What does zhes mean? Ventricular extrasystole - how dangerous is it? Chest pain

Ventricular extrasystoles (VES) are extraordinary contractions of the heart that occur under the influence of premature impulses that originate from the intraventricular conduction system.
Under the influence of an impulse generated in the trunk of the His bundle, its branches, branches of the legs or Purkinje fibers, the myocardium of one of the ventricles contracts, and then the second ventricle without previous contraction of the atria. This explains the main electrocardiographic signs of PVCs: premature dilated and deformed ventricular complex and the absence of a normal P wave preceding it, indicating atrial contraction.

In this article, we will consider the causes of ventricular extrasystole, its symptoms and signs, and talk about the principles of diagnosis and treatment of this pathology.

Extrasystoles can appear in healthy people after taking stimulants (caffeine, nicotine, alcohol).

Ventricular extrasystole can be observed in healthy people, especially with (Holter-ECG). Functional PVCs are more common in people under 50 years of age. It can be triggered by physical or emotional fatigue, stress, hypothermia or overheating, acute infectious diseases, taking stimulants (caffeine, alcohol, tannin, nicotine) or certain medications.

Functional PVCs are often detected when the activity of the vagus nerve increases. In this case, they are accompanied by a rare pulse, increased salivation, cold wet extremities, and arterial hypotension.

Functional PVCs do not have a pathological course. When the provoking factors are eliminated, they most often go away on their own.

In other cases, ventricular extrasystole is caused by organic heart disease. For its occurrence, even against the background of heart disease, additional exposure to toxic, mechanical or autonomic factors is often required.

Often PVCs accompany chronic ischemic heart disease (). With daily ECG monitoring, they occur in almost 100% of such patients. Arterial hypertension, heart defects, heart failure and myocardial infarction are also often accompanied by ventricular extrasystole.

This symptom is observed in patients with chronic lung diseases, rheumatism. Extrasystole of reflex origin occurs, associated with diseases of the abdominal organs: cholecystitis, gastric and duodenal ulcers, pancreatitis, colitis.
Another common cause of ventricular extrasystole is a metabolic disorder in the myocardium, especially associated with the loss of potassium by cells. These diseases include pheochromocytoma (a hormone-producing tumor of the adrenal gland) and hyperthyroidism. PVCs can occur in the third trimester of pregnancy.

Drugs that can cause ventricular arrhythmias include primarily cardiac glycosides. They also occur when using sympathomimetics, tricyclic antidepressants, quinidine, and anesthetics.

Most often, PVCs are recorded in patients who have serious changes at rest: signs, myocardial ischemia, rhythm and conduction disturbances. The frequency of this symptom increases with age and is more common in men.

Clinical signs

With a certain degree of convention, we can talk about different symptoms for functional and “organic” PVCs. Extrasystoles in the absence of severe heart disease are usually single, but are poorly tolerated by patients. They may be accompanied by a feeling of freezing, interruptions in heart function, and isolated strong beats in the chest. These extrasystoles often appear at rest, in a lying position, or during emotional stress. Physical tension or even a simple transition from a horizontal to a vertical position leads to their disappearance. They often occur against a background of a slow pulse (bradycardia).

Organic PVCs are often multiple, but patients usually do not notice them. They appear during physical activity and go away with rest, in a lying position. In many cases, such PVCs are accompanied by rapid heartbeat (tachycardia).

Diagnostics

The main methods of instrumental diagnosis of ventricular extrasystole are ECG at rest and 24-hour Holter ECG monitoring.

Signs of PVC on ECG:

• premature dilated and deformed ventricular complex;
• discordance (multidirectionality) of the ST segment and T wave of the extrasystole and the main wave of the QRS complex;
• absence of a P wave in front of the VES;
• the presence of a complete compensatory pause (not always).

Interpolated PVCs are distinguished, in which the extrasystolic complex is inserted, as it were, between two normal contractions without a compensatory pause.

If PVCs come from the same pathological focus and have the same shape, they are called monomorphic. Polymorphic PVCs emanating from different ectopic foci have different shapes and different coupling intervals (the distance from the previous contraction to the R wave of the extrasystole). Polymorphic PVCs are associated with severe cardiac damage and a more serious prognosis.
Early PVCs (“R to T”) are classified into a separate group. The criterion for prematurity is the shortening of the interval between the end of the T wave of sinus contraction and the beginning of the extrasystole complex. There are also late PVCs that occur at the end of diastole, which may be preceded by a normal sinus P wave, superimposed on the beginning of the extrasystolic complex.

VES can be single, paired or group. Quite often they form episodes of allorhythmia: bigeminy, trigeminy, quadrigeminy. With bigeminy, a VES is recorded through every normal sinus complex; with trigeminy, a VES is recorded every third complex, and so on.

