Can you see heart failure on an ECG?

Heart failure (HF) is a serious syndrome that can result from both diseases of the heart and some other organs. In this condition, the heart cannot cope with the blood supply to the organs, and the consequences are fatal, so it is very important to detect the disease as early as possible. Heart failure symptoms are often detected on an ECG (electrocardiogram), although there are other ways to detect heart failure.

Causes of the disease

Heart failure is rarely among the first symptoms of heart disease.

• coronary disease;
• cardiomyopathy;
• valve defects;
• endocarditis;
• hypertension and so on.

Moreover, if in acute infarction, signs of heart failure may appear within the next few hours, since one or another part of the myocardium dies, then in hypertension, the disease may not manifest itself for many years.

• alcohol abuse;
• smoking;
• problems with the thyroid gland;
• anemia and so on.

Despite the large total number of causes, most often heart failure is accompanied by a disease such as high blood pressure and insufficient blood supply to the myocardium (ischemia or coronary heart disease).

A person should carefully monitor their blood pressure to prevent possible complications. Ideally, it should not exceed 130/85. The upper limit of normal pressure is considered to be 140/90. At a higher constant pressure in a person, the vessels expand and wear out, which reduces their elasticity. The myocardium experiences an increased load, wears out over time and can no longer pump blood normally. Therefore, if the pressure constantly exceeds normal limits, it is necessary to consult a doctor for the appointment of permanent therapy.

It also happens that it is not possible to find out the causes of heart failure - “from scratch” there is a thickening of the heart walls, the organ hypertrophies, blood circulation worsens for no apparent reason. This is often seen in younger patients.

In this case, we can talk about a genetic predisposition to HF.

Myocardial infarction does not always pass in severe form, putting the patient in the hospital. Sometimes it happens that a person endures it and does not even suspect it. At the same time, a heart attack is a serious injury to the heart muscle, after which scars, sprains can appear on it, it can hypertrophy. In the future, this may adversely affect the work of the "pumping station" of the body and, as a result, the blood supply to organs.

How does HF manifest?

Based on which part of the heart is affected, the symptoms of heart failure can vary.

• dyspnea;
• violation of the rhythm of the heartbeat;
• dizziness, darkening in the eyes;
• veins protrude on the neck;
• the skin turns pale;
• legs swell in the evenings and start to hurt.

Later, the so-called dropsy may occur (fluid accumulates in the abdominal cavity). The patient cannot perform any physical work, after which coughing fits occur, which many associate with other causes, such as smoking.

Symptoms can manifest with varying intensity, there is even a possibility of death. Therefore, with the manifestation of one, and even more so several phenomena, you should immediately seek medical help. First of all, you need to do an electrocardiogram. Whether ECG shows heart failure remains an open question, but it can help detect other conditions that contribute to HF and require treatment on their own.

Varieties of heart failure

HF develops in different ways depending on the causes that caused it.

• acute heart failure - occurs almost instantly, the count goes to hours and even minutes, the patient is subject to immediate hospitalization and emergency treatment;
• chronic condition - with the pathological development of the disease, complex therapy is prescribed, aimed at relieving symptoms and improving the patient's life.

Depending on the localization, heart failure is divided into left ventricular and right ventricular. The first type is characterized by the presence of weakness, fatigue and shortness of breath. This is a consequence of fluid retention in the vessels supplying blood to the lungs. With left ventricular failure, edema of the lower extremities and bursting sensations in the cervical region develop.

Symptoms usually appear more quickly with right ventricular failure, since the left ventricle is the most powerful part of the heart and is usually immune to disease for a long time. However, when he does "give up", SN begins to develop rapidly.

The New York Heart Association has developed a classification of heart failure into classes, depending on the degree of symptoms and the restrictions imposed on the patient's lifestyle.

1. The first class - physical activity is practically unlimited, since the load does not cause any negative manifestations.
2. Class 2 - minor restrictions on physical activity. In a calm state, the patient feels normal, but with exertion, shortness of breath, tachycardia and rapid fatigue appear.
3. 3rd grade is already characterized by serious limitations. A person feels normal only in a state of complete rest. At the slightest activity, the same symptoms appear as in the second grade.
4. In the fourth grade the patient is unable to do any work, as the negative symptoms are present even at rest and are aggravated by the slightest exertion.

Methods for diagnosing heart failure

In medicine, there is no special procedure designed specifically for the diagnosis of heart failure. The doctor chooses, as a rule, several methods from the existing types of research in each individual case.

