Существуют различные методы обследования системы кровообращения и в частности сердца, среди которых выделяются эхокаргиография и ультразвуковая диагностика. Электрокардиография считается самым простым методом обследования, который используется для оценки состояния сердечно-сосудистой системы. В это же время ультразвуковая диагностика позволяет не только получить информацию о сокращении сердца, но и визуализировать его ткани. Что лучше УЗИ сердца или ЭКГ, предстоит разобраться в этой статье.
Содержание
Какая из методик предпочтительнее
Электрокардиография проводится с использованием электрического тока слабого напряжения и позволяет узнать частоту сердечных сокращений, определить длительность интервалов между систолой и диастолой. Этот вид обследования считается обязательным при нахождении пациента в стационаре под врачебным наблюдением и применяется для исследования сердечной мышцы детей с трехмесячного возраста. Принять решение относительно того, подходит ли вам УЗИ сердца или ЭКГ, можно только после сравнения этих методик.
Электрокардиограмма позволяет узнать состояние здоровья пациента — норму и отклонения, не давая дополнительной информации о причине нарушений.
Эхокардиография представляет собой относительно современное обследование сердечно-сосудистой системы, которое проводится с использованием ультразвуковых волн и дает возможность не только выявить наличие отклонений, но и определить причину их возникновения. В ходе УЗИ на мониторе аппарата отображается четкая визуализация анатомических структур сердечной мышцы, которую можно анализировать в режиме реального времени. Если решать, что лучше кардиограмма или УЗИ сердца в плане информативности, то диагностическая ценность УЗИ превышает кардиограмму.
Обследование сердца при помощи электрокардиограммы
Принцип этой методики обследования основан на считывании электрических импульсов сердца, которые генерируются при сокращении сердечной мышцы. Информацию фиксирует кардиограф в формате графической кривой на специальной бумажной ленте с нанесенной шкалой. Аппараты для проведения этого обследования имеются практически в каждой клинике, длительность проведения процедуры составляет не дольше нескольких минут, сама кардиография достаточно проста и доступна.
Непосредственно перед началом процедуры пациент должен снять украшения и обнажиться до пояса, чтобы освободить место для датчиков. Затем он ложится на кушетку возле аппарата и по возможности расслабляется, чтобы его волнение не повлияло на результаты диагностики. Медсестра накладывает на кожу четыре электрода в установленном порядке, фиксирует их присосками и подключает к аппарату, после чего начинается обследование.
ЭКГ позволяет определить такие нарушения в функционировании сердечно-сосудистой системы:
нарушение сердечного ритма (аритмия, тахикардия);
нарушение питания миокарда (ишемия, инфаркт);
гипертрофия желудочков;
атриовентрикулярная блокада;
пороки различного характера.
Кардиограмма не дает информации относительно:
отклонений, которые сопровождаются минимальными электрическими импульсами, таких как малые пороки клапанов;
патологии, которой нет в момент записи ЭКГ, но возникшая у пациента ранее;
изменений стенок предсердий и желудочков, таких как утолщения, а также функциональных изменений при врожденных и приобретенных пороках.
Данные будут имеет низкую точность результатов при взбудораженном состоянии пациента, в период климакса или менструации у женщин (возможна регистрация ложноположительных результатов различных нарушений).
Однако именно ЭКГ незаменима в поиске редко (один – два эпизода в сутки) встречающихся аритмий (холтеровское мониторирование), в предварительной диагностике инфаркта миокарда (патологический зубец Q, и другие быстро определяемые феномены у постели больного).
Показания к проведению процедуры
ЭКГ может назначаться лечащим кардиологом или проводиться по инициативе пациента. Показания к проведению такой диагностики включают:
головокружения, обмороки;
общую слабость, одышку;
беспричинное учащенное сердцебиение;
болевые ощущения в грудной полости;
при подозрениях на заболевания сердечно-сосудистой системы;
пациентам, которые страдают от сахарного диабета, заболеваний щитовидной железы, нарушения обмена веществ;
при подготовке к оперативному вмешательству.
Проходить это обследование планово рекомендуется людям в возрасте от 65 лет, тем, кто недавно перенес тяжелое инфекционное заболевание, а также людям с нездоровыми привычками, такими как частое употребление алкоголя и неумеренное курение.
