In the article, we consider what changes in the ECG with pulmonary embolism are observed.
An electrocardiogram is performed in order 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 an organ is working well or certain pathologies are observed in a patient.
Description of the disease
TELA - pulmonary embolism, which is diagnosed using an electrocardiogram. Pathology is the formation of a thrombus in the arteries of the lungs. Pulmonary embolism is one of several types of venous thromboembolism that occurs in different parts of the body. According to statistics, this pathology takes third place among other diseases of cardiovascular origin that provoke a fatal outcome.
What reflects the ECG with pulmonary embolism?
Signs of the development of pulmonary embolism
In the absence of initial chronic heart pathologies, the symptoms of pulmonary embolism are well visualized on the results of the cardiogram. Special attention is paid to the functions of the right heart. The disease is often recorded as a consequence of other pathological processes.
There are several stages of this disease. Types of ECG abnormalities with pulmonary embolism:
- Sharp. Lasts from 3 to 7 days. There are manifestations of S1QIII, in which there are noticeable increase in denticles, there is a change in the localization of the transition region to the left side, the QRS complex is dissolved in V1-2, V6R-3R leads of the rSR '(rSr') type, and the position of the ST segment is disturbed. In some cases, violations in the teeth of the lungs can be noticed. Symptoms of pulmonary embolism during ECG should not go unnoticed.
- Subacute. It develops in about 1-3 weeks. At this stage, negative teeth are formed, gradually deepening. At the same time, a subtle displacement of the anterior zone and a slight increase in the teeth remain.
- The reverse development. The term of this stage lasts about 2-3 months. With the reverse development, the exact opposite effect is noted: negative teeth gradually decrease. Closer to the end of this stage, the cardiogram returns to its original form, in which only violations of chronic heart pathology are visualized.
Correctly conduct such a diagnostic study and study its results can only a qualified cardiologist.
Symptoms of pathology
There are several symptoms by which the presence of heart pathologies can be established. In patients with thromboembolism occur:
- tachycardia;
- manifestations of shortness of breath;
- tachypnea;
- noticeable decrease in SpO2;
- recent fainting;
- hypotension is one of the factors that occur with pulmonary embolism;
- unnatural pallor of the skin;
- heavy sweating;
- expectoration of blood during expectoration;
- mild manifestation of fever;
- other external symptoms.
With the above symptoms, the patient is registered in the cardiology department and a special examination is prescribed.
Acute forms of pathology
In acute forms of pulmonary thromboembolism on an ECG, the following differences in results can be observed:
- differences characteristic of sinus tachycardia and other conditions;
- heart turn;
- the occurrence of negative T waves simultaneously in the chest leads - the phenomenon is equivalent to increased pressure in the pulmonary artery;
- blockade of the right leg of His - this phenomenon is compared with an increased risk of a fatal outcome;
- lack of visible signs on an ECG;
- a turn of the axis of the heart to the right;
- supraventricular arrhythmia;
- other differences that are characteristic of pathology and are noticeable to an experienced specialist.
For prevention, it is necessary to conduct a cardiogram once a year, since such a pathology often proceeds without specific symptoms.
ECG with pulmonary embolism is a mandatory type of diagnosis.
Classification of pulmonary embolism
The European community of cardiology for a more convenient diagnosis and the use of effective therapeutic measures have classified this disease. In this case, the main criteria for classification were the extent of the lesion and the severity of the development of the pathological process.
Thus, TELA has several main classifications:
- massive, in which there is cardiogenic shock, low pressure, not concomitant with other diseases;
- spicy;
- non-massive, in which there is stable hemodynamics;
- subacute;
- chronic
- heart attack pneumonia;
- unmotivated shortness of breath;
- acute pulmonary heart.
The main signs of pulmonary embolism in ECG diagnostics
Pronounced signs of pathology are:
- signs of congestion of the right atrium ;
- signs of overload of the right ventricle;
- blocking the right leg of the bundle of His;
- shift of the transition region to the left side;
- some deviation of the axis to the right;
- sinus tachycardia;
- atrial extrasystole (premature and extraordinary excitation of the myocardium);
- paroxysms of atrial fibrillation.
Tel treatment
They are placed in intensive care of patients with signs of clinical pulmonary embolism on an ECG.
For example, in a critical condition a person is undergoing resuscitation measures, and further therapy is aimed at normalizing blood circulation in the lungs and preventing chronic pulmonary hypertension.
In order to prevent relapse of the disease, bed rest is necessary. For oxygenation, oxygen is inhaled. 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, to prevent relapse, heparin therapy is performed. With heart attack pneumonia, antibiotic therapy is used.
In cases of the occurrence of massive pulmonary embolism and the lack of effectiveness of thrombolysis, surgical thrombembolectomy is performed. As an alternative to this method, catheter fragmentation of thromboembol is used. In relapses of pulmonary embolism, the installation of a special filter in the pulmonary artery is practiced.
Photo ECG with pulmonary embolism is presented below.
First aid
The very first thing that is necessary if there is a suspicion of thromboembolism is to quickly call an ambulance and lay the patient on a flat, solid surface. He must be provided with absolute peace.
To begin with, health workers carry out resuscitation measures, which include oxygen therapy and mechanical ventilation. As a rule, before hospitalization, a patient with pulmonary embolism is administered intravenously unfractionated heparin in a dosage of 10 thousand units, along with this medication 20 ml of reopoliglyukin is administered.
In addition, when providing emergency care for symptoms of pulmonary embolism on an 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 whether he suffers from diseases such as epilepsy, tachycardia, arterial hypotension, and make sure that he does not have symptoms of myocardial infarction.
At the first hour, the patient is also injected with the analgesic Promedol, and in his absence Analgin is allowed. In the case of severe tachycardia, appropriate therapy is urgently performed, and when breathing stops, resuscitation is performed.
With severe pain, the administration of a narcotic 1% solution of the Morphine drug in a volume of 1 ml is indicated, but before administering this medication intravenously, you need to make sure that the person does not have a convulsive syndrome.
After normalizing the condition, the ambulance takes the patient to the cardiac surgery department as soon as possible, where he is treated accordingly in stationary conditions.
Reviews
Reviews of the described disease confirm that PE is a very complex and life-threatening pathological condition of a person. Patients note that often ambulance staff do not have time to conduct an electrocardiogram, because in severe conditions provoked by pulmonary embolism, they immediately begin resuscitation. Patients say that they make a cardiogram already in a hospital, after stabilization of a critical condition of a person. In the case of mild forms of this disease, a cardiogram can be performed directly 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 when a pathology occurred - acute pressing pains in the sternum, severe difficulty in the respiratory process, severe palpitations, dizziness, often loss of consciousness.
We examined what the ECG shows with pulmonary embolism.