An electrocardiogram is often prescribed to detect various cardiac pathologies. The method is actually very simple. However, it is considered one of the most informative. If the procedure does not show clear results, the patient is prescribed an ECG with a load. The technique allows revealing hidden pathologies and prescribing adequate treatment.
General description of the procedure
Practically everyone has had to undergo a procedure called electrocardiography (ECG) at least once. It is a registration of electrical impulses (currents) during the contraction of the heart muscle. A special device, an electrocardiograph, allows you to record data and display them on a graph. The result obtained looks like a complex curved line. The doctor usually deals with the decoding of the received values.
A fairly simple technique for diagnosing heart disease allows you to get accurate results. An electrocardiogram is one of the cheapest and most accessible methods. It can also be an advantagename the absence of violations of the integrity of the skin.
Exercise ECG
There are several techniques for performing electrocardiography, one of which is the exercise ECG. The usual procedure, when the patient is at rest, does not always show all the abnormalities in the work of the heart. Registration of cardiac impulses during physical activity allows you to establish the exact cause of the pathology due to the active work of the heart muscle and the whole organism as a whole.
Techniques
There are several ways to carry out electrocardiography with a load. One of the common methods is functional tests. No special devices are used, except for a stopwatch and a cardiograph. The patient is asked to perform simple exercises. It can be squats or steps on the step platform.
Veloergometry is considered one of the most informative methods for diagnosing the performance of the heart muscle. For its implementation, an exercise bike is used, equipped with special sensors and a powerful computer. When performing an exercise ECG, all data will be transmitted to the computer for recording and analysis.
A treadmill test has a similar diagnostic technique, only a treadmill is used for physical activity. If the patient begins to feel unwell, the diagnosis will be completed and the necessary medical assistance will be provided.
Indications for appointment
The procedure allows you to timely detect existing problems withheart muscle and set the level of endurance in each patient. An electrocardiogram is one of the mandatory diagnostic methods for people who work in difficult conditions.
The procedure can be prescribed in the case when the standard ECG did not show any abnormalities, but the patient complains of the periodic appearance of unpleasant symptoms. Direct indications for undergoing manipulation with a gradually increasing load are the following pathologies:
- need to determine the type and degree of coronary heart disease;
- atrial fibrillation;
- complaints of frequent pain in the heart area;
- hypertension;
- congenital and acquired pathologies of the heart;
- arrhythmia, tachycardia;
- appearance of cyanosis of the skin or sudden weakness.
If the preliminary diagnosis on the electrocardiograph indicates the presence of a pathology of the heart, then it makes no sense to carry out a test with a load.
Contraindications
Before prescribing an exercise ECG to a patient, the specialist must ensure that there are no contraindications. Because in some cases this type of diagnosis can be life-threatening. In medical practice, there are absolute and relative contraindications to manipulation. The first group includes severe pathologies:
- condition after myocardial infarction (the procedure can be performed no earlier than 14 days after the attack);
- arrhythmia, not amenable todrug exposure;
- severe infectious pathologies;
- pericarditis, myocarditis, endocarditis;
- acute heart failure;
- pulmonary embolism;
- severe aortic stenosis;
- suspected aneurysm dissection in a vessel.
If the patient has relative contraindications, only the doctor should determine the need for exercise electrocardiography.
Diagnostics are usually prescribed only as a last resort, when other methods have proven ineffective. This category includes such pathological conditions as lack of magnesium and calcium, severe diabetes mellitus, heart defects with moderate stenosis, ventricular extrasystole, hypothyroidism, left ventricular aneurysm, late pregnancy.
How is the procedure?
To do an ECG with stress, you need to contact a cardiologist and undergo a preliminary examination. If the patient has no contraindications, he may be prescribed a test on an exercise bike (bicycle ergometry) or a treadmill. The most informative and frequently used is the first option.
Before starting the diagnosis, a specialist attaches sensors to the patient's skin. The procedure will be carried out with simultaneous fixation of blood pressure. Sensors are attached to the clavicle, shoulder blades and lower back. In the first three minutes, it is necessary to complete 180 revolutions of the simulator (60revolutions every minute). Every three minutes, the load will be increased until fatigue, dizziness or pain appear.
The patient should report their feelings and the doctor will complete the ECG procedure. After the load, the data is recorded for another 10 minutes. This time is usually enough for the heart rate to return to normal. The results are sent to the doctor for diagnosis.
Correctly interpret the results
Exercise ECG allows you to get the most reliable information about the state of the heart muscle and blood vessels. The conclusion contains the following indicators:
- Patient completed work (J).
- Threshold power (W).
- Reasons for early termination of the study.
- Conclusion on performance.
- Dynamics of pulse and blood pressure.
- The time it took for the normalization of heart rate and blood pressure.
- Blood pressure at the peak of exercise.
- Irregular heart rhythm (normally it should not be).
- Coronary disorders (detailed description of the type of disorder, time of occurrence).
- IHD class depending on the power level of physical activity at which deviations appeared.
Exclusively, a specialist deals with the interpretation of the results of the ECG with stress. The norm of indicators differs depending on the age and gender of the patient. The slightest deviations from generally accepted norms do not yet indicate the presencepathological condition. If necessary, the procedure can be repeated after a while.
Test Conclusion
Negative option indicates high performance and no changes in the ECG with exercise. A doubtful sample is considered if a shift of the ST segment is fixed (a change in the interval on the graph between the S and T teeth). The reason for this phenomenon may lie in increased pulmonary ventilation, frequent stress, long-term therapy with antiarrhythmic drugs, potassium deficiency in the body.
With a positive test, the patient has atrial fibrillation, frequent extrasystoles, ST segment displacement of more than 2 mm. In this case, it is important to note the period when such signs appeared, the maximum load, heart rate.
What does right atrial loading indicate?
The ECG shows various pathologies of the heart muscle. One of the dangerous syndromes is right atrial hypertrophy. This pathology is often observed in diseases of the respiratory organs, because this part of the heart interacts with the pulmonary system. With congenital malformations of the pulmonary artery, an overload of the right atrium also appears.
Pathologies of the valves can be seen during an electrocardiogram. A sign of deviation is a change in the P wave. A timely diagnosis will allow you to start therapy aimed at eliminating this phenomenon.
Preparing for the procedure
To get a reliable result, you need toproperly prepare for an exercise ECG. Before the test, you should exclude emotional and physical stress, stop drinking alcoholic beverages. For a few days, medications that affect the functioning of the heart muscle are excluded. Heavy food can have a negative impact on the result of the test.