Обследование сердца при помощи ультразвуковой диагностики
Тех пациентов, которые прежде не имели дела с такой процедурой, часто интересует вопрос, эхокардиограмма – что это. Это результат обследования под названием «эхокардиография», направленного на оценку анатомических и функциональных изменений сердца и его клапанов. Принцип действия основан на свойствах ультразвуковых волн отражаться с разной интенсивностью от тканей различной плотности.
трансторакальной – стандартная процедура, которая проводится путем прикладывания УЗ-датчика к груди пациента и сбора полученных результатов;
стрессовой – предусматривает считывание параметров сердечной мышцы в момент физической нагрузки, такой как езда на велотренажере или ходьба по беговой дорожке. Такая методика позволяет выявить недостаток кровяного тока, иногда для ее проведения используются стимулирующие работу сердца препараты (аденозин, добутамин);
чреспищеводной – предусматривает введение через пищевод датчика. Отличается высокой точностью результатов благодаря близкому расположению пищевода к обследуемому органу;
внутрисосудистой – становится возможной при катетеризации сердца и направлена она на определение наличия закупорки сосудов.
Рассматривая, как проводится УЗИ сердца, отметим, что такая диагностика занимает от 15 до 20 минут, и предварительная подготовка к ней не требуется. Рекомендуется избегать чрезмерных физических нагрузок в течение суток перед УЗИ, приостановить применение успокоительных и стимулирующих препаратов, ограничить потребление кофе, крепкого чая, алкоголя. Также следует быть умеренным в еде и вовсе отказаться от нее за два часа до проведения чреспищеводного обследования.
Проводится осмотр в положении лежа на кушетке с обнаженной грудной клеткой, на область обследования врач наносит контактный гель, а затем дотрагивается до обработанной кожи датчиком — на мониторе появляется изображение работающего сердца.
Эхокардиография может быть рекомендована пациентам, которые страдают от беспричинной слабости, головокружений, частых головных болей или обмороков. Показания к такому обследованию включают:
тошноту, сопровождающуюся гипертензией;
одышку;
отечность нижних конечностей;
боли за грудиной или под лопатками;
нарушение частоты сердечных сокращений;
побледнение или посинение кожных покровов.
Также рекомендуется проходить эхокардиографию тем, у кого имеются подозрения на аномальные изменения в строении клапанной системы, пациентам с системными заболеваниями (ревматизм, склеродермия, волчанка). УЗИ сердца в плановом режиме рекомендуется пациентам старше 65 лет, больным с варикозным расширением вен и тромбофлебитом, перед проведением хирургического вмешательства, а также для оценки эффективности лечения.
Достоинства, недостатки ЭКГ и ЭХО КГ
Вопрос, в чем разница между ЭКГ и ЭХО сердца, интересует многих пациентов, планирующих визит к кардиологу. Всего существует три различия между этими диагностическими методиками:
техника осуществления исследования;
отклонения, которые выявляются в ходе процедуры;
информативность полученных результатов.
Кардиограмма записывает электростатическую работу сердца в виде графика на специальной бумаге, который позволяет определить ритм сердечной пульсации, числовые показатели сердечных сокращений, наличие у пациента аритмии. Результаты ультразвукового исследования фиксируются в электронном виде и позволяют оценить не только пульсацию, но и морфологические особенности сердечной мышцы пациента.
Основной ответ на вопрос, чем отличается ЭКГ от ЭХО КГ — информативностью. Если электрокардиография направлена только на электростатичность и оценку сердечных ритмов, то ультразвуковая диагностика определяет физиологическую способность кровеносной системы перекачивать кровь.
Оба метода считаются достаточно доступными, хотя именно ультразвуковая диагностика позволяет с более высокой вероятностью обнаружить сердечную патологию.
Чтобы решить, что лучше сделать ЭКГ или УЗИ сердца, необходимо определиться с целью прохождения обследования. Если необходимо понять, есть ли у пациента аритмия, будет достаточно электрокардиограммы, которая подходит также для выявления ишемии и подтверждения подозрения на инфаркт. Для диагностики более сложных отклонений необходимо отдать предпочтение ультразвуковой процедуре, поэтому следует учитывать отличие ЭКГ от ЭХО КГ по диагностической ценности перед тем, как выбирать тип обследования.