During daily ECG monitoring, the number and morphology of extrasystoles, their distribution during the day, and dependence on load, sleep, and medication are specified. This important information helps determine the prognosis, clarify the diagnosis and prescribe treatment.

The most dangerous in terms of prognosis are considered to be frequent, polymorphic and polytopic, paired and group VES, as well as early extrasystoles.

The differential diagnosis of ventricular extrasystoles is carried out with supraventricular extrasystoles, complete block of the bundle branches, and escaped ventricular contractions.

If ventricular extrasystole is detected, the patient should be examined by a cardiologist. Additionally, general and biochemical blood tests, an electrocardiographic test with dosed physical activity, and echocardiography may be prescribed.

Treatment

Treatment of ventricular extrasystole depends on its causes. For functional PVCs, it is recommended to normalize the daily routine, reduce the use of stimulants, and reduce emotional stress. A diet enriched with potassium or drugs containing this microelement (Panangin) is prescribed.
For rare extrasystoles, special antiarrhythmic treatment is not prescribed. Herbal sedatives (valerian, motherwort) are prescribed in combination with beta-blockers. In case of JS against the background of vagotonia, sympathomimetics and anticholinergic drugs, for example, Bellataminal, are effective.
If the extrasystoles are organic, treatment depends on the number of extrasystoles. If there are few of them, ethmosin, etacizin or allapinin can be used. The use of these drugs is limited due to the possibility of their arrhythmogenic effects.

If extrasystole occurs in the acute period of myocardial infarction, it can be stopped with lidocaine or trimecaine.

Cordarone (amiodarone) is currently considered the main drug for suppressing ventricular extrasystole. It is prescribed according to a scheme with a gradual reduction in dosage. When treating with cordarone, it is necessary to periodically monitor the function of the liver, thyroid gland, external respiration and the level of electrolytes in the blood, as well as undergo an examination by an ophthalmologist.

In some cases, persistent ventricular premature beats from a known ectopic lesion are well treated with radiofrequency ablation surgery. During such an intervention, cells that produce pathological impulses are destroyed.

The presence of ventricular extrasystole, especially its severe forms, worsens the prognosis in people with organic heart disease. On the other hand, functional PVCs most often do not affect the quality of life and prognosis of patients.

Video course “Everyone can do an ECG”, lesson 4 - “Heart rhythm disturbances: sinus arrhythmias, extrasystole” (VES - from 20:14)

Should stairwells in the entrances of apartment buildings be cleaned? Who is responsible for washing the elevators and cleaning the windows in our hallways? After reading the article, our reader contacted the editor with these questions. The portal's observer examined the issue from a practical and legal point of view.

How does it happen...

Everyone knows that “some or other” cleaning is carried out periodically in the entrances of our houses. Sometimes residents of high-rise buildings even tell each other about unexpected encounters with quiet aunties-cleaners from the housing department, who periodically honestly wipe down the entrance railings with a wet rag. However, most often, entryway cleaning seems like a mythical service.

The columnist called his housing department and asked how often wet cleaning takes place at his entrance.

For what purpose are you interested? - the dispatcher became wary.

From a practical point of view. “I’m wondering how much the state should pay for a dirty entrance,” the columnist said.

Why is it dirty? Your address is cleaned 2 times a week.

The entire entrance? I live on the seventh floor. I can't believe it.

Ha! The entire entrance?! Are you laughing? The first floor is cleaned, swept, the floor is washed. That’s all, concluded the ZhES.

It turns out that residents of high-rise floors are not entitled to wet cleaning of the staircase at all? Then what do we regularly pay money for, based on the amounts calculated in monthly allowances?

The columnist asked this question to the lawyer.

And how it should be...

According to Art. 4 of the Law of the Republic of Belarus No. 405-Z dated July 16, 2008 “On the protection of the rights of consumers of housing and communal services,” housing and communal services are classified into basic and additional.

Basic housing and communal services include services that are provided without fail and ensure the necessary amenities of residential buildings, residential and auxiliary premises, local areas in relation to the conditions of the relevant settlement, their compliance with established sanitary and technical requirements.

The list of basic housing and communal services was approved by Resolution of the Council of Ministers of the Republic of Belarus No. 99 dated January 27, 2009. Basic housing and communal services include:

− maintenance of an apartment building;

− cold and hot water supply;

− water disposal (sewerage);

− centralized gas supply;

− power supply;

− centralized heat supply;

− use of the elevator;

− removal and disposal of solid household waste.

In order to find out exactly what work is included in the maintenance of a residential building and how often they should be performed, the lawyer recommended contacting TKP 45-1.04-14-2005 (02250)“Technical operation of residential and public buildings and structures. Procedure", and also to « Industry standards for time, maintenance and material consumption standards for residential maintenancefund", approved by resolution of the Ministry of Housing and Communal Services of the Republic of Belarus No. 29 dated July 5, 2007.

