Esophagography

Esophagography (from the Greek. oisophagos - esophagus, kardia - heart and grapho - write - a graphic registration of the movements of the heart through the esophagus.
The technique. Esophagography performed with a thin rubber or PVC probe, one end of which ended small thin rubber balloon, is injected to a necessary depth in the esophagus, and the other connected with the recording equipment. The simplest registrars are capsule Marea and light capsule Frank, entry is on kymograph. The last time as esophagocardiac use a gauge attachment to electronic recorders to record the pressure curve in the cavities of the heart; they provide the highest quality recording. Special advantages of using multi-channel recording devices allowing simultaneously with esophagocardiac to register ECG, FCG, apical cardiogram, carotid spirogramma. Such polycardiography study greatly facilitates the breakdown esophagogram and interpretation of the individual waves.
Registration of esophagogram also possible using a miniature of piezosensor (see Piezography), placed in the esophagus. The sensor signals are fed to the amplifier, and then on the recording device.
Esophagography spend in the supine position of the patient; desirable prior anaesthesia mucous membrane of the pharynx 1 - 2% solution dikaina. When writing the left atrial contractions (esophagogastrectomy) sensor enter into the esophagus to a depth of 30-40 cm from the edge cutters, left ventricular (esophagogastrectomy) 35-45 cm, pulsation of the aorta (esophagoectomy) - 20-30 see
Normal esophagocardiac. On normal esophagogram distinguish three waves. The first - wave of contraction of the Atria, called the wave, or as occurs through 0.05 sec. after the start, and P wave on ECG and ends after an average of 0.13 sec. The second wave - ventricular denoted as wave In, or vs begins after an average of 0.05 sec. after the beginning zubza Q on ECG, often bifurcated into waves and C. the Appearance of this wave is usually explained by increased pressure in the left atrium due arching in its cavity slamming of atrioventricular valve in the period of isometric contraction of the left ventricle. Subsequent decline curve coincides with the phase of rapid expulsion of blood from the left ventricle, it is due to a reduction of the heart and some of discharge of the left atrium from the esophagus. The third wave D due to their passive filling the left atrium from the pulmonary veins and time corresponds to the slow phase exile blood from the left ventricle and phase isometric relaxation. The final plateau-like top coincides with the opening of the mitral valve, and the downward elbow of this wave with the phase of rapid filling of the left ventricle in the early diastole. For this wave should small gradual rise corresponding to slow filling of the left atrium from the pulmonary veins, when the flow of blood into it prevails over the outflow in the left ventricle (Fig. 1). It is established that esophagotracheal quite accurately reflects the change of pressure in the left atrium. Registration esophagogastrectomy practical value has no. Normal asiakkaitamme similar curve ripple aorta and is characterized by high positive wave arising in the period of the expulsion of blood from the left ventricle into the aorta.

Fig. 1. Esophagotracheal (2) a healthy person is recorded simultaneously with the electrocardiogram (1), ECG (3) and phonocardiograms (4) - wave of contraction of the Atria; In - ventricular wave; D -, wave filling the Atria.

Esophagocardiac in heart disease. Greatest practical interest changes esophagogastrectomy with mitral heart disease. When the mitral valve insufficiency hollow between ventricular wave (C), and wave of the filling of the Atria (D) expressed bad, in severe cases, wave and D are merged and replaced with one big wave, reflecting the increased content of left atrial as from the pulmonary veins and reverse the flow of blood from the left ventricle. Rising knee of this wave are often has a small notch is obviously due to the resulting twists and associated noise mitral insufficiency. The top of her often coincides with the second heart sound. Wave ends steep decline (Fig. 2).
In mitral stenosis on esophagogram in most cases, there is an increase in the amplitude and duration of waves and slow curve in the phase of rapid filling of the left ventricle of the heart chambers (Fig. 3). The more severe the degree of stenosis of the top and descending waves knee D are before, due to an earlier opening of the mitral valve due to increased pressure in the left atrium. When combined mitral blemish on esophagogram signs of both evils, but in most cases more clearly revealed signs of mitral valve insufficiency.
The value of esophagography for clinic is still not completely understood. It is established that the shape of the curve of esophagogastrectomy you can judge the state of the contractile function of the left atrium. The use of esophagography in polycardiography examination (ECG, FCG, is explained by the ICG and others) makes it possible to study the phase structure of systolic left atrium, which is important for the diagnosis of mitral heart disease. Contraindications to the study are severe heart failure, a tendency to thrombosis and embolism, overall condition, acute esophagitis.

Fig. 2. Esophagotracheal patient with mitral valve insufficiency (the designations are the same as in Fig. 1).
Fig. 3. Esophagotracheal patient with stenosis of the left atrioventricular holes (the designations are the same as in Fig. 1).