To identify various cardiac pathologies, an electrocardiogram is often prescribed. The method is actually very simple. However, he 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 you to identify hidden pathologies and prescribe adequate treatment.
General description of the procedure
Almost every person had to undergo a procedure called electrocardiography (ECG) at least once . It is a registration of electrical impulses (currents) during contraction of the heart muscle. To fix the data and display it on the graph allows a special device - an electrocardiograph. The result looks like a complex curved line. The decryption of the obtained values is usually done by the doctor.
A fairly simple technique for diagnosing heart disease allows you to get accurate results. An electrocardiogram is one of the cheapest and most affordable methods. An advantage can also be called the absence of violations of the integrity of the skin.
Exercise Electrocardiography
There are several methods for conducting electrocardiography, one of which is an ECG with a load. 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.
Methodologies
There are several ways to perform electrocardiography with a load. One common technique is functional testing. In this case, no special devices are used, a coma of a stopwatch and a cardiograph. The patient is offered to perform simple exercises. It can be squats or steps on the step platform.
Bicycle ergometry is considered one of the most informative methods for diagnosing the health of the heart muscle. For its use, an exercise bike equipped with special sensors and a powerful computer is used. When performing an ECG with physical activity, all data will be transmitted to the computer for fixation 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 with the heart muscle and establish 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 deviations, but the patient complains about the periodic appearance of unpleasant symptoms. Direct indications for undergoing manipulation with a gradually increasing load are the following pathologies:
- the need to determine the type and degree of coronary heart disease;
- atrial fibrillation ;
- complaints of frequent pain in the heart;
- hypertension;
- congenital and acquired pathologies of the heart;
- arrhythmia, tachycardia;
- the appearance of cyanosis of the skin or sudden weakness.
If preliminary diagnosis on an electrocardiograph indicates the presence of a pathology of the heart, then conducting a load test does not make sense.
Contraindications
Before assigning an ECG to the patient with a load, the specialist must make sure 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 the 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 to drug exposure;
- severe infectious pathologies;
- pericarditis, myocarditis, endocarditis;
- acute heart failure;
- pulmonary embolism ;
- severe aortic stenosis ;
- suspected dissection of the aneurysm in the vessel.
If the patient has relative contraindications, only the doctor should determine the need for electrocardiography with physical activity.
Diagnosis is usually prescribed only as a last resort, when other methods have been ineffective. This category includes pathological conditions such as a lack of magnesium and calcium, severe diabetes mellitus, heart defects with moderate stenosis, ventricular extrasystole, hypothyroidism, left ventricular aneurysm, and late pregnancy.
How is the procedure going?
To make an ECG with a load, 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 often used is the first option.
Before starting the diagnosis, the 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, you need to complete 180 revolutions of the simulator (60 revolutions every minute). Every three minutes, the load will increase until fatigue, dizziness or pain occurs.
The patient should report on his feelings and the doctor will complete the ECG procedure. After the load, 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.
We decipher the results correctly
An ECG with a load allows you to get the most reliable information about the condition of the heart muscle and blood vessels. The conclusion contains the following indicators:
- Patient work (J).
- Threshold power (W).
- Reasons for early termination of the study.
- Conclusion on performance.
- Heart rate and blood pressure dynamics.
- The time it took to normalize the heart rate and blood pressure.
- The value of blood pressure at the peak of physical activity.
- Heart rhythm disturbances (it should not be normal).
- Coronary disorders (a detailed description of the type of violation, the time of its appearance).
- The class of coronary heart disease depending on the level of physical activity power at which deviations appeared.
Only a specialist is engaged in the interpretation of ECG results with a load. 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 presence of a pathological condition. If necessary, the procedure can be repeated after some time.
Test conclusion
A negative option indicates high performance and the absence of changes in the ECG with a load. A doubtful sample is considered if the ST segment shift is fixed (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, prolonged therapy with antiarrhythmic drugs, and a deficiency of potassium in the body.
With a positive test, the patient has atrial fibrillation, frequent extrasystoles, an ST segment shift of more than 2 mm. In this case, it is important to note the period when similar symptoms appeared, the maximum load, heart rate.
What does the load on the right atrium mean?
Various pathologies of the heart muscle are recorded on the ECG. One of the dangerous syndromes is hypertrophy of the right atrium. This pathology is often observed in diseases of the respiratory organs, because this part of the heart interacts precisely with the pulmonary system. With congenital malformations of the pulmonary artery, an overload of the right atrium also appears .
Pathology of the valves can be noticed when conducting 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.
Preparation for the procedure
To get a reliable result, you need to properly prepare for an ECG with a load. Before the test, you should exclude emotional and physical stress, abandon the use of alcoholic beverages. For several days, the administration of drugs that affect the functioning of the heart muscle is excluded. Heavy food can negatively affect the result of the sample.