According to these documents, the technical maintenance of multi-apartment residential buildings is understood as a set of organizational and technical measures to maintain the serviceable and operational condition of building structures by eliminating their minor faults, ensuring the established parameters and modes of their operation, carrying out work to prepare the house for spring-summer, autumn-winter periods of the year.

In fact, maintenance includes the entire range of work to maintain a house from the roof to the foundation and the surrounding area.

According to established standards and rules, the housing maintenance organization (ZhES) is obliged, in particular, to carry out:

− washing windows in the entrance - 2 times a year;

− wet sweeping of the staircase from the 1st to the 3rd floor - 1 time per day;

− washing and disinfection of stairwells of the entire entrance - 2 times a week;

− cleaning the basement and attic - once a month;

− removing garbage from the garbage collection chamber - once a day;

− cleaning the loading valve of the garbage chute - 2 times a month;

− wet cleaning of the garbage collection chamber - once a week;

− washing and disinfection of the replaceable waste bin - once a month.

All actions that need to be carried out during cleaning are regulated.

Thus, cleaning of staircases should be carried out starting from the top floor and only after completion of work on cleaning the garbage chute valves. When sweeping staircases and landings, waste must be thrown into a garbage chute or collected in a special container and transported to the designated location. Walls (painted with oil or synthetic paint) should be cleaned with a brush.

According to current standards, each housing unit must be assigned a certain number of workers for comprehensive cleaning of courtyard and intra-house areas. The calculation of the required number of people who need to be involved in cleaning a house of a certain area is made using a special formula.

Information about who carries out the cleaning, how often and where, should be placed by the housing department on the notice board within the visible accessibility of the residents of a particular house.

ZhES - railway power station ... Dictionary of Russian language abbreviations

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Restoration of structures for groundwater intake. - 31. Restoration of structures for groundwater intake. In case of partial destruction of structures included in the water intake complex, in order to restore full or partial water supply to the city it is necessary: ​​by a specialized drilling team... ... Dictionary of terms of normative and technical documentation

Instructions for organizing the preparation and carrying out work to restore the city's water supply and sewerage system during a special period - Terminology Instructions for organizing the preparation and carrying out work to restore the city's water supply and sewerage system during a special period: 39. Restoration of coastal wells. During restoration work on coastal wells... ... Dictionary-reference book of terms of normative and technical documentation

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Ventricular extrasystole: causes, signs, treatment

Ventricular extrasystoles (VES) are extraordinary contractions of the heart that occur under the influence of premature impulses that originate from the intraventricular conduction system.

Under the influence of an impulse generated in the trunk of the His bundle, its branches, branches of the legs or Purkinje fibers, the myocardium of one of the ventricles contracts, and then the second ventricle without previous contraction of the atria. This explains the main electrocardiographic signs of PVCs: premature dilated and deformed ventricular complex and the absence of a normal P wave preceding it, indicating atrial contraction.

In this article, we will consider the causes of ventricular extrasystole, its symptoms and signs, and talk about the principles of diagnosis and treatment of this pathology.

Causes

Ventricular extrasystole can be observed in healthy people, especially with 24-hour electrocardiogram monitoring (Holter-ECG). Functional PVCs are more common in people under 50 years of age. It can be triggered by physical or emotional fatigue, stress, hypothermia or overheating, acute infectious diseases, taking stimulants (caffeine, alcohol, tannin, nicotine) or certain medications.

Functional PVCs are often detected when the activity of the vagus nerve increases. In this case, they are accompanied by a rare pulse, increased salivation, cold wet extremities, and arterial hypotension.

Functional PVCs do not have a pathological course. When the provoking factors are eliminated, they most often go away on their own.

In other cases, ventricular extrasystole is caused by organic heart disease. For its occurrence, even against the background of heart disease, additional exposure to toxic, mechanical or autonomic factors is often required.

Often PVCs accompany chronic ischemic heart disease (angina pectoris). With daily ECG monitoring, they occur in almost 100% of such patients. Arterial hypertension, heart defects, myocarditis, heart failure and myocardial infarction are also often accompanied by ventricular extrasystole.

This symptom is observed in patients with chronic lung diseases, alcoholic cardiomyopathy, and rheumatism. Extrasystole of reflex origin occurs, associated with diseases of the abdominal organs: cholecystitis, gastric and duodenal ulcers, pancreatitis, colitis.

Another common cause of ventricular extrasystole is a metabolic disorder in the myocardium, especially associated with the loss of potassium by cells. These diseases include pheochromocytoma (a hormone-producing tumor of the adrenal gland) and hyperthyroidism. PVCs can occur in the third trimester of pregnancy.

Drugs that can cause ventricular arrhythmias include primarily cardiac glycosides. They also occur when using sympathomimetics, tricyclic antidepressants, quinidine, and anesthetics.