Недостатки электрокардиографии включают кратковременность записи, невозможность прямого диагностирования пороков и наличия новообразований. Этот метод не регистрирует гемодинамику и шумы сердца, а тест, проведенный в состоянии покоя, может вовсе не показать имеющуюся у пациента патологию. В то же время четкость результатов УЗИ ограничена площадью датчика, оно имеет более низкое разрешение по сравнению с МРТ и сталкивается с различными помехами из-за неоднородности внутренней среды грудной полости.
Положительные черты при этом имеют обе методики: доступность, простота и скорость проведения, неинвазивность. Некоторые относятся только к УЗИ — возможность получения объемного изображения обследуемого органа.
Выводы
Ультразвуковое обследование сердца и электрокардиография нередко используются одновременно для получения более полных и точных результатов. По отдельности эти процедуры позволяют диагностировать отклонения в сердечном ритме, различные нарушения в строении сердечной мышцы. Расшифровка данных ложится на врача-диагноста, который может назначать дополнительные процедуры для уточнения полученных сведений.
Видео : Консультация хорошего кардиолога. УЗИ сердца
Закончил Санкт-Петербургский государственный медицинский университет имени академика И.П.Павлова. Работаю терапевтом более 15 лет. Мой девиз в работе и в жизни: "Никогда не говори никогда."
Ультразвуковая диагностика хронических заболеваний сердца является обязательным методом обследования. Она дает исчерпывающую информацию о размерах камер сердца, толщине стенок, функциональной способности клапанов и нарушении нормального тока крови.
И хотя некоторые пациенты этого не знают, но УЗИ сердца и эхокардиография это одно и тоже. Ниже описаны суть методики, показания к ее назначению, а также патологии, которые можно диагностировать с ее помощью.
Суть методики, цель проведения
То чем отличается УЗИ сердца от ЭХО сердца? УЗИ сердца и эхокардиография – это одно и тоже. ЭХО относится к безопасным неинвазивным методикам визуализации органа. В его основе находится использование ультразвуковых волн, которые человеческое ухо не воспринимает. При прохождении через ткани различной плотности, определенная их часть отбивается назад и улавливается специальным датчиком. Полученная информация визуализируется на экране прибора.
Показания и противопоказания
Эхокардиографию назначают пациенту при наличии одного из следующих показаний:
гипертоническая болезнь;
острая ревматическая лихорадка;
клиника стенокардии;
инфекционный эндокардит;
ишемическая болезнь сердца;
перенесенный инфаркт миокарда;
признаки сердечной недостаточности;
системные воспалительные процессы с поражением сердца;
обнаружение на ЭКГ отклонений от нормы;
наличие шума над клапаном при аускультации;
подозрение на наличие врожденного порока развития;
хронические заболевания почек;
обнаружение на рентгенограмме грудной клетки увеличенного сердца;
сахарный диабет;
подготовка пациента к оперативному вмешательству (в пожилом возрасте).
Противопоказаний исследование не имеет. В период беременности или лактации у женщин УЗИ также назначают без ограничений.
К какому врачу обратится
Виды эхокардиографии
Существует несколько методик ультразвукового исследования сердца:
Двухмерная В-эхокардиография. Наиболее распространенный вариант. Датчик ставится на переднюю стенку грудной клетки. Изображение обрабатывается компьютером и выводится на экран в форме двухмерного черно-белого изображения. Этого достаточно для определения основных показателей.
Допплерэхокардиография. Режим исследования, который позволяет следить за направлением тока крови в полости камер. Обычно все аппараты в кардиологических клиниках позволяют ее провести. Позволяет врачу оценить выраженность регургитации крови, обнаружить наличие области нелинейного тока, а также более точно оценить площадь просвета при открытии клапанов.
Эхокардиография с контрастированием. Внутривенно пациенту вводят специальное вещество, которое усиливает контрастность крови. Это вид обследования отошел на задний план после внедрения допплерографии.
Чреспищеводная эхокардиография. Датчик с зондом вводится через ротовую полость и через стенку пищевода визуализирует сердце. Является методом выбора при необходимости обнаружить небольшие тромбы в камерах (например, при мерцательной аритмии).
УЗИ сердца со стрессовой нагрузкой. Используется только в специализированных клиниках. Пациенту дают дозированную нагрузку, во время которой изучают изменения в работе сердца. Методика позволяет обнаружить скрытые формы заболеваний.
