Vertical position of the electrical axis of the heart. Deviation of the electrical axis of the heart to the right in a child. What sinus rhythm problems can be seen on an ECG?

The electrical axis of the heart (EOS) is one of the main parameters of the electrocardiogram. This term is actively used both in cardiology and in functional diagnostics, reflecting the processes occurring in the most important organ of the human body.

The position of the electrical axis of the heart shows the specialist what exactly is happening at every minute. This parameter is the sum of all bioelectrical changes observed in the organ. When taking an ECG, each electrode of the system registers excitation passing at a strictly defined point. If you transfer these values to a conventional three-dimensional coordinate system, you can understand how the electrical axis of the heart is located and calculate its angle relative to the organ itself.

How is an electrocardiogram taken?

ECG recording is performed in a special room, maximally shielded from various electrical interference. The patient sits comfortably on the couch with a pillow under his head. To take an ECG, electrodes are applied (4 on the limbs and 6 on the chest). An electrocardiogram is recorded during quiet breathing. In this case, the frequency and regularity of heart contractions, the position of the electrical axis of the heart and some other parameters are recorded. This simple method allows you to determine whether there are abnormalities in the functioning of the organ, and, if necessary, refer the patient for a consultation with a cardiologist.

What influences the location of the EOS?

Before discussing the direction of the electrical axis, you should understand what the conduction system of the heart is. It is this structure that is responsible for the passage of impulses through the myocardium. The conduction system of the heart is atypical muscle fibers that connect different parts of the organ. It begins with the sinus node, located between the mouths of the vena cava. Next, the impulse is transmitted to the atrioventricular node, located in the lower part of the right atrium. The next to take the baton is the His bundle, which quickly diverges into two legs - left and right. In the ventricle, the branches of the His bundle immediately pass into those that penetrate the entire heart muscle.

An impulse entering the heart cannot escape the myocardial conduction system. This is a complex structure with fine settings, sensitively responding to the slightest changes in the body. In case of any disturbances in the conduction system, the electrical axis of the heart can change its position, which will be immediately recorded on the electrocardiogram.

EOS location options

As you know, the human heart consists of two atria and two ventricles. Two circles of blood circulation (large and small) ensure the normal functioning of all organs and systems. Normally, the mass of the myocardium of the left ventricle is slightly greater than that of the right. It turns out that all the impulses passing through will be somewhat stronger, and the electrical axis of the heart will be oriented specifically towards it.

If you mentally transfer the position of the organ to a three-dimensional coordinate system, it will become clear that the EOS will be located at an angle from +30 to +70 degrees. Most often, these are the values recorded on the ECG. The electrical axis of the heart can also be located in the range from 0 to +90 degrees, and this, too, according to cardiologists, is the norm. Why do such differences exist?

Normal location of the electrical axis of the heart

There are three main provisions of the EOS. The range from +30 to +70° is considered normal. This option occurs in the vast majority of patients who visit a cardiologist. The vertical electrical axis of the heart is found in thin, asthenic people. In this case, the angle values will range from +70 to +90°. The horizontal electrical axis of the heart is found in short, tightly built patients. On their card, the doctor will mark the EOS angle from 0 to +30°. Each of these options is normal and does not require any correction.

Pathological location of the electrical axis of the heart

A condition in which the electrical axis of the heart is deviated is not a diagnosis in itself. However, such changes in the electrocardiogram may indicate various disorders in the functioning of the most important organ. The following diseases lead to serious changes in the functioning of the conduction system:

Cardiac ischemia;

Chronic heart failure;

Cardiomyopathies of various origins;

Congenital defects.

Knowing about these pathologies, the cardiologist will be able to notice the problem in time and refer the patient for inpatient treatment. In some cases, when EOS deviation is registered, the patient requires emergency care in intensive care.

Deviation of the electrical axis of the heart to the left

Most often, such changes in the ECG are observed with enlargement of the left ventricle. This usually occurs with the progression of heart failure, when the organ simply cannot fully perform its function. The development of such a condition cannot be ruled out in arterial hypertension, accompanied by pathology of large vessels and increased blood pressure. In all these conditions, the left ventricle is forced to work for wear and tear. Its walls thicken, leading to inevitable disruption of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the left also occurs with narrowing of the aortic mouth. In this case, stenosis of the lumen of the valve located at the exit from the left ventricle occurs. This condition is accompanied by a disruption of normal blood flow. Part of it is retained in the cavity of the left ventricle, causing it to stretch and, as a result, thickening of its walls. All this causes a natural change in EOS as a result of improper conduction of the impulse through the myocardium.