Most often, PVCs are recorded in patients who have serious changes on the ECG at rest: signs of left ventricular hypertrophy, myocardial ischemia, rhythm and conduction disturbances. The frequency of this symptom increases with age and is more common in men.

Clinical signs

With a certain degree of convention, we can talk about different symptoms for functional and “organic” PVCs. Extrasystoles in the absence of severe heart disease are usually single, but are poorly tolerated by patients. They may be accompanied by a feeling of freezing, interruptions in heart function, and isolated strong beats in the chest. These extrasystoles often appear at rest, in a lying position, or during emotional stress. Physical tension or even a simple transition from a horizontal to a vertical position leads to their disappearance. They often occur against a background of a slow pulse (bradycardia).

Organic PVCs are often multiple, but patients usually do not notice them. They appear during physical activity and go away with rest, in a lying position. In many cases, such PVCs are accompanied by rapid heartbeat (tachycardia).

Diagnostics

The main methods of instrumental diagnosis of ventricular extrasystole are ECG at rest and 24-hour Holter ECG monitoring.

Signs of PVC on ECG:

• premature dilated and deformed ventricular complex;
• discordance (multidirectionality) of the ST segment and T wave of the extrasystole and the main wave of the QRS complex;
• absence of a P wave in front of the VES;
• the presence of a complete compensatory pause (not always).

Interpolated PVCs are distinguished, in which the extrasystolic complex is inserted, as it were, between two normal contractions without a compensatory pause.

If PVCs come from the same pathological focus and have the same shape, they are called monomorphic. Polymorphic PVCs emanating from different ectopic foci have different shapes and different coupling intervals (the distance from the previous contraction to the R wave of the extrasystole). Polymorphic PVCs are associated with severe cardiac damage and a more serious prognosis.

Early PVCs (“R to T”) are classified into a separate group. The criterion for prematurity is the shortening of the interval between the end of the T wave of sinus contraction and the beginning of the extrasystole complex. There are also late PVCs that occur at the end of diastole, which may be preceded by a normal sinus P wave, superimposed on the beginning of the extrasystolic complex.

VES can be single, paired or group. Quite often they form episodes of allorhythmia: bigeminy, trigeminy, quadrigeminy. With bigeminy, a VES is recorded through every normal sinus complex; with trigeminy, a VES is recorded every third complex, and so on.

During daily ECG monitoring, the number and morphology of extrasystoles, their distribution during the day, and dependence on load, sleep, and medication are specified. This important information helps determine the prognosis, clarify the diagnosis and prescribe treatment.

The most dangerous in terms of prognosis are considered to be frequent, polymorphic and polytopic, paired and group VES, as well as early extrasystoles.

The differential diagnosis of ventricular extrasystoles is carried out with supraventricular extrasystoles, complete block of the bundle branches, and escaped ventricular contractions.

If ventricular extrasystole is detected, the patient should be examined by a cardiologist. Additionally, general and biochemical blood tests, an electrocardiographic test with dosed physical activity, and echocardiography may be prescribed.

Treatment

Treatment of ventricular extrasystole depends on its causes. For functional PVCs, it is recommended to normalize the daily routine, reduce the use of stimulants, and reduce emotional stress. A diet enriched with potassium or drugs containing this microelement (Panangin) is prescribed.

For rare extrasystoles, special antiarrhythmic treatment is not prescribed. Herbal sedatives (valerian, motherwort) are prescribed in combination with beta-blockers. In case of JS against the background of vagotonia, sympathomimetics and anticholinergic drugs, for example, Bellataminal, are effective.

If the extrasystoles are organic, treatment depends on the number of extrasystoles. If there are few of them, ethmosin, etacizin or allapinin can be used. The use of these drugs is limited due to the possibility of their arrhythmogenic effects.

If extrasystole occurs in the acute period of myocardial infarction, it can be stopped with lidocaine or trimecaine.

Cordarone (amiodarone) is currently considered the main drug for suppressing ventricular extrasystole. It is prescribed according to a scheme with a gradual reduction in dosage. When treating with cordarone, it is necessary to periodically monitor the function of the liver, thyroid gland, external respiration and the level of electrolytes in the blood, as well as undergo an examination by an ophthalmologist.

In some cases, persistent ventricular premature beats from a known ectopic lesion are well treated with radiofrequency ablation surgery. During such an intervention, cells that produce pathological impulses are destroyed.

The presence of ventricular extrasystole, especially its severe forms, worsens the prognosis in people with organic heart disease. On the other hand, functional PVCs most often do not affect the quality of life and prognosis of patients.

Video course “Everyone can do an ECG”, lesson 4 - “Heart rhythm disturbances: sinus arrhythmias, extrasystole” (VES - from 20:14)

Prognosis and treatment of ventricular extrasystoles

If ventricular extrasystoles (VES) occur due to anxiety, stress, alcohol or caffeine intake (cola drinks, coffee, tea, nasal drops), they may disappear after eliminating the provoking factors and calming the patient. Antiarrhythmic treatment should be prescribed only in cases where the patient does not tolerate the symptoms of PVCs, but special attention is required to the safety of therapy. If treatment is necessary, beta blockers should be tried in all cases where there are no contraindications.

