In the article, we will consider what ECG changes are observed with PE.
An electrocardiogram is performed to study the functionality of the heart and the functioning of the vascular system. Based on the results of this diagnostic study, a specialist can easily determine whether the organ is working well or if the patient has certain pathologies.
Description of the disease
PE - pulmonary embolism, which is diagnosed by electrocardiogram. Pathology consists in the formation of a blood clot in the arteries of the lungs. PE is one of several types of venous thromboembolism that occurs in different parts of the body. According to statistics, this pathology ranks third among other diseases of cardiovascular origin, which provoke a fatal outcome.
What does the ECG show in PE?
Signs of PE
In the absence of initial chronic pathologiesheart symptoms of pulmonary embolism are well visualized on the results of the cardiogram. The specialist pays special attention to the functions of the right parts of the heart. The disease is often registered as a consequence of other pathological processes.
There are several stages of this disease. Types of ECG abnormalities in PE:
- Spicy. Lasts from 3 to 7 days. Manifestations of S1QIII are observed, in which there are noticeable increases in denticles, a change in the localization of the transitional area to the left side, the dissolution of the QRS complex in V1-2, V6R-3R leads of the rSR '(rSr') type, and a violation of the position of the ST segment. In some cases, you may notice irregularities in the teeth of the lungs. PE symptoms on ECG should not go unnoticed.
- Subacute. Develops in approximately 1-3 weeks. At this stage, negative teeth are formed, gradually deepening. At the same time, there remains a barely noticeable displacement of the anterior zone and a slight increase in the teeth.
- Reverse development. The term of this stage lasts about 2-3 months. With the reverse development, the opposite effect is noted: the negative teeth gradually decrease. Toward the end of this stage, the cardiogram returns to its original form, which only visualizes violations of chronic heart pathology.
Only a qualified cardiologist can properly conduct such a diagnostic study and study its results.
Symptoms of pathology
There are several symptoms that can be used to establish the presence of pathologieshearts. Patients with thromboembolism experience:
- tachycardia;
- manifestations of shortness of breath;
- tachypnea;
- noticeable drop in SpO2;
- recent fainting;
- hypotension is one of the factors that occur in PE;
- unnatural pallor of the skin;
- heavy sweating;
- blood discharge during expectoration;
- mild fever;
- other external symptoms.
With the above signs, the patient is registered in the cardiology department and a special examination is prescribed.
Acute forms of pathology
In acute forms of pulmonary thromboembolism, the following differences in the results can be observed on the ECG:
- differences characteristic of sinus tachycardia and other conditions;
- heart reversal;
- The occurrence of negative T waves simultaneously in the chest leads - the phenomenon is equated to increased pressure in the pulmonary artery;
- blockade of the right leg of His - this phenomenon is compared with an increased risk of death;
- no visible ECG signs;
- turn the axis of the heart to the right;
- arrhythmia of the supraventricular type;
- other differences that are characteristic of pathology and noticeable to an experienced specialist.
For the purpose of prevention, it is necessary to carry out a cardiogram once a year, since such a pathology often occurs without certain symptoms.
ECG for PE is a mandatory type of diagnosis.
Classification of PE
The European Society of Cardiology has classified this disease for more convenient diagnosis and application of effective therapeutic measures. At the same time, the main criteria for classification were the extent of the lesion and the severity of the development of the pathological process.
Thus, PE has several main classifications:
- massive, in which there is cardiogenic shock, low blood pressure, not associated with other diseases;
- spicy;
- non-massive, with stable hemodynamics;
- subacute;
- chronic.
- heart attack pneumonia;
- unmotivated shortness of breath;
- acute cor pulmonale.
Main signs of PE in ECG diagnostics
Pronounced signs of pathology are:
- signs of right atrial overload;
- signs of right ventricular overload;
- blocking the right bundle branch block;
- Shift the transition area to the left side;
- some right axis deviation;
- sinus tachycardia;
- atrial extrasystole (premature and extraordinary excitation of the myocardium);
- paroxysms of atrial fibrillation.
Treatment of PE
Place in intensive care of patients with signs of clinical PE on the ECG.
For example, in a critical condition, a person undergoes resuscitation, andfurther therapy is aimed at normalizing blood circulation in the lungs, preventing chronic pulmonary hypertension.
In order to prevent recurrence of the disease, bed rest is necessary. For oxygenation, oxygen inhalation is carried out. In addition, a massive infusion treatment is carried out to reduce blood density and maintain pressure.
At an early stage, thrombolytic therapy is indicated in order to dissolve blood clots as soon as possible and restore blood flow in the pulmonary artery. Subsequently, heparin therapy is performed to prevent relapses. Antibacterial therapy is used for pneumonia infarction.
In cases of massive PE and the ineffectiveness of thrombolysis, operative thromboembolectomy is performed. As an alternative to this method, catheter fragmentation of the thromboembolus is used. In case of recurrence of PE, the installation of a special filter in the pulmonary artery is practiced.
Photo of ECG with PE is presented below.
Emergency First Aid
The very first thing to do if you suspect a thromboembolism is to quickly call an ambulance, put the patient on a flat hard surface. He must be given absolute rest.
To begin with, medical workers carry out resuscitation measures, which consist of oxygen therapy and mechanical ventilation. As a rule, before hospitalization, a patient with PE is given intravenous unfractionated heparin at a dosage of 10 thousand units, along with this medication, 20 ml of rheopolyglucin is administered.
In addition, when providing emergency care for symptoms of PE on the ECG, the following pharmacological preparations are administered to the patient:
- "Eufillin" (2, 4% solution) - 10 ml;
- "No-shpa" (2% solution) - 1 ml;
- "Platifillin" (0.02% solution) - 1 ml.
With a single injection of the Eufillin medication, the patient needs to find out if he suffers from diseases such as epilepsy, tachycardia, arterial hypotension, to make sure that he does not have symptoms of myocardial infarction.
In the first hour, the patient is also injected with the anesthetic "Promedol", and in its absence, "Analgin" is allowed. In the event of the development of severe tachycardia, appropriate therapy is urgently carried out, and when breathing stops, resuscitation is carried out.
In case of severe pain syndrome, the introduction of a narcotic 1% solution of the drug "Morphine" in a volume of 1 ml is indicated, but before administering this medication intravenously, it is necessary to make sure that the person does not have a convulsive syndrome.
After normalization of the condition, the ambulance delivers the patient as soon as possible to the cardiosurgical department, where he is given appropriate treatment under inpatient conditions.
Reviews
Reviews about the described disease confirm that PE is a very complex and life-threatening pathological condition of a person. Patients note that ambulance staff often have no time to conduct an electrocardiogram, because whensevere conditions provoked by pulmonary embolism, they immediately begin to implement resuscitation measures. Patients say that the cardiogram is done already in a hospital, after stabilization of the critical condition of a person. In the case of mild forms of this disease, a cardiogram can be performed right at home when an ambulance is called, but the patient will be taken to the hospital in any case. Patients in the reviews described the condition in the event of a pathology - acute pressing pains in the sternum, severe difficulty in the respiratory process, pronounced palpitations, dizziness, often - loss of consciousness.
We reviewed what the ECG shows with PE.