Deviation of the electrical axis of the heart to the right

This condition clearly indicates Similar changes develop in some diseases of the respiratory system (for example, bronchial asthma or Some congenital ones can also cause an enlargement of the right ventricle. First of all, it is worth noting pulmonary artery stenosis. In some situations, tricuspid valve insufficiency can also lead to the occurrence of such a pathology.

Why is changing EOS dangerous?

Most often, deviations of the electrical axis of the heart are associated with hypertrophy of one or another ventricle. This condition is a sign of a long-standing chronic process and, as a rule, does not require emergency care from a cardiologist. The real danger is the change in the electrical axis due to His bundle block. In this case, the conduction of impulses through the myocardium is disrupted, which means there is a risk of sudden cardiac arrest. This situation requires urgent intervention by a cardiologist and treatment in a specialized hospital.

With the development of this pathology, the EOS can be deviated both to the left and to the right, depending on the localization of the process. The blockade can be caused by myocardial infarction, infection of the heart muscle, as well as taking certain medications. A regular electrocardiogram allows you to quickly make a diagnosis, which means it allows the doctor to prescribe treatment taking into account all important factors. In severe cases, it may be necessary to install a pacemaker (pacemaker), which will send impulses directly to the heart muscle and thereby ensure normal functioning of the organ.

What to do if the EOS is changed?

First of all, it is worth considering that the deviation of the heart axis itself is not the basis for making a particular diagnosis. The position of the EOS can only give impetus to a more careful examination of the patient. For any changes in the electrocardiogram, you cannot do without consulting a cardiologist. An experienced doctor will be able to recognize normal and pathological conditions and, if necessary, prescribe additional examinations. This may include echocardioscopy for targeted study of the condition of the atria and ventricles, blood pressure monitoring and other techniques. In some cases, consultation with related specialists is required to decide on further management of the patient.

To summarize, several important points should be highlighted:

The normal EOS value is considered to be the range from +30 to +70°.

Horizontal (from 0 to +30°) and vertical (from +70 to +90°) positions of the heart axis are acceptable values and do not indicate the development of any pathology.

Deviations of the EOS to the left or to the right may indicate various disorders in the conduction system of the heart and require consultation with a specialist.

A change in EOS detected on a cardiogram cannot be made as a diagnosis, but is a reason to visit a cardiologist.

The heart is an amazing organ that ensures the functioning of all systems of the human body. Any changes that occur in it inevitably affect the functioning of the whole organism. Regular examinations by a therapist and an ECG will allow timely detection of serious diseases and avoid the development of any complications in this area.

EOS is the total direction of the electrical wave that passes through the ventricles at the moment of contraction. It should be understood that the electrical axis of the heart is not its anatomical axis. Moreover, very often with hypertrophy of the left or right ventricles, the EOS will not deviate in the appropriate direction.

Briefly again: EOS is about the direction of movement of electricity through the heart muscle.

How is EOS formed, how is it related to ECG leads

EOS is formed by a wave of depolarization of the ventricular myocardium. If the wave passed from top to bottom, it is a vertical EOS. If from right to left - horizontal. If from the right-bottom to the left-up - deviation of the EOS to the left, etc. That is, we are interested Where electricity moves. The lead diagram, which is visible below, shows which EOS angle corresponds to which ECG lead.

At the moment of contraction, different ECG leads will record a complex of different shapes, but those electrodes towards which the wave passed will record the highest positive wave R, and those electrodes from which this wave moved away will record the deepest S. Electrodes to which the wave first approached and then moved away, they will record first the positive and then the negative phase of the QRS.Remember these facts - we will need them later to determine the electrical axis.

What is EOS?

In post-Soviet countries, the lead system is somewhat different from the internationally accepted one: there are so-called “horizontal” and “vertical” EOS, which in other countries are not separately distinguished and are included in the concept of the norm.

