心电图检查能发现的问题有哪些？/What are the problems that can be detected by electrocardiogram examination?

心脏的跳动主要由位于右心房上方的窦房结控制的它是直接指挥心脏的司令部。窦房结能自动产生兴奋，并以生物电的形式沿着特殊的传导系统迅速地传到心脏的各个部分。心肌接受到兴奋信号后，产生一系列相应的电活动，引起心肌收缩。尽管这一系列的电活动十分微弱，但仍然会传到身体的表面。如果我们在体表的不同部位放上电极，把这些微弱的电活动放大后再记录下来，便能展现出一幅反映心脏活动的图形，这就是心电图。

那么，通过心电图检查能发现哪些问题呢？

1、心脏监护：对危重病人进行监护（包括心脏手术后），可以随时发现心脏是否有异常。

2、识别心律不齐的性质：医生用听诊器听心脏或摸脉搏，只能发现心律不规则，但究竟属哪种性质的疾病？是“司令部”窦房结失灵？还是传导系统的某一个环节病变？只能依靠心电图帮助明确论断。

3、能迅速反映心肌梗死的部位及心肌缺血、劳损的程度：还能帮助诊断心肌炎、心肌病、心包炎等。对先天性心脏病的诊断具有十分重要的价值。

4、诊断心房、心室肥大：心脏分上下左右4个部分，上为左右心房，下为左右心室，心电图可以帮助诊断是哪一个（或两个）心房或心室肥大。

5、了解药物的疗效及对心肌的影响：例如用洋地黄治疗心力衰竭，用各种药物治疗心律失常等，均需定期进行心电图的动态观察。

6、诊断电解质代谢紊乱：在没有条件进行生化测定的情况下，低血钾、高血钾及低血钙在心电图上均有特异的改变。

The beating of the heart is mainly controlled by the sinoatrial node located above the right atrium, which is the command center that directly commands the heart. The sinoatrial node can automatically generate excitation and rapidly transmit it to various parts of the heart in the form of bioelectricity along a special conduction system. After receiving excitation signals, the myocardium produces a series of corresponding electrical activities, causing myocardial contraction. Although this series of electrical activities is very weak, they still reach the surface of the body. If we place electrodes on different parts of the body surface, amplify these weak electrical activities, and record them, we can display a graph reflecting heart activity, which is called electrocardiogram.

So, what problems can be found through electrocardiogram examination?

1. Cardiac monitoring: Monitoring critically ill patients (including after cardiac surgery) can detect any abnormalities in the heart at any time.

2. Identifying the nature of arrhythmia: Doctors using stethoscopes to listen to the heart or touch the pulse can only detect irregular heart rhythm, but what kind of disease does it belong to? Is it a malfunction of the sinoatrial node in the 'headquarters'? Or is it a lesion in a certain link of the conduction system? Only relying on electrocardiogram can help clarify the judgment.

3. It can quickly reflect the location of myocardial infarction and the degree of myocardial ischemia and strain, and can also help diagnose myocarditis, cardiomyopathy, pericarditis, etc. The diagnosis of congenital heart disease has significant value.

4. Diagnosis of atrial and ventricular hypertrophy: The heart is divided into four parts: the upper part is the left and right atria, and the lower part is the left and right ventricles. Electrocardiogram can help diagnose which one (or both) atrial or ventricular hypertrophy is.

5. Understanding the efficacy of drugs and their impact on the myocardium: for example, using digitalis to treat heart failure, using various drugs to treat arrhythmia, etc., all require regular dynamic observation of electrocardiogram.

6. Diagnosis of electrolyte metabolism disorder: In the absence of biochemical testing conditions, specific changes in hypokalemia, hyperkalemia, and hypocalcemia can be observed on electrocardiogram.