EKG and ECHO

Mar 23, 2012 , Translated by Kristina Knazko

ekg-a-echo.jpg - kopie
ekg-a-echo.jpg - kopie
EKG and ECHO are among the most common cardiological and internal methods of examination. EKG and ECHO are accessible and efficient methods to monitor current heart function and provide quick diagnosis of possible disorders. EKG and ECHO are painless examination methods that do not burden the patient.

EKG and ECHO

The incidences of circulator illnesses, has unfortunately been rising inexorably in recent years. The cause of this rise is primarily high blood pressure, unhealthy lifestyle, smoking, poor diet and a lack of exercise. All of these factors contribute significantly to atherosclerosis, hardening of the arteries, which causes a significant proportion of illnesses and deaths. These diseases of the cardiovascular system are the main causes of death in developed countries and about 18 million people die from them worldwide.

Electrocardiography

EKG, ECG or electrocardiograph is an important examining method in the diagnosis of heart diseases. The main advantage is its excellent accessibility, efficiency and method of measurement that does not burden the patient. The examination occurs while the patient is lying down and 10 electrodes are attached – 1 on each leg and 6 on the front of the chest. These electrodes detect the changes in electric potential on the skin, which arise when the muscle of the heart is at work. These need to be strengthened in order to provide accurate measurements. The result of the examination is the electrocardiogram, a curve consisting of spikes and waves on a graph corresponding to the heart's activity over time. Due to the electrode placements, values from different parts of the heart are obtained, allowing the doctor to determine the location of any possible changes. Even though EKG should be a part of everyone's yearly visit to the physician, it is performed mainly in certain cases where there is suspicion of heart attack, chest pain during physical activity, irregular heartbeat, collapse or other. In special cases, a 24 hour EKG can be used; a portable EKG that is connected to a patient for a whole day. This allows the detection of any changes during various daily situations.

Echocardiography

An ECHO or echocardiograph is a very important method of examination of the appearance and function of the heart, which usually follows suspicious EKG results. This method uses ultrasounds; waves which are reflected at the interface of different tissues, allowing them to be viewed. An ECHO can be performed from the front of the chest or by the introduction of a device into the esophagus, where the image is even clearer. This examination can help estimate the size of the individual cardiac chambers, the thickness of their walls as well as the functioning of the valves. Heart contractions, the movements of individual parts, the direction and force of the blood flow, etc, can be monitored. As with the EKG, the patient lies down and to be able to better navigate the ultrasonic waves, a conductive gel is applied to the chest. The whole procedure does not take more than 10 minutes. It can be more difficult to examine a patient that is obese. Both the examinations can also be performed during physical stress, which may also reveal problems that were not detected at rest. Physical stress can be brought on by exercise, or induced by certain medications.

Indicators of EKG and ECHO

Indicators are a set of circumstances that lead to the use of certain diagnostic or therapeutic methods. EKG is used for diagnosing acute or chronic chest pain or palpitations i.e. pounding of the heart. An ECHO is used in suspected valve defects, infectious endocarditis, congenital heart defects, cardiac arrhythmias, aortic aneurysms or cardiomyopathy.

EKG, ECHO and Further Treatment

There are of course many other diagnostic methods that are widely used in cardiology. Thanks to quality diagnosis, correct treatment is much easier to determine, but is not always able to eliminate all identified problems. Treatment is often focused on alleviating symptoms and preventing life-threatening conditions. The patient's cooperation is very important as well. With strict adherence to medical recommendations, the quality of life despite an ill heart, can still be very high.

Diskuze:

Lakhiatwal: The EKG here contains a<a href="http://rnkqhzphh.com"> nrarow</a>-complex rhythm alternating with a wide complex rhythm. While there are similarities to "biventricular ventricular tachycardia," the lack of two alternating WIDE complex rhythm excludes this in the differential. Most interesting are the negative P waves in leads II, III, and aVF that precede the<a href="http://rnkqhzphh.com"> nrarow</a>-complex beats. The wide complex beats obscure more careful analysis of the rhythm, so additional information can be gained if the rhythm is "disturbed" by varying the AV node conduction a bit.My question was "Did you perform carotid massage or Valsalva on the patient?" The cardiologist who brought me the EKG had not performed either of these manuevers, but when they were attempted, no change to the rhythm occurred. It was elected to administer adenosine 6 mg IVP instead.With adenosine, the rhythm stopped briefly, but then immediately reinitiated. The EKG, however, changed considerably to . (Beta blockers were administered and had little affect on the patients tachycardia rate. Note that the 5th and 7th beats of the subsequent EKG have the same morphology as the wide complex beats seen in the first EKG, except the 7th beat is somewhat<a href="http://rnkqhzphh.com"> nrarow</a>er, making it consistent with a fusion beat between the<a href="http://rnkqhzphh.com"> nrarow</a>-complex rhythm and a PVC. Hence, the wide complex beats in the original EKG are from a ventricular source (ventricular bigeminy) and the<a href="http://rnkqhzphh.com"> nrarow</a>-complex beats are being driven by a long-RP supraventricular tachycardia (the second rhythm of the "tango").The differential of the long-RP supraventricular tachycardia is fairly short: ectopic atrial tachycardia, atypical AV nodal reentrant tachycardia, or PJRT (paroxysmal junctional reentrant tachycardia from a decrementally-conducting retrograde-only accessory pathway). On EP study, the patient was found to have an incessant atrial tachycardia arising from the posteroseptal tricuspid annular area that was successfully ablated.Of interest, the patient presented in congestive heart failure and was found to have an ejection fraction (post-ablation) of 18% with severe MR. The patient was discharged with a LifeVest and medical therapy for her cardiomyopathy thought to be induced by the tachycardia. Two months after ablation, both the the EF and mitral insufficiency had improved and the LifeVest never fired.

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