The difference is clearly visible in these two diagrams:

As you can see, there are now four provisions of the EOS:

Normal (from -30 o to 90 o)
Deviation to the left (from -30 o to -90 o)
Deviation to the right (from 90 o to 180 o)
Extreme right EOS (from -90 o to 180 o)

How to determine the position of the EOS

We will consider a somewhat simplified, “student” method of determining the EOS, which will allow us to find out its direction with an accuracy of 10-15 degrees. This will be more than enough for your daily work with patients. Method that will give the angle α accurate to the nearest degree, will be considered separately.

So, in order to determine the EOS, you need to look at 6 leads from the limbs (I, II, III, aVR, aVL, aVF), find the most “positive” and “negative” complex, as well as (if possible) the isoelectric lead ( lead in which the positive and negative parts of the QRS complex are equal).

Example No. 1

We see that the highest R wave in lead II. This means that the wave was mainly moving in his direction.
The deepest S is in lead aVR - which means the wave came FROM it.
In lead aVL, the QRS complex consists of the same positive R and negative S - this means that the wave first approached this electrode and then moved away from it (passed by).
The electrical axis of this patient coincides with lead II. Looking at the diagram above we conclude that the axis is normal, angle α = 60°

Example No. 2

Tallest R wave in lead I (a wave of depolarization went to it)
The deepest S is in leads III and aVR - which means the wave came from them.
The isoelectric QRS complex is visible in lead aVF, which means the depolarization wave has passed across this lead.
Summarize: the electrical wave passed from the right leads (III, aVR) to lead I, passing across lead aVF. We look at the diagram a little higher and define the axis as horizontal (in a new way: normal), angle α = 0°

Example No. 3 (for independent solution)

Tallest R wave in lead III
Deepest S in lead aVL
A nearly isoelectric QRS complex is seen in lead I.
Answer: the electrical wave passed from the left (aVL) to the right (lead III), passing almost across the horizontal lead I. Based on the diagram, we determine the axis as deviated to the right, angle α = 120°

Example No. 4 (for independent decision)

Deviation of the EOS to the right with an axis angle of +100° or more is normal. An important reason for axis deviation to the right is. Another reason- lateral wall of the left ventricle. Disruption of the normal lateral wall of the LV and the absence of electrical potentials in this area can cause deviation of the EOS to the right. - a rarer cause of deviation of the EOS to the right.

On the electrocardiogram of patients with chronic lung diseases (chronic bronchitis), it also often deviated to the right. Finally, a sudden shift in the average electrical axis of the complex QRS to the right side (not necessarily causing an actual deviation of the EOS to the right) may be a manifestation of acute pulmonary embolism (Ch. 11, 24).

EOS deviation to the left

Deviation of the EOS to the left with an axis angle of -30° or more can also occur for several reasons. Sometimes (but not always) left axis deviation is detected in patients with. - a common cause of pronounced deviation of the EOS (exceeding -45°). Deviation of the axis to the left can be combined with, which is possible in the absence of obvious heart disease.

However, its deviation (Fig. 5-13,) is a frequent sign of either LV, ventricular conduction disturbances (anterior block or), as well as other conditions (see Chapter 24).

Rice. 5-13. The normal position of the average electrical axis of the QRS complex, its deviations to the right or left are observed in most cases. Sometimes the angle of the QRS axis can range from -90" to 180", which can be caused by a sharp deviation of the EOS to the left or right.

The values of the EOS deviation angles to the left and right (from -30° to +100°), which are given on the website, arbitrary. A number of authors use other boundaries (for example, from 0° to +90°). This apparent discrepancy is due to the lack of absolute signs in the clinical ECG. When describing RV and LV hypertrophy, the criteria for voltage changes, which are given by different authors, also vary.

Occasionally, biphasic complexes are observed in all six limb leads ( QR or R.S.), What doesn't allow determine the average electrical axis of the complex QRS in the frontal plane. In such cases we talk about uncertain EOS(Fig. 5-14), which is possible normally, as well as in various pathological conditions.

Rice. 5-14. Uncertain position of the electrical axis of the heart. In all six leads of the frontal plane there are biphasic complexes (RS or QR).

If the EOS is deviated to the left, what does this mean, you need to find out from your doctor. The conclusion is made after examining the patient and analyzing the clinical parameter.

Medical indicators

Using the electrical axis of the heart, cardiologists evaluate the electrical processes that move the heart muscles. The direction of EOS depends on various anatomical and physiological factors. The average rate of the indicator is +590. Normally, the EOS value fluctuates between +200...+1000.

