CT coronary angiography. Amanani ayahlukahluka kakhulu phakathi kwekliniki encane, uchungechunge lokuxilonga kanye nesibhedlela esikhulu sesithathu, kanye naphakathi kwamadolobha.

Izici ezithonya lokho okukhokhayo:

• Uhlobo lwesikhungo, ilabhorethri ezimele, ikhaya labahlengikazi, isibhedlela senkampani noma isikhungo sikahulumeni
• Idolobha nendawo
• Ukuthi i-ECG izimele noma ihlanganiswe kuphakheji yokuhlolwa kwempilo noma yangaphambi kokuhlinzwa
• Ukuthi imali yokubika yodokotela wenhliziyo ehlukile ikhokhiswa yini ngaphezu kokuqoshwa
• Kungakhathaliseki ukuthi ukuhlolwa kwenziwa emnyangweni wezimo eziphuthumayo noma njengomuntu olaliswe esibhedlela, lapho kungaba yingxenye yephakheji yokunakekelwa ebanzi
• Izinsizakalo ze-ECG ezingaphandle kwamahora okusebenza, eziseceleni kombhede noma eziqoqwa ekhaya
• Izengezo ezifana nokulandelela okuphindaphindiwe noma okulandelanayo, imichilo yesigqi noma ukuqapha okulandelayo kwe-Holter

Ngomshwalense: izivivinyo zokuxilonga zesiguli sangaphandle zivame ukungambozwa ngaphansi komshwalense wezempilo ojwayelekile ngaphandle kokuthi inqubomgomo ifaka i-OPD noma inzuzo yokuhlola impilo. Uma i-ECG yenziwa ngesikhathi sokungeniswa esibhedlela esimboziwe, ngokuvamile iyingxenye yesimangalo. Ama-ECG angaphambi kokuqashwa, umshwalense, ezokwelapha kanye nesitifiketi sokufaneleka ngokuvamile akhokhwa ngumfakisicelo noma umqashi. Qinisekisa ukumbozwa nomshwalense wakho noma ideski lomshwalense wesibhedlela ngaphambi kokuhlolwa.

Izinganekwane namaqiniso

Imibuzo ejwayelekile ukubuzwa

Ingabe i-ECG ingaba yinto evamile noma ngabe nginomthambo ovalekile?

Yebo. I-ECG ephumulile ayibonisi imithambo yenhliziyo, futhi abantu abaningi abanokuncipha okukhulu banokulandelana okuvamile phakathi kweziqephu. Uma unezinkinga zesifuba noma ukuphelelwa umoya, udokotela wakho angase ancome ukuhlolwa kokusebenza noma i-CT coronary angiography naphezu kwe-ECG evamile.

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

Leli gama lisho ukuthi iphethini yokubuyiselwa kwe-polarization ayijwayelekile ngokwezincwadi kodwa ayikhombisi ukuxilongwa okuthile. Izimbangela zifaka phakathi ukwakheka komzimba, ukubekwa komthofu, ukushintsha kwama-electrolyte, imithi kanye nezinhlobo ezijwayelekile. Kudinga ukubuyekezwa kanye nezimpawu zakho, izici eziyingozi kanye nanoma yikuphi ukulandelwa kwangaphambilini, kunokuchazwa okuhlukile.

Uyini umehluko phakathi kwe-ECG ne-Holter monitor?

I-ECG ejwayelekile iqopha cishe imizuzwana eyishumi yesigqi, ngakho-ke iqopha kuphela okwenzekayo ngaleso sikhathi. I-Holter noma i-patch monitor iqopha njalo usuku kuya emavikini amaningana, okuyinto engcono kakhulu ekushayweni kwenhliziyo, ukucima komoya noma ukungasebenzi kahle kwenhliziyo okusolwayo okufika nokuhamba.

Kuthatha isikhathi esingakanani ukuqokwa kwe-ECG yonke?

Ukuqoshwa kukagesi ngokwako kuthatha cishe imizuzwana eyishumi. Ukubekwa kwama-electrode, ukubeka kanye nokugqoka ngokuvamile kwenza ukuvakasha okuphelele kube yimizuzu emihlanu kuya kweyishumi. Kungathatha isikhathi eside ezinganeni, uma kudingeka ukulandelwa okuphindaphindiwe ngenxa yezinto ezinyakazayo, noma uma izinwele zesifuba zidinga ukunqunywa kuqala.

Ingabe i-ECG iyalimaza noma isebenzisa imisebe?

I-ECG ephumuzayo ayisebenzisi imisebe, ayinazinaliti futhi ayinakho ukugqama. Ama-electrode amane anamathele esikhumbeni. Iningi labantu alizwa lutho ngaphandle kokudonswa okuncane lapho ama-adhesive pad ehlutshiwe, futhi ngezinye izikhathi kuba nokubomvu kwesikhumba noma ukulunywa okuncane ezindaweni zama-electrode.

Ingabe i-ECG iphephile uma ngine-pacemaker?

Yebo, futhi kuvame ukwenziwa ngqo ukuhlola ukuthi i-pacemaker isebenza kanjani. Tshela uchwepheshe nganoma iyiphi idivayisi efakwe, ngoba ukulandelela okuhamba ngesivinini kufundwa ngendlela ehlukile. Ukuphenywa kwedivayisi okusemthethweni yithimba le-cardiology kunikeza ulwazi mayelana ne-ECG engaphezulu.