Pulmonary heart disease is one of the most hidden common diseases with serious consequences for progress in the routine scenes of respiratory and cardiology, while electrocardiograms, as a simple and low-cost routine, are one of the core means of screening and supporting the diagnosis of pulmonary heart disease. When many people get the ekg report, looking at the high and low waveform lines above them, wondering which anomalies point to the possibility of pulmonary heart disease, today they have a clear picture of the diagnostic logic of typical ekgs that have been tested clinically for many years, error zones that are easy to step on, and practical interpretation techniques。
The core pathological background of the pulmonary heart electrocardiogram
A lot of people wonder why diseases in the lungs leave special marks on the ekg. This is due to long-term chronic lung pathologies, such as chronic obstructive pulmonary disease, bronchial extension, severe mestizo pulmonary pneumonia, which continue to increase pulmonary vascular resistance, slowly transfer pressure to the right heart, and allow modern paid fattening, expansion of the right-heart room and the right-heart room, with a shift in the conductive path and direction of heart electrical activity, ultimately reflected in changes in the wave characterization of the ekg。
Most of the cardiac changes caused by common coronary heart disease and myocardial diseases are concentrated on the left heart, and there is a very clear difference between right heart-led changes from pulmonary heart disease. This is also how we can distinguish the core basis of pulmonary heart disease and other heart diseases through electrocardiograms. It is not necessary to wait for patients to show visible signs of failure, such as swelling of their lower limbs, increased asthma, etc., and early capture from the electrocardiogram signals of an elevated right heart load will allow early intervention to avoid irreversible progress。
The core diagnostic criteria for typical ekgs are broken down by article
The clinically accepted diagnostic criteria for pneumococcal electrocardiograms have very clear quantitative indicators, not just one or two abnormal waveforms, and we break the core into dimensions that ordinary people can understand。
The first is the core axle deflection indicator, where the right oscillation +90° is a key base criterion, and where some patients with severe pulmonary oedema are squeezed because of their heart position, and even where the weight of the axle is greater than +120°, there is a significant difference from the pattern of distribution between -30° and +90° of the average healthy human axle。
This is followed by the characteristic wave shape of the body-conductor, the lung-type p wave being the most commonly heard term, which refers to the p-wave amplitude of the second, third, and avf-links exceeding 0. 22 mv, the sharp morphology of which is the typical telecommunications expression of the thick right-heart room, like the “warning signal” sent by the right-heart room on the electrocardiogram, except for the r/s ratio of the avr-link, which is greater than 1, and directs the electrical vector of the right-heart, breaking the normal pattern of the right-heart coverage of the left-heart activity。
The characteristics of the chest cavity are also of very high reference value, with the r/s margin of v1 and the r/s margin of v5 having a direct reflection that the thickness of the right heart wall has exceeded the corresponding section of the left heart chamber, and that the main direction of the electrical activity from the left to the right is directly supported by the thickness of the right heart chamber. There is also a readily overlooked supporting characteristic of low-voltage haematosis, combined with complete or incomplete right beam transmission retardation, as prolonged pulmonary emphysema leads to high gas content in the chest contours, decompresses the conductive strength of the heart telecommunications signal, and results in overall wavelength amplitudes of all conductors below the normal reference values, which are accompanied by a highly visible electrocardiogram of pulmonary heart patients。
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Although the ekg features are highly oriented, there are a number of cases of similar abnormal waveforms in clinical settings that can easily be miscalculated without careful identification。
For example, some of the obese-sized healthy people have physical characteristics of the right side of the light-axis, no chronic lung history, no symptoms of edema to their lower limbs, no post-movement suffocation symptoms, and this physico-axis deviation cannot be linked to pulmonary heart disease at all. There are also cases of acute lung infections, such as severe pneumonia and the persistence of asthma, and a short period of pulmonary vascular convulsions that increase the sexual load of the right heart, as well as the temporary appearance of pulmonary p-wave waves, which will return to normal once the infection is controlled and the convulsion is mitigated, without any direct diagnosis of chronic pulmonary heart disease。
In addition to this, there is also an associated electrocardiogram of the right-weight heart in case of insulation in the room of congenital heart disease and narrow pulmonary valves, which must be combined with the patient's medical history, heart ultrasound and chest image, and cannot be determined directly on the basis of the results of the electrocardiogram, avoiding unnecessary psychological burden and risk of misdiagnosis
Clinical practical interpretation techniques
When actually reading the film, do not stare at the conclusions under one indicator in isolation, combining multiple features for cross-checking, such as the patient's chronic bronchitis history at the same time, the electrocardiogram meets the three core conditions of the right-axis + pulmonary p-wave + v1 lead r/s≥1 and the consistency of the diagnosis of pulmonary heart disease is very high. If there is only a single right-hand axis, the other indicators are normal and not sufficient to support the diagnosis, but only follow-up and review on a regular basis。
For some patients whose chronic pulmonary osmosis leads to a particularly severe turn-off of the heart, the conventional 12-conductive electrocardiogram may not capture all the right-heart abnormal signals, adding v3r, v4r right-hand chest cavity links, giving a clearer picture of the electrical activity of the right heart and excavating early unusual pulmonary heart signals。
It is also necessary to combine the physical signs of the patient, such as the presence of an aneurysm at the same time as the pulmonary pulmonary pulmonary valve hearing area, the matching of the corresponding electrocardiograms, the severity of the diagnosis, and the avoidance of the early cases of hidden pulmonary heart disease。
In general, electrocardiograms are powerful tools for initial screening and assistive diagnosis of pulmonary heart disease, but they are never the only criteria for determining the quality of life in the long term by combining electrocardiogram characteristics with the patient's history, symptoms and other findings in order to provide the most accurate diagnosis and help more people with chronic pulmonary disease to grasp the intervention window at an early stage of the disease, slow the progress of the disease and maintain a stable quality of life over time
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