If continuous 24-hour ECG recording reveals a positive correlation between heart rate and the occurrence of PVCs, this indicates a high likelihood of a beneficial effect (3-blockers. However, this study is not specific enough to refuse to try to treat those patients with these drugs , in which such a correlation is not found. The next in descending order of preference would be mexiletine and disopyramide, quinidine, procainamide and amiodarone are very toxic with long-term use and are usually unsuitable for use. Class 1c drugs (flecainide, encainide) are very effective in suppressing PVCs, but have been shown to worsen the survival of post-MI patients in whom PVCs are usually asymptomatic. The role of these drugs in the treatment of patients with symptomatic PVCs is currently being tested.

There is no convincing evidence that PVCs (of any frequency) in patients without heart disease can have prognostic value. However, VES are prognostically significant if they complicate aortic valve stenosis, heart failure, or the course of the post-infarction period. The prognostic value of PVCs depends on their frequency, and in the post-infarction period, more than 10/hour is taken as the threshold value; It is likely that a similar threshold could be adopted for other situations. Despite this, no positive results were found in suppressing the VVCs. Among post-MI patients receiving antiarrhythmic drugs, mortality was usually higher than in the group of patients taking placebo (especially for class 1c drugs - encainide and flecainide).

In post-infarction patients at high risk (judging by the high frequency of PVCs), a change in prognosis can be achieved not by prescribing class I antiarrhythmic drugs, but by using beta blockers or operations that restore coronary blood flow (angioplasty, coronary bypass surgery, etc.).

Some types of PVCs developing in the acute stage of MI were considered as precursors of VF. However, PVCs of the R-on-T type, observed almost exclusively in the first 6 hours of MI, are a temporary phenomenon, and neither by mechanism nor prognostically are they related to VF. Therefore, there is no basis for selective treatment of PVCs in the early stage of MI.

“Prognosis and treatment of ventricular extrasystoles” - article from the Cardiology section

What is the rate of VES per day?

07/13/2016, Maria, 42 years old

Medicines taken: sometimes I take Concor 2.5 mg 1/4 tablet

Conclusion of ECG, ultrasound, other studies:

ECG, ECHO - normal, no abnormalities.

Holter - registered: single VES per day, NGES - 3, paired VES - 1. VES grade 4a according to Ryan.

Heart rate during the day: min. 58, max. 146, avg. 86

Heart rate in the evening: min. 57,max. 103, average 71

Complaints: Constant feeling that the heart is not working properly, extrasystole.

What is the rate of VES per day? Is it necessary to prescribe antiarrhythmic drugs? How life-threatening is VES?

The doctor prescribed Sotahexal 80 mg per day, should I take it? What could be the causes of PVCs in a healthy heart?

More articles on this topic:

1 Comment

Hello. Extrasystole is premature contractions of the heart. This type of arrhythmia is the most common. Approximately 70% of people normally experience extrasystoles during the day. There are two types of extrasystoles - functional and organic in origin. Functional - of neurogenic origin (stress, anxiety, smoking, drinking coffee and alcohol), they do not pose any threat to health. Just these extrasystoles occur with a healthy heart. Extrasystoles of organic origin occur in various myocardial diseases (myocarditis, myocardial infarction, etc.), while in addition to extrasystoles, the patient is bothered by other symptoms (heart failure develops). As a rule, when determining the origin of extrasystoles, data from ultrasound of the heart and 24-hour ECG monitoring (time and conditions for the occurrence of extrasystoles) are used. The number of extrasystoles per day should normally not exceed 1,000. If there are more of them, then they resort to prescribing medications. If there are less than 1,000 of them, but the patient notes a significant limitation of normal life activity (pronounced interruptions in the functioning of the heart), then a drug may also be prescribed. Based on the Holter monitoring data, the number of extrasystoles you have does not exceed the norm, but taking into account your complaints, the doctor prescribed you Sotahexal. Stay healthy.

HELLO. PLEASE TELL ME. DO I NEED TO DO AN OPERATION (CAUSTERATION) THE CARDIOLOGIST SAID. WHAT YOU NEED.

I AM VERY STRONGLY TORIED BY ARRHYTHMIA, WHICH SIMPLY DOESN'T ALLOW ME TO SLEEP AND LIVE NORMALLY.