Если пациент не будет дополнительно проходить УЗИ органов брюшной полости и мочеполовой системы, то специальной подготовки ему не нужно. Однако, перед исследованием желательно помыть мылом кожу грудной области.
Обследование проводится в кабинете ультразвуковой диагностики врачом функциональной диагностики. Пациент полностью снимает одежду с грудной клетки и ложится на специальную кушетку. На кожу наносится специальный гель, который улучшает проходимость ультразвуковых волн.
Методика проведения
При стандартной трансторакальной эхограмме с допплером датчик ставится последовательно на 4 стандартные позиции:
Парастернальную – вдоль левого края грудины. Позволяет визуализировать левый желудочек, митральный, аортальный, трехстворчатый клапаны.
Апикальную – в 5 межреберье на уровне соска. Оцениваются функциональные показатели левого желудочка, митральный клапан.
Субкостальную – датчик устанавливается над мечевидным отростком. Визуализируется правый желудочек, клапан легочной артерии.
Супрастернальную – в яремную ямку. Обследуют сосуды грудной полости, аорту.
Расшифровка результатов
Результаты обследования вносятся в специальный бланк и выдаются на руки пациенту сразу после окончания процедуры или отправляются на электронную почту.
Показатели нормы
Основные показатели нормы эхокардиографии собраны в следующей таблице:
Показатель
Норма у взрослого пациента
Фракция выбора
55-65 %
Конечный диастолический диаметр ЛЖ
38-54 мм
Конечный систолический диаметр ЛЖ
25-36 мм
Толщина задней стенки ЛЖ
8-12 мм
Толщина межжелудочковой перегородки
8-11 мм
Диаметр левого предсердия
18-40 мм
Диаметр аорты
18-36 мм
Толщина стенки ПЖ
4-7 мм
Ударный объем
55-105 мл
Индекс массы тела миокарда
55-94 г/м2
Уровень среднего давления в легочной артерии
До 15 мм.рт.ст.
Функция клапанов сердца
Не изменены
Полезное видео
Как проводится УЗИ сердца врач рассказывает в этом видео.
Какие патологии можно обнаружить
При проведении эхокардиографии выявляют следующие заболевания и состояния:
признаки гипертрофической болезни;
перенесенный инфаркт миокарда;
врожденные пороки развития;
недостаточность митрального, аортального, трикуспидального и легочного клапанов;
сердечную недостаточность;
аневризму сердца;
дилатационную и гипертрофическую кардиомиопатию;
перикардит;
сужение просвета (стеноз) клапанов сердца;
миокардит;
метаболическую кардиомиопатию;
тромбы в полости сердца;
аневризму или расслоение аорты;
инфекционный эндокардит;
признаки гипертензии в системе легочной артерии (тромбоэмболия, хронические заболевания дыхательной системы);
гидро- и гемоперикард.
При обследовании опытный врач также замечает аритмии и нарушения ритмичности сердечных сокращений. Цена обследования находится в пределах 1200-3500 рублей.
Отличия УЗИ сердца от ЭКГ
В чем разница между ЭКГ и ЭХО сердца? Электрокардиография изучает электрические импульсы, которые возникают и распространяются в миокарде. С ее помощью врачи диагностируют различные нарушения проводимости (блокады), аритмии. Наибольшую ценность ЭКГ имеет для быстрой диагностики инфаркта миокарда. Однако, электрокардиография не дает информацию о состоянии клапанов, камер сердца. Также ее информативность более низкая при врожденных и ревматологических заболеваниях.
Немногие знают, что помимо стандартной процедуры электрокардиографии есть и другие методы обследования сердца, например, УЗИ, КТ, МРТ, которые позволяют оценить работу сердца неинвазивным методом.
УЗИ сердца занимает больше времени и стоит дороже, но ультразвуковое обследование обладает большей информативностью. Эту процедуру обычно назначают после проведенной ЭКГ, если ее результаты сомнительны или неясны.
Что такое ЭхоКГ и УЗИ сердца? Преимущества метода
ЭхоКГ – эффективный ультразвуковой метод диагностики сердца
Процедура ЭКГ известна всем. Это обследование позволяет выявить сбои в работе сердца, нарушения ритма и т.д. Однако с помощью ЭКГ не всегда можно конкретизировать диагноз, поэтому назначается дальнейшее обследование.
