Most ECG pathologies can be diagnosed. The causes of their appearance are due to concomitant diseases and features of the patient's lifestyle.
What does this mean if the ECG detected changes in the myocardium? In most cases, the patient requires conservative treatment and lifestyle correction.
Description of procedure
Electrocardiogram( ECG) - is one of the most informative, simpleand available cardiac studies. It analyzes the characteristics of the electric charge, which contributes to the contractions of the heart muscle.
Dynamic recording of charge characteristics is performed on several parts of the muscle. The electrocardiograph reads information from the electrodes placed on the ankles, wrists and skin of the chest in the region of the projection of the heart, and converts them into graphics.
Norm and deviations - possible causes of
Normally, the electrical activity of the areas of the myocardium, which the ECG registers, should be uniform. This means that the intracellular biochemical exchange in the heart cells occurs without pathologies of and allows the cardiac muscle to produce mechanical energy for contractions.
If the balance in the internal environment of the body is disrupted for various reasons - , the following characteristics of the are recorded on the ECG:
- diffuse myocardial changes;
- focal changes in the myocardium.
The reasons for such changes in the myocardium on ECG can be both harmless conditions of , not threatening the life and health of the subject, and serious dystrophic pathologies requiring urgent medical attention.
Causes of myocarditis:
- rheumatism, as a consequence of scarlet fever, sore throat, chronic tonsillitis;
- complications of typhus, scarlet fever;
- consequences of viral diseases: influenza, rubella, measles;
- autoimmune diseases: rheumatoid arthritis, systemic lupus erythematosus.
One of the reasons for changing muscle tissue can be cardio-dystrophy - a metabolic disorder in the heart cells without affecting the coronary arteries. Lack of nutrition cells leads to a change in their normal functioning, violation of contractility.
Causes of cardiomyopathy:
- Intrusion into the blood of toxic metabolic products due to severe impairment of kidney and liver function;
- Endocrine diseases: hyperthyroidism, diabetes mellitus, adrenal gland tumor, and as a result, excess hormones or metabolic disorders;
- Constant psycho-emotional stress, stress, chronic fatigue, starvation, unbalanced nutrition with nutrient deficiency;
- Children have a combination of increased loads with a sedentary lifestyle, vegetative-vascular dystonia;
- Lack of hemoglobin( anemia) and its consequences - oxygen starvation of myocardial cells;
- Severe infectious diseases in acute and chronic form: influenza, tuberculosis, malaria;
- Dehydration of the body;
- Avitaminosis;
- Intoxication of alcohol, occupational hazards.
Cardiogram determination
In case of diffuse lesions of the , deviations from the normal pattern are noted in all leads. They look like numerous areas with disturbed electrical impulses.
This is expressed in a cardiogram, as a decrease in the T wave, which is responsible for repolarization of the ventricles. In case of focal lesions, such abnormalities are recorded in one or two leads. These deviations are expressed on the graph, as negative T wave in the leads.
If focal changes of are represented, for example, by scars remaining in connective tissue after a heart attack, they appear on the cardiogram as electrically inert areas.
Diagnostics
The decoding of the electrocardiogram data takes 5-15 minutes .Her data can reveal:
- The size and depth of ischemic lesion;
- Localization of myocardial infarction, as it happened a long time in the patient;
- Disorders of electrolyte metabolism;
- Increased cardiac cavity;
- Thickening of the walls of the heart muscle;
- Intracardiac conduction disturbances;
- Heart rhythm disturbances;
- Toxic myocardial damage.