SINUS RHYTHM WITH A TENDENCY TO BRADYCARDIA WAS RECORDED. SINOSAL ARRHYTHMIA AVERAGE HEART RATE 54 IN 1 MINUTE (DURING SLEEP), MAXIMUM HEART RATE 118 IN 1 MINUTE (WALKING)

ECTOPIC ACTIVITY 1198 MORPHORIC PVCs, EPISODES OF BIGEMIA, 4212 SINGLE SUPRAVENTRICULAR EXTRASYSTOLES,

1546 PAIRS, 78 NVT JUNGES (3-5 COMPLEXES)

I REALLY LOOK FORWARD TO YOUR ANSWER. THANK YOU.

If extrasystoles interfere with your life, then the RFA (“cauterization”) option is quite reasonable; the number of extrasystoles is quite large, which increases the success of the procedure.

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The latest dictionary of Russian abbreviations. AND

Let us remember again that we all speak Russian poorly...

Dal V.I. Explanatory dictionary of the living Great Russian language

VA – ventricular arrhythmia (med.)

ZHAKT – housing-rental cooperative partnership

ZhAT – railway automation and telemechanics

Reinforced concrete – reinforced concrete, reinforced concrete

Concrete products – reinforced concrete products

Reinforced concrete structures - reinforced concrete structures

ZhBR – journal of concrete works

ZHBU – living conditions

ZhVL - vital medicines

VEDs – vital medicines

VEDs – vitally important drugs

The vital organ is a vital organ

VVP - vital drugs

ZhVPR – reversible trailed roller header

ZhVS – vest for water sports

ZHS – housing and civil construction

ZhD – railway; railway

IDA – iron deficiency anemia (med.)

ZhDBr – railway brigade

Railway BTNB – Railway “Berkakit-Tommot-Nizhny Bestyakh”

ZhDV - railway troops

ZhIP (ZhDP) - Live long and prosper! (English) LLAP, “Live long and prosper!”) - a Vulcan gesture in the science fiction television series "Star Trek" ( Star Trek), a raised palm with the middle and ring fingers spread apart and the thumb extended

ZhDP – railway enterprise

ZhDT – railway transport

ZhDTOP – public railway transport

JSL – Sri Lanka Railways

ZhDYA – Railways of Yakutia (company name); Pearl heritage of Yakutia (name of the ensemble)

Vital capacity – vital capacity of the lungs (med.)

LiveJournal (LJ) LiveJournal, abbr. L.J.)

ZhZI – Life of wonderful ideas

ZhZL – Life of remarkable people (book series)

ZhIP – housing and property law

LCD – liquid crystal; residential complex; housing complex; Housing Code

GSD – cholelithiasis (med.)

LCD – liquid crystal display

Gastrointestinal infections - gastrointestinal infections

Gastrointestinal bleeding (gastrointestinal bleeding)

LCS – liquid municipal waste

ZHKP – railway registration code

Housing and communal services - housing and communal services; housing and communal services

Gastrointestinal tract - gastrointestinal tract (med.)

Housing and communal services - housing and communal services

Housing and communal services - live as you want (joking); housing and communal services

ZHMB - the abdomen is soft, painless (med.)

ZHMNO – Journal of the Ministry of Public Education

ZHMNP – Journal of the Ministry of Public Education

WNBA - Women's National Basketball Association

Vital and Essential Drugs – vital and essential medicines

Vital and Essential Drugs – vital and important drugs

Vital and Essential Drugs – vital and essential medicines

ZhNK - housing savings cooperative

ZhOV - housing provision for military personnel

ZHOZ – residential and public buildings

JORKH - “Journal of Organic Chemistry” (name of the journal)

Residential premises - residential premises

ZhPNPG - residential premises unsuitable for habitation of citizens

FGM – female genital organs (medical)

ZhPPPG - residential premises suitable for citizens to live in

LRE – liquid rocket (jet) engine

ZhREO – housing repair and operational association; housing repair and maintenance association

ZhSK – housing construction cooperative

YSS – iron binding capacity of serum (honey)

ZHSTL – life strategy of a creative personality

ZhT – railway transport; ventricular tachycardia (med.)

ZhTK – Railway Trading Company; railway transport corridor

ZhTF – Journal of Technical Physics

ZhF – housing stock

ZhFSI – housing fund for social use

ZHV - Black Lives Matter (social movement in the USA)

Housing office - housing maintenance office

ZhES – railway power station; ventricular extrasystole (med.); housing maintenance service

Housing Department - Housing Operations Department; housing maintenance department; housing maintenance area

Frequent ventricular extrasystole: causes and treatment of the disease

One of the most common heart rhythm disturbances (HRA) is extrasystole, i.e. extraordinary (“intercalated”) contraction of the ventricular myocardium. According to statistics, more than 40% of people over the age of 40 suffer from such cardiac pathology. In addition, during instrumental studies of the heart and ECG registration, ventricular extrasystole is detected in healthy individuals under 30 years of age in 10-15% of cases and is considered a variant of the physiological norm.