The patient is examined in a specialized room, which is shielded from various electrical noise. The patient takes a supine position with a pillow placed under his head. To take an ECG, electrodes are applied. Data is recorded during quiet breathing. At the same time, the device records the frequency and regularity of heartbeats, including the position of the EOS and other parameters.

In a healthy person, deviation of the electrical axis of the heart to the left is allowed when:

deep exhalation;
changing body position;
body features (hypersthenic).

The EOS shifts to the right in a healthy person when:

the end of a deep breath;
body features (asthenic).

The location of the EOS is determined by the mass of the 2 parts of the ventricle. The indicator under consideration is determined using 2 methods.

In the first case, the specialist identifies a displacement in the alpha angle. The value of the main indicator is calculated using a special table according to Diede.

In the second case, the specialist compares the R and S waves in leads 1 and 3. A sharp deviation of the EOS in any direction is not an independent pathology.

An electrical axis shifted to the left indicates the following problems:

left ventricular hypertrophy;
impaired functioning of the left ventricular valve;
cardiac blockade.

The above phenomena lead to incorrect functioning of the left ventricle. Any deviation of EOS indicates pathologies such as ischemia, CHF, congenital heart disease, and heart attack. Blockade of the conduction system of the main organ is associated with taking certain medications.

Additional diagnostic techniques

If a deviation of the electrical axis to the left is recorded on the cardiogram, additional instrumental examination of the patient is performed. It is recommended to have an electrocardiogram while walking on a treadmill or exercise bike. Using ultrasound, the degree of ventricular hypertrophy is assessed.

If sinus rhythm is disturbed, EOS is rejected, daily Holter ECG monitoring is performed. Data is recorded throughout the day. If the myocardial tissue is significantly hypertrophied, a chest x-ray is performed. Using angiography of the coronary arteries, the degree of vascular damage during current ischemia is determined. Echocardioscopy allows you to determine the condition of the atria and ventricles of the heart.

Therapy for the phenomenon under consideration is aimed at eliminating the underlying disease. Some heart pathologies are treated medically. Additionally, it is recommended to eat right and lead a healthy lifestyle.

In severe cases of the disease, surgical intervention is required. If the conduction system is seriously impaired, a pacemaker transplant is performed. This device sends signals to the myocardium, causing it to contract.

Most often, the phenomenon in question does not threaten human life. But, if a sharp change in the position of the axis is diagnosed (value greater than +900), this can lead to cardiac arrest. Such a patient must be urgently hospitalized in intensive care. To prevent this condition, annual scheduled examinations by a cardiologist are indicated.

Changes to the right

Deviation of the axis to the right is not an independent pathology, but is a diagnostic symptom of a disorder in the functioning of the main organ. Most often, such a clinic indicates an abnormal enlargement of the right atrium or ventricle. After finding out the exact cause of the development of this anomaly, the doctor makes a diagnosis.

If necessary, the patient is prescribed additional diagnostics:

1. Ultrasound - provides information about changes in the anatomy of the main organ.
2. Chest X-ray - reveals myocardial hypertrophy.
3. Daily ECG - performed for concomitant rhythm disturbances.
4. ECG during exercise - helps to detect myocardial ischemia.
5. CAG - performed to diagnose lesions of the coronary artery.

Deviation of the axis to the right can be caused by the following pathologies:

1. Ischemia is an incurable pathology in which there is blockage of the coronary arteries. If left untreated, the disease can lead to myocardial infarction.
2. Acquired or congenital stenosis of the pulmonary artery - due to the narrowing of the vessel, the normal flow of blood from the right ventricle stops, which provokes an increase in blood pressure.
3. Atrial fibrillation - can provoke a cerebral stroke.
4. Chronic cor pulmonale - observed with impaired lung function and chest pathology. Under such conditions, hypertrophy may develop.
5. The presence of a hole in the septum between the atria, through which blood is ejected from left to right. This provokes the development of heart failure.
6. Valve stenosis - manifests itself as a narrowing of the opening between the left ventricle and the corresponding atrium, which impedes the diastolic movement of blood. This pathology is acquired.
7. Pulmonary embolism - provoked by blood clots that occur in large vessels. They then move through the system, clogging the artery and its branches.
8. Primary pulmonary hypertension, which is accompanied by high blood pressure caused by various reasons.

