ECG with exercise: what are the results of the norm?

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 assigned an ECG with a load. The technique allows to reveal hidden pathologies and to prescribe adequate treatment.

General description of the procedure

Almost every person had to undergo at least once a procedure called electrocardiography (ECG). It is the recording of electrical impulses (currents) with the contraction of the heart muscle. To fix the data and display them on the graph allows a special device - an electrocardiograph. The result looks like a complicated curve line. Decipherment of the obtained values is usually handled by a doctor.

A fairly simple technique for diagnosing heart diseases allows you to obtain accurate results. An electrocardiogram is one of the cheapest and available methods. The advantage is also the absence of violations of the integrity of the skin.

Electrocardiography with physical activity

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 deviations in the work of the heart. Registration of cardiac impulses with physical activity allows 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

Carry out electrocardiography with exercise in several ways. One of the most common methods is functional tests. No special instruments are used, a coma of a stopwatch and a cardiograph. The patient is offered to perform simple exercises. These can be squats or steps on a step-platform.

Bicycle ergometry is considered one of the most informative methods of diagnosing the efficiency of the heart muscle. To conduct it, an exercise bike equipped with special sensors and a powerful computer is used. When performing an exercise ECG, all data will be transferred to the computer for recording and analysis.

A similar technique for carrying out the diagnosis is a treadmill test, only for physical exertion a treadmill is used. If the patient begins to feel bad, the diagnosis will be completed and the necessary medical care will be provided.

Indication for appointment

The procedure allows you to timely detect the existing problems with the heart muscle and determine the level of endurance in each patient. An electrocardiogram is one of the mandatory diagnostic methods for people who work in harsh conditions.

The procedure can be prescribed in the event that the standard ECG did not show any deviations, but the patient complains of the periodic appearance of unpleasant symptoms. Direct indications for undergoing manipulation with gradually increasing load are the following pathologies:

• The need to determine the type and extent 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 the preliminary diagnosis on the electrocardiograph indicates the presence of a pathology of the heart, then the test with the load does not make sense.

Contraindications

Before assigning an ECG to the patient with a load, the specialist should be convinced of the absence of 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:

• A condition after the transferred myocardial infarction (the procedure can be performed no earlier than 14 days after the attack);
• Arrhythmia, not amenable to medicamentous effects;
• Severe infectious diseases;
• Pericarditis, myocarditis, endocarditis;
• Acute heart failure;
• Thromboembolism of the pulmonary artery ;
• Aortic stenosis in severe form;
• Suspicion of aneurysm bundle in the vessel.

If the patient has relative contraindications, only the doctor should determine the need for electrocardiography with physical exertion.

Diagnosis is usually appointed only as a last resort, when other methods have proved ineffective. This category includes such pathological conditions as lack of magnesium and calcium, severe degree of diabetes mellitus, heart defects with moderate stenosis, ventricular extrasystole, hypothyroidism, left ventricular aneurysm, late pregnancy.

How does the procedure work?

To make an ECG with a load, you need to consult a cardiologist and undergo a preliminary examination. If the patient has no contraindications, he can be assigned a test on an exercise bike (veloergometry) or a treadmill. The most informative and often used is the first option.

Before the diagnosis begins, the skin sensor is attached to the sensor by the specialist. The procedure will be performed with simultaneous fixation of blood pressure. Sensors are attached in the area of the clavicle, scapula and lumbar region. In the first three minutes, 180 revolutions of the simulator (60 revolutions every minute) must be performed. Every three minutes, the load will be increased until fatigue, dizziness or pain develops.

The patient should report his feelings and the doctor will complete the ECG procedure. After loading, 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 decipher the results

ECG with exercise allows you to get the most reliable information about the state of the heart muscle and blood vessels. The conclusion contains the following indicators:

1. The patient's work (J).
2. Threshold power (W).
3. Causes of early termination of the study.
4. Conclusion on health.
5. The dynamics of the pulse and blood pressure.
6. The time it took to normalize the heart rate and blood pressure.
7. The amount of blood pressure at the peak of physical activity.
8. Violations of the heart rate (in the norm it should not be).
9. Coronary disorders (detailed description of the type of violation, the time of its appearance).
10. Class of IHD, depending on the level of exercise power at which deviations occurred.

Only the specialist deals with the interpretation of ECG results with the load. The norm of the indicators differs depending on the age and sex of the patient. The slightest deviations from the generally accepted norms do not yet indicate the presence of a pathological condition. If necessary, the procedure can be repeated after a while.

Conclusion of the test

The negative variant testifies to high working capacity and absence of changes on an electrocardiogram with a load. A doubtful test is considered if the shift of the ST segment is fixed (changing the interval on the graph between the teeth S and T). The reason for this phenomenon can be found in increased pulmonary ventilation, frequent stresses, prolonged therapy with antiarrhythmic medicines, and potassium deficiency in the body.

With a positive sample, the patient has atrial fibrillation, frequent extrasystoles, an ST segment displacement of more than 2 mm. In this case, it is important to note the period when such signs, maximum load, heart rate appeared.

What is the load on the right atrium?

ECG fixes various pathologies of the heart muscle. One of the dangerous syndromes is hypertrophy of the right atrium. This pathology is often observed in diseases of respiratory organs, because this part of the heart interacts with the pulmonary system. In congenital malformations of the pulmonary artery, there is also an overload of the right atrium.

The pathology of the valves can be seen when conducting an electrocardiogram. A sign of the deviation is a change in the tooth P. A timely diagnosis will allow the initiation of therapy aimed at eliminating this phenomenon.

Preparation for the procedure

In order to obtain a reliable result, it is necessary to prepare correctly for carrying out the ECG with the load. Before the test, emotional and physical stresses should be excluded, and alcoholic beverages should be avoided. Within a few days, the intake of medications that affect the functioning of the heart muscle is excluded. Heavy food can adversely affect the result of the test.