Часто пациенты интересуются, ЭхоКГ и УЗИ сердца – одно и то же или же нет. Эхокардиографию называют УЗИ сердца, так как она основана на ультразвуковом обследовании сердца, но при этом она включает и элементы электрокардиографии. Во время обследования одновременно проводятся процедура УЗИ и ЭКГ, что значительно повышает информативность. Метод основывается на способности тканей тела отражать ультразвук и возвращать его обратно в датчик.
Поскольку разные ткани обладают различной эхогенностью, на экран выводится двух- или трехмерное изображение.
ЭхоКГ сердца имеет множество преимуществ:
Безболезненность и неинвазивность. Процедура проводится как обычное УЗИ, но с присоединением к телу нескольких электродов. Это совершенно безболезненно. Никакие инъекции перед процедурой не проводятся. Единственный дискомфорт, который может испытывать пациент – это несильный холод от геля и датчика. Любые боли во время ЭхоКГ не связаны с воздействием ультразвука.
Безопасность. Процедура безопасна для пациентов всех возрастов. Она практически не имеет противопоказаний. ЭхоКГ можно проводить пожилым людям, детям, беременным женщинам. Ультразвук не обладает побочными эффектами и не оказывает воздействия на плод.
Доступность процедуры. Процедура может проводиться в любом медицинском центре, частном или муниципальном. При наличии направления от врача процедура проводится бесплатно. Аппаратура для проведения ЭхоКГ есть практически в любом городе.
Небольшая цена. По сравнению с МРТ цена на ЭхоКГ невелика. Цена на ЭКГ несколько ниже, но сама процедура менее информативна. Стоимость варьируется в зависимости от медицинского учреждения.
Высокая информативность. Процедура ЭхоКГ обладает высокой информативностью. С помощью ультразвукового обследования можно оценить не только ЧСС и сердечный ритм, но и размеры сердца, работу сосудов, наличие кист и опухолей.
Показания и противопоказания
Обследование назначается как в диагностических, так и в профилактических целях
Проводить процедуру ЭхоКГ можно как по назначению врача, так и для профилактики. Рекомендуется пройти обследование всем, у кого есть симптомы сердечных заболеваний, подозрения на наличие того или иного сердечно-сосудистого заболевания, а также для профилактического обследования уже имеющихся хронических заболеваний.
Назначение на обследование:
Нарушения работы сердца. Если больной часто испытывает приступы тахикардии или стенокардии, сердцебиение сильно учащается или замедляется, все это сопровождается неприятными ощущениями в области груди, обследование сердца пройти необходимо. Обычно сначала назначают ЭКГ, а затем уже УЗИ.
Одышка. В здоровом организме одышка может возникать после физических нагрузок и кардиотренировок. Но частая или постоянная одышка даже в спокойном состоянии требует обязательного обследования. Чаще всего она указывает на нарушения работы сердечной мышцы.
Отеки. Возникновение отеков говорит о задержке жидкости в тканях организма. Это может быть признаком как нарушения работы почек, так и сердечно-сосудистых заболеваний. В этом случае назначается всестороннее обследование организма.
Гипертония. Люди с повышенным артериальным давлениям входят в группу риска по сердечным заболеваниям. Постоянное повышенное давление значительно увеличивает нагрузку на сердце и сосуды. По этой причине гипертоникам рекомендуется ежегодное обследование сердца.
Боли в грудной клетке. Боль в груди может возникать только в определенном положении, при ходьбе или же в спокойном состоянии. В любом случае она считается тревожным симптомом, нуждающимся в обследовании. Также ЭхоКГ назначается при частых головных болях.
Очень часто проходят эту процедуру спортсмены, чьи увлечения связаны с экстримом. Подобные виды спорта повышают нагрузку на сердце, и заниматься ими можно только после профилактического обследования.
Противопоказаний процедура практически не имеет. Как ЭКГ, так и УЗИ проводятся всем без исключения. Помешать процедуре могут только травмы грудной клетки, деформации, воспаления кожи. В этом случае обследование будет затруднено. В некоторых случаях проведению процедуры мешает лишний вес. Тогда процедуру ЭхоКГ заменяют на МРТ.
Подготовка и процедура
Процедура ультразвукового обследования сердца – неинвазивная и безопасная
Никакой подготовки процедура она не требует. Для стандартной процедуры ЭхоКГ достаточно просто прийти в кабинет в назначенное время. В некоторых случаях рекомендуют не переедать или не есть за 3 часа до обследования. Полный желудок немного приподнимает диафрагму, что может затруднить обследование.