What is ventricular extrasystole

The phenomenon of ventricular extrasystole (VES) is an extraordinary single contraction of the myocardium that occurs under the influence of premature electrical impulses that emanate from the wall of the chambers of the right or left ventricle, as well as the nerve fibers of the conduction system of the heart (bundle of His, Purkinje fibers). As a rule, extrasystoles that occur during PVCs negatively affect only the ventricular rhythm, without disrupting the functioning of the upper parts of the heart.

Classification

The standard Lown classification was created based on the results of daily Holter ECG monitoring. It distinguishes 6 classes of ventricular extrasystole:

1. 0 class. On the ECG there is no frequent ventricular extrasystole, the patient does not experience any changes in heart function or morphological changes.
2. 1st grade. During one hour of observation, less than single monomorphic (monotopic, identical) ventricular pathological contractions were recorded.
3. 2nd grade. During the hour of the study, more than 30 single monomorphic or paired extrasystoles were recorded.
4. 3rd grade. During the first 15 minutes, at least 10 paired, polymorphic (polytopic, heterogeneous) extrasystoles are recorded. Often this class is combined with atrial fibrillation.
5. 4a grade. Over the course of an hour, monomorphic paired ventricular extrasystoles were recorded;
6. 4b grade. During the entire duration of the study, polymorphic paired ventricular extraordinary contractions are recorded.
7. 5th grade. Group or salvo (3-5 in a row for minutes) polymorphic contractions were recorded.

Frequent ventricular extrasystole of class 1 does not manifest itself symptomatically and is not accompanied by serious pathological changes in hemodynamics, therefore it is considered a variant of the physiological (functional) norm. Extraordinary contractions of classes 2-5 are combined with a high risk of developing atrial fibrillation, sudden cardiac arrest and death. According to the clinical classification of ventricular arrhythmias (according to Mayerburg), there are:

1. Extrasystoles of a benign, functional course. They are characterized by the absence of clear clinical symptoms of organic myocardial pathology and any objective signs of left ventricular dysfunction. The function of the ventricular node is preserved and the risk of cardiac arrest is minimal.
2. Ventricular arrhythmias have a potentially malignant course. They are characterized by the presence of extraordinary contractions against the background of morphological lesions of the heart muscle, a decrease in cardiac output by 20-30%. They are accompanied by a high risk of sudden cardiac arrest and are characterized by a gradation towards a malignant course.
3. Arrhythmias of malignant course. Characterized by the presence of ventricular extraordinary contractions against the background of severe organic myocardial damage, they are accompanied by a maximum risk of sudden cardiac arrest.

Reasons for ventricular extrasystole

The appearance of extraordinary contractions of the ventricles is caused by organic pathologies of the myocardium and the use of medications. In addition, extrasystole is a frequent complication of other systemic lesions: endocrine diseases, malignant tumors. Some of the most common causes of PVCs are:

• ischemic disease;
• cardiosclerosis;
• myocardial infarction;
• myocarditis;
• arterial hypertension;
• pulmonary heart;
• chronic heart failure;
• mitral valve prolapse;
• uncontrolled use of M-anticholinergics, sympathomimetics, diuretics, cardiac glycosides, etc.

Functional or idiopathic ventricular arrhythmia is associated with smoking, stress, and consumption of large quantities of caffeinated drinks and alcohol, which lead to increased activity of the autonomic nervous system. Extrasystole often occurs in patients who suffer from cervical osteochondrosis.

Symptoms of frequent ventricular extrasystole

Single premature myocardial contractions are recorded in many healthy young people during monitoring of heart function throughout the day (Holter ECG monitoring). They do not have a negative impact on well-being; a person does not notice their presence in any way. Symptoms of extraordinary contractions appear when hemodynamics are disrupted due to extrasystoles.

Ventricular arrhythmia without morphological lesions of the myocardium is difficult for the patient to tolerate; attacks of suffocation and panic occur. This condition usually develops against the background of bradycardia and is characterized by the following clinical manifestations:

• sensation of sudden cardiac arrest;
• isolated strong beats in the chest;
• worsening after eating;
• disruption of heart function in the morning after waking up, an emotional outburst or during physical activity.

Extraordinary contractions of the ventricular myocardium against the background of morphological disorders of the heart, as a rule, are multiple (polymorphic) in nature, but for the patient they often occur without clinical manifestations. Symptoms develop with significant physical activity and disappear in a lying or sitting position. This type of right or left ventricular arrhythmia develops against the background of tachycardia and is characterized by:

• suffocation;
• feeling of panic, fear;
• dizziness;
• darkening of the eyes;
• loss of consciousness.

Diagnostics

The main method for diagnosing frequent ventricular extrasystole is recording an electrocardiogram at rest and a 24-hour Holter monitor. A daily study of the ECG helps to determine the number and morphology of pathological contractions, how they are distributed throughout the day, depending on various factors and conditions of the body (period of sleep, wakefulness, use of drugs). In addition, if necessary, the patient is additionally prescribed:

• electrophysiological study of the myocardium by stimulating the heart muscle with electrical impulses while simultaneously observing the result on an ECG;
• echocardiography or ultrasound (ultrasound) - determination of the morphological cause of arrhythmia, which is usually associated with hemodynamic disturbances;
• laboratory tests to determine fast phase protein, electrolytes, levels of hormones of the pituitary gland, adrenal glands and thyroid gland, the amount of globulins.

Ventricular extrasystole on ECG

The main methods for diagnosing heart rhythm disturbances are electrocardiography and Holter monitoring of myocardial function (impulses of the conduction system). Ventricular extrasystole, when deciphering the studies performed, is manifested by the following signs:

• expansion of the QRS complex;
• absence of P wave;
• extraordinary premature appearance of an altered QRS complex;
• complete compensatory pause after a pathological QRS complex;
• T wave deformation (rare);
• ST segment expansion.

Treatment of ventricular extrasystole

In order to achieve the desired effect in the treatment of extrasystole, it is necessary to prescribe a set of therapeutic measures:

• Prohibition on the consumption of alcoholic beverages, strong tea, coffee, and smoking.
• Recommendations to adhere to the basic principles of proper nutrition and increase the proportion of foods with a large amount of potassium in the diet (potatoes, seafood, beef, etc.) and other necessary microelements for normal heart function.
• Refusal of heavy physical activity.
• If the patient often experiences stress and insomnia, it is recommended to use light soothing herbal preparations (motherwort, lemon balm, peony tincture) or sedatives (valerian tincture).
• If indicated, the patient is referred for surgical treatment.
• Antiarrhythmic drugs are prescribed.
• It is recommended to use medications that support heart function and vitamin and mineral complexes.

Drug therapy

The drug treatment regimen is prescribed individually and depends entirely on the type of pathology and cause, the frequency of arrhythmias, and the presence of other concomitant systemic chronic diseases. Antiarrhythmic drugs that are used for pharmacological therapy of PVCs are divided into the following categories:

• blockers of sodium, calcium and potassium channels (Novocainamide);
• beta-blockers (Concor-Cor);
• antihypertensive drugs (Anaprilin);
• thrombolytics (Aspirin).

Standard pharmacological therapy includes the use of the following pharmacological drugs:

1. Cordinorm. A drug based on the substance bisoprolol, which has antiarrhythmic and hypotensive effects. Prescribed for the treatment of heart rhythm disorders. The advantage of the drug is its rapid action and versatility of use, but the disadvantage is the high likelihood of developing side effects.
2. Aspirin. Tablets containing acetylsalicylic acid. The medication improves blood supply to the myocardium and has a vasodilating effect. Aspirin is indicated for coronary heart disease and myocardial infarction. The advantage of the medicine is the versatility of its use, and the disadvantage is the frequent development of allergic reactions.
3. Novocainamide. A medicine whose active ingredient is procainamide. The drug significantly reduces the excitability of the heart muscle and suppresses pathological ectopic foci of excitation. Medication is prescribed for various cardiac arrhythmias. The advantage of the medicine is the rapid effect it produces, and the disadvantage is the need to accurately calculate the dosage to prevent the development of side effects.

A patient who has started drug treatment is recommended to have a control electrocardiogram after 2-3 months. If extraordinary cardiac contractions become rare or disappear, then the therapeutic course is gradually, under the supervision of a doctor, canceled. In cases where the result has not changed or improved slightly during treatment, the medications are continued without changes for several more months. In case of a malignant course of the disease, medications are taken by the patient for life.

Surgical intervention

The indication for surgical treatment of arrhythmia is the ineffectiveness of drug therapy. As a rule, this type of elimination of pathology is recommended for those patients who have organic heart damage in combination with impaired hemodynamics. The following types of surgical intervention exist:

• Radiofrequency ablation (RFA). During the procedure, the surgeon inserts a small catheter into the heart cavity through a large vessel and uses radio waves to cauterize problem areas of the myocardium. To make it easier to find the affected area, electrophysiological monitoring is used. The effectiveness of RFA, according to statistics, is 75-90%. The operation is contraindicated for elderly people (over 75 years old).
• Installation of a pacemaker. This device is a small box that contains electronics and a battery that lasts between 8 and 10 years. Electrodes extend from the pacemaker, which the doctor attaches to the ventricle or atrium during surgery. They send impulses that cause the heart muscle to contract. Such an electronic device helps the patient get rid of various rhythm disturbances and return to a full life. Among the disadvantages of installing a pacemaker is the need to replace it.

Folk remedies

Traditional medicine recipes are used to treat functional type extrasystole. If there are serious organic changes in the myocardium, you should consult a cardiologist, since some alternative methods of treatment have contraindications for use. Remember that the use of folk remedies will not replace full-fledged drug therapy or surgery. At home, you can prepare the following folk remedies for the treatment of