Features of diagnosis in various pathologies of the myocardium:
- myocarditis - on the data of the cardiogram it is clearly visible the decrease of the teeth in all leads, disturbance of the heart rhythm, the result of the general blood test shows the presence of the inflammatory process in the body;
- myocardial dystrophy - ECG values are identical to those obtained with myocarditis, this diagnosis can be differentiated only with the help of laboratory data( blood biochemistry);
- myocardial ischemia - ECG data show changes in the amplitude, polarity and shape of the T wave, in those leads that are associated with the ischemic zone;
- Acute myocardial infarction - horizontal displacement of segment ST upward from the isoline, trough-like displacement of this segment;
- necrosis of the heart muscle - irreversible death of myocardial cells is reflected on the ECG chart as a pathological Q tooth;
- transmural necrosis - this irreversible damage to the wall of the heart muscle across the entire thickness is expressed in the cardiogram data as the disappearance of the R wave and the acquisition of a ventricular complex of the QS type.
When diagnosing additionally, one should pay attention to the symptoms of the accompanying diseases .It can be pain in the heart with myocardial ischemia, edema of the legs and hands in cardiosclerotic changes, signs of heart failure as a consequence of a heart attack carried on the legs, trembling of hands, sudden weight loss and exophthalmia in hyperthyroidism, weakness and dizziness in anemia.
The combination of such symptoms with the diffuse changes detected on the ECG requires an in-depth examination of the .
What diseases they accompany
Pathological changes in the myocardium, revealed on the ECG, can be accompanied by a violation of the blood supply to the heart muscle, the processes of repolarization, inflammatory processes and other metabolic changes.
In a patient with diffuse changes, such symptoms may appear:
- dyspnea,
- retrosternal pain,
- increased fatigue,
- cyanosis( blanching) of the skin,
- heart palpitations( tachycardia).
Diseases accompanied by changes in the heart muscle:
- Myocardial dystrophy - a violation of biochemical metabolic processes occurring in the heart;
- Allergic, toxic, infectious myocarditis - inflammation of the myocardium of various etiologies;
- Myocardiosclerosis - replacement of heart muscle cells with connective tissue, as a consequence of inflammation or metabolic diseases;
- Infringements of water-salt exchange ;
- Hypertrophy of the of the cardiac muscle.
Additional surveys are needed to differentiate them.
Additional diagnostic tests
These cardiograms, despite their informative nature, can not be the basis for an accurate diagnosis. In order to fully assess the degree of changes in the myocardium, the cardiologist appoints additional diagnostic measures:
- General clinical blood test - assesses the level of hemoglobin and such indicators of the inflammatory process as the level in the blood of leukocytes and ESR( erythrocyte sedimentation);
- Analysis for blood biochemistry - assesses the protein, cholesterol, glucose content for analysis of kidneys and liver;
- General clinical analysis of urine - assesses the performance of the kidneys;
- US for suspected pathology of internal organs - according to indications;
- Daily monitoring of ECG parameters;
- Conducting ECG with load;
- ultrasound of the heart ( echocardiography) - assesses the state of the heart to determine the cause of myocardial pathology: dilatation, cardiac muscle hypertrophy, signs of decreased myocardial contractility, impaired his motor activity.
Treatment for focal and diffuse disorders of
In the treatment of myocardial pathologies, uses different groups of drugs:
- Corticosteroid hormones are an antiallergic drug;
- Cardiac glycosides - for the treatment of diffuse changes in the myocardium, manifestations of heart failure( ATP, Cocarboxylase);
- Diuretics - for the prevention of edema;
- Means for improving metabolism( Panangin, Magneter, Asparcum);
- Antioxidants( Mexidol, Actovegin) - to eliminate the negative effects of lipid oxidation products;
- Antibiotics - for anti-inflammatory therapy;
- Drugs for the treatment of concomitant diseases;
- Vitamin preparations.
If conservative treatment does not lead to significant improvements in the condition of the patient with myocardial diseases, he undergoes an implantation of the myocardiostimulator.
The main provisions of dietary nutrition:
- The use of salt and excess fluid is limited to a minimum;
- Sharp and fatty foods are not recommended;
- The menu should include vegetables, fruits, low-fat fish and meat, dairy products.
Changes in the myocardium detected on the ECG, require additional laboratory and instrumental examination of the .If necessary, the cardiologist will prescribe the treatment in a hospital or in an outpatient setting. Timely measures taken will help avoid serious complications.