Процедура ЭхоКГ достаточно проста для пациента. Проводится она быстро и занимает не более 10-15 минут.
Пациент заходит в кабинет врача, раздевается до пояса и ложится на кушетку на левый бок. Врач смазывает кожу пациента в области груди специальным гелем и прикрепляет электроды.
Врач водит ультразвуковым датчиком до грудной клетке. Изображение выводится на экран, врач его фиксирует и проводит записи. Пациент при этом испытывает только небольшой холод и несильное давление. О любых болевых ощущениях нужно сообщать врачу.
Если проведение обычной процедуры ЭхоКГ невозможно, назначают чреспищеводную процедуру. Эта процедура напоминает ФГС. Через пищевод в рот пациент вводится датчик, через который информация поступает на монитор. Подготовка в этом случае будет несколько более сложной: перед процедурой нужно воздерживаться от еды не менее 8-10 часов. Во время такого обследования возникает сильный рвотный рефлекс. Больному рекомендуют глубоко дышать носом и не напрягать мышцы гортани и пищевода.
Есть и еще одна разновидность этой процедуры – стресс-ЭхоКГ.
Обследование проводится во время физических нагрузок, или же работа сердца усиливается с помощью специальных препаратов. Такая процедура считается более информативной, потому что позволяет выявить скрытые нарушения в работе сердца.
Вся процедура занимает около часа. Нагрузки подбираются индивидуально для каждого пациента. Обследуемого просят прийти в удобной одежде, чтобы ничего не мешало проведению процедуры.
Больше информации об УЗИ сердца можно узнать из видео:
Ни беременность, ни грудное вскармливание не являются противопоказаниями для проведения УЗИ. Прерывать грудное вскармливание не нужно. Для большего удобства женщина посещает кабинет врача после кормления. Следующее кормление можно проводить так же, как обычно. Ультразвук никак не влияет на грудное молоко и не наносит вред ребенку.
Расшифровка результатов
Во время процедуры ЭхоКГ оценивается работа сердца и сама сердечная мышца
Все показатели вносятся в специальный протокол, который затем отдается пациенту на руки. В число показателей входят размеры миокарда, размеры желудочков и толщина их стенок, ЧСС, ударный объем сердца, объем выбрасываемой крови. С помощью допплер-УЗИ можно оценить работу артерий и сосудов, движение крови по ним.
С помощью ЭхоКг можно выявить следующие заболевания:
Аневризма. При аневризме часть сердечной мышцы выбухает, образуя мешок. Сократительная способность сердца в этом случае снижается. Обычно аневризма появляется как последствие инфаркта. При этом заболевании появляется слабость, одышка, аритмия. Разрыв аневризмы обычно приводит к летальному исходу.
Сердечная недостаточность. Сердечная недостаточность может возникать по различным причинам. Она приводит к нарушению работы сердца, которое становится не способно в полной мере снабжать все органы и ткани кислородом. Кровоток значительно ухудшается, что приводит к различным осложнениям.
Перикардит. Воспаление перикарда обычно возникает по причине инфекции или перенесенного инфаркта миокарда. При правильном лечение перикардит вылечивается полностью и не сопровождается осложнениями.
Пороки сердца. Пороки могут быть врожденными и приобретенными, но все они требует регулярного обследования. При пороках сердца наблюдаются различные дефекты клапанов или перегородок, в результате которых нормальная работа сердца нарушается. Некоторые пороки сердца могут приводить к летальному исходу.
Опухолевые процессы. С помощью ЭхоКГ можно обнаружить различные опухоли и кисты на ранних стадиях. Злокачественные и доброкачественные новообразования в области сердца встречаются редко, но их своевременная диагностика очень важна.
Инфаркт миокарда. При инфаркте прекращается кровоснабжение к части сердечной мышцы, в результате чего начинаются некротические процессы. Инфаркт может привести как к смерти больного, так и к различным тяжелым последствиям.
Стоит помнить, что сердце – сложный орган и его обследование также проводится с учетом многих нюансов. Расшифровать результат обследования может только врач-кардиолог. Самостоятельно интерпретировать результаты нельзя, так как это приведет к ошибочному диагнозу.
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