The medical concept of “electrical axis of the heart” is used by cardiologists to reflect the electrical processes occurring in this organ. The location of the electrical axis must be calculated to determine the total component of the bioelectrical changes that occur in the muscle tissue of the heart during its contractile activity. The main organ is three-dimensional, and in order to correctly determine the direction of the EOS (which means the electrical axis of the heart), you need to imagine the human chest as a system with some coordinates that allow you to more accurately determine the angle of displacement - this is what cardiologists do.

The cardiac conduction system is a collection of sections of muscle tissue in the myocardium, which is an atypical type of fiber. These fibers have good innervation, which allows the organ to contract synchronously. The contractile activity of the heart begins in the sinus node; it is in this area that the electrical impulse originates. Therefore, doctors call the correct heart rate sinus.

Originating in the sinus node, the exciting signal is sent to the atrioventricular node, and then it travels along the His bundle. Such a bundle is located in the section that blocks the ventricles, where it is divided into two legs. The leg extending to the right leads to the right ventricle, and the other, rushing to the left, is divided into two branches - posterior and anterior. The anterior branch is accordingly located in the region of the anterior zones of the septum between the ventricles, in the anterolateral compartment of the wall of the left ventricle. The posterior branch of the left bundle branch is localized in two-thirds of the septal part separating the ventricles of the organ, the middle and lower, as well as the posterolateral and lower walls, located in the area of the left ventricle. Doctors say that the anterior branch is located slightly to the right of the posterior branch.

The conduction system is a powerful source that supplies electrical signals that cause the main part of the body to work normally, in the correct rhythm. Only doctors can calculate any violations in this area; they cannot do this on their own. Both an adult and a newborn baby can suffer from pathological processes of this nature in the cardiovascular system. If deviations occur in the conduction system of the organ, the axis of the heart may become confused. There are certain standards for the position of this indicator, according to which the doctor identifies the presence or absence of deviations.

Parameters in healthy people

How to determine the direction of the electrical axis of the heart? The weight of the muscle tissue of the left ventricle usually significantly exceeds that of the right ventricle. You can find out whether a given measurement is a horizontal or vertical vector using these standards. Since the mass of the organ is distributed unevenly, it means that electrical processes should occur more strongly in the left ventricle, and this shows that the EOS is directed specifically to this section.

Doctors project this data using a specially developed coordinate system, from which we can conclude that the electrical axis of the heart is in the region of +30 and also +70 degrees. However, every person, even a child, has individual body characteristics, its own anatomical characteristics. This shows that the slope of the EOS in healthy people can vary between 0-90 degrees. Based on such data, doctors have identified several areas of this indicator that are considered normal and do not interfere with the functioning of the organ.

What positions of the electrical axis exist:

semi-vertical electrical position of the heart;
vertically directed electrical position of the heart;
horizontal state of the EOS;
vertical placement of the electrical axis.

It should be noted that all five positions can occur in a person in good health. Finding the reason for such features is quite easy; human physiology explains everything.

Since the body structure of people is different, it is extremely rare to meet a pure hypersthenic or a very skinny individual; usually such types of structure are considered intermediate, and the direction of the heart axis can deviate from normal values (semi-vertical state or semi-horizontal position).

In what cases are we talking about pathology, the causes of violations

Sometimes the direction of the indicator can indicate the presence of a disease in the body. If, as a result of the diagnosis, deviations of the electrical axis of the heart to the left are detected, it means that the person has certain ailments, especially hypertrophic changes in the left ventricle. Often such a violation becomes a consequence of pathological processes, as a result of which the cavity of this section stretches and increases in size.

What diseases cause hypertrophy and a sharp tilt of the EOS to the left:

Ischemic damage to the main organ.
Arterial hypertension, especially with regular pressure surges to high tonometer values.
Cardiomyopathy. The disease is characterized by an increase in the weight of the muscle tissue of the heart and the expansion of all its cavities. This disease often appears after anemia, myocardial infarction, myocarditis or cardiosclerosis.
Chronic heart failure.
Disturbances in the aortic valve, its insufficiency or stenosis. A pathological process of this type can be acquired or congenital in nature. Such diseases cause disruption of blood flow in the cavities of the organ, which leads to overload of the left ventricle.
People involved in sports activities professionally also often exhibit these disorders.