1. Magnetic resonance imaging. It is considered the safest examination, moreover, it allows to detect heart failure at an early stage, even in the complete absence of external manifestations.
2. Coronary angiography. In this study, a catheter is inserted into the vessels of the neck and upper limbs, which allows the doctor to examine the coronary vessels. Wiring takes place with the help of X-rays. The patient thus needs hospitalization, although the procedure does not cause significant damage.
3. Angiography, as a rule, is carried out simultaneously with the previous technique, since it also requires the use of radiography. A dye, visible in X-rays, is injected into the blood, and thus the features of cardiac blood flow are examined.
4. An echocardiogram is an ultrasound examination that gives an idea of ​​the presence of hypertrophy of the heart and its work.
5. Doppler examination is carried out using ultrasound, as a rule, in conjunction with the previous paragraph. Serves to study the blood flow and determine the localization of insufficiency.
6. Nuclear diagnostics. By introducing a substance that emits radiation into the blood, a three-dimensional model of the heart and blood circulation is created. This study is of very high accuracy, even the slightest failure can be traced.
7. In a stress test, the patient performs specific exercises to put stress on the heart while being monitored by echocardiography or nuclear imaging.
8. An analysis is carried out for the presence in the blood of a special peptide, which increases with heart failure.
9. Electrocardiogram (ECG), including its daily monitoring.

Unlike other studies, almost any adult and even a teenager is familiar with the ECG. It is among the mandatory studies and is carried out in many cases, up to influenza and respiratory diseases.

An ECG is carried out quickly, does not cause any discomfort to a person, does not expose him to any traumatic effects or radiation. Therefore, it is carried out even during medical examinations and medical examinations.

What does an electrocardiogram show

An ECG is used not only to detect heart failure, but also other possible heart problems. It is carried out as follows: the patient assumes a prone position, after which electrodes are connected to the arms, legs and chest, transmitting information to the apparatus, which prints out the cardiogram. These electrodes pick up any electrical activity of the heart, even the weakest.

• heart rate;
• the state of the myocardium (muscles of the heart);
• general condition of the heart.

Most accurately, cardiography reflects the rhythm of heart contractions. Based on it, the cardiologist determines whether the patient has tachycardia (rapid heartbeat), or, conversely, the rhythm is too slow, there are any failures.

• supraventricular arrhythmia - laboratory tests and revision of existing treatment are prescribed;
• ventricular arrhythmia - angiogram, tests under physical stress, a study of the blood supply to the heart muscle, sometimes a special device is implanted - an ICD (implantable cardioverter-defibrillator);
• ischemia or a previous heart attack - echocardiography, angiography, coronary bypass surgery are prescribed to restore blood supply to the myocardium;
• left ventricular hypertrophy - dopplerography and echocardiogram are recommended.

The state of the heart muscle is considered a somewhat less accurate indicator that can be extracted from the ECG. The fact is that dead tissue reacts in a special way to electrical signals passed through it. Thus, the doctor can determine whether the patient has a predisposition to a heart attack, whether there are scars on the muscle tissue of the myocardium, dead muscle areas, and so on.

As for the general condition of the heart, here the cardiogram allows you to see any problems only if the patient is observed during intense physical exertion.

Other Examinations with ECG

Electrocardiography is not always performed in a way that is familiar to most people who have done it at least once.

1. Research with the use of physical activity.
2. Holter monitoring (daily observation).

Special equipment has been developed for carrying out a study under load, for example, a specially designed bicycle or a treadmill. Doctors advise regularly conducting such a cardiogram for smokers, hypertensive patients, people with high cholesterol levels, and so on.

The load during the procedure gradually increases and parallel monitoring is carried out. The test shows not only any violations, but also allows you to determine the "margin of safety" of the patient's heart. The physical load increases to the point where the patient can no longer continue the test - thus the limit of working capacity is recognized.

In addition to the ECG, the exercise test measures maximum oxygen consumption (Vo2) and is closely related to the number of deaths in patients with heart failure.

When oxygen consumption ceases to increase during the increase in load, it is considered that the procedure should be stopped. In this case, the patient gets tired sharply and shortness of breath appears.

The patient is at serious risk when the Vo2 is less than 10 ml/kg per minute. A Vo2 level greater than 18 ml/kg per minute is considered normal. Intermediate indications are considered the so-called gray zone, that is, they do not allow you to accurately determine the degree of danger to the patient. It is also believed that this test is less effective for women than for men.

There is also daily monitoring of the electrocardiogram, or Holter monitoring. In this study, the patient wears (for example, on his belt) a small device that continuously monitors the performance of the heart for one or two days.

In general, electrocardiography, although not the most accurate and comprehensive method of examination, but it provides the prerequisites for more thorough research, or, conversely, saves the patient from unnecessary trouble with further diagnostics, which is not necessary.