In addition to hypertrophic changes, deviation of the heart axis sharply to the left may indicate problems with the conductive properties of the inner part of the ventricles, which usually arise with various blockades. What it is and what it threatens will be explained by the attending physician.

A blockade found in the left bundle branch is often diagnosed, which also refers to a pathology that shifts the EOS to the left.

The opposite condition also has its own reasons for its occurrence. Deviation of the electrical axis of the heart to the other side, the right, indicates hypertrophy of the right ventricle. There are certain diseases that provoke such a disorder.

What diseases lead to a tilt of the EOS to the right:

Pathological processes in the triscupid valve.
Stenosis and narrowing of the lumen of the pulmonary artery.
Pulmonary hypertension. This disorder often occurs against the background of other ailments, such as obstructive bronchitis, organ damage by emphysema, and bronchial asthma.

In addition, diseases that lead to a shift in the direction of the axis to the left can also cause the EOS to be tilted to the right.

Based on this, doctors conclude: a change in the electrical position of the heart is a consequence of ventricular hypertrophy. In itself, such a disorder is not considered a disease; it is a sign of another pathology.

First of all, it is necessary to note the position of the EOS during the mother's pregnancy. Pregnancy changes the direction of this indicator, as serious changes occur in the body. The rapidly enlarging uterus puts pressure on the diaphragm, which leads to a displacement of all internal organs and changes the position of the axis, as a result of which its direction can become semi-vertical, semi-horizontal or otherwise, depending on its initial state.

As for children, this indicator changes with age. In newborn babies, a significant deviation of the EOS to the right side is usually detected, which is absolutely normal. By adolescence, this angle is already established. Such changes are associated with a difference in the weight ratio and electrical activity of both ventricles of the organ, as well as with a change in the position of the heart in the chest area.

A teenager already has a certain angle of EOS, which normally remains throughout his life.

Symptoms

Changing the direction of the electrical axis cannot cause unpleasant sensations in humans. Disorders of well-being usually provoke hypertrophic damage to the myocardium if they are accompanied by severe hemodynamic disturbances, and also lead to the development of heart failure, which is very dangerous and requires treatment.

Symptoms:

pain in the head and chest area;
breathing problems, shortness of breath, suffocation;
swelling of the tissues of the lower, upper extremities and facial area;
weakness, lethargy;
arrhythmia, tachycardia;
disturbance of consciousness.

Determining the causes of such disorders is an important part of all therapy. The prognosis of the disease depends on the correctness of the diagnosis. If such symptoms occur, you should immediately consult a doctor, as cardiac problems are extremely dangerous.

Diagnosis and treatment

Typically, axis deviation is detected on an ECG (electrocardiogram). This method is not more often than others prescribed during a routine examination. The resulting vector and other characteristics of the organ make it possible to evaluate the activity of the heart and calculate deviations in its work. If such a disorder is detected on the cardiogram, the doctor will need to carry out several additional examinations.

Diagnostic methods:

Ultrasound of the organ is considered one of the most informative methods. With the help of such a study, it is possible to identify ventricular hypertrophy, disturbances in the structure of the heart and evaluate its contractile characteristics.
X-ray of the chest area, allowing you to see the presence of a shadow of the heart, which usually occurs with myocardial hypertrophy.
ECG in the form of daily monitoring. It is necessary to clarify the clinical picture in case of disorders related not only to the axis itself, but also to the origin of the rhythm not from the sinus node area, which indicates a disorder of the rhythmic data.
Coronary angiography or coronary angiography. It is used to study the characteristics of damage to the coronary arteries during organ ischemia.
An exercise ECG can detect myocardial ischemia, which is usually the cause of a shift in the direction of the EOS.

It is necessary to treat not a change in the electrical axis indicator, but the disease that caused the pathology. Using diagnostics, doctors accurately determine the factors that provoked such disorders.

Changing the angle of the electrical axis of the heart does not require therapy.

No class of medications will help in this case. The disease that led to such changes needs to be eliminated. Drugs are prescribed to patients only after an accurate diagnosis has been made. Depending on the nature of the lesions, medications are used. Sometimes it is advisable to undergo surgery.

In order to determine the functional abilities of the heart, it is necessary to conduct special examination methods. If it turns out that there are disturbances in the conduction system of the organ, there is no need to panic, you must follow all the doctor’s recommendations. Medicine today can eliminate almost any pathology, you just need to seek help in a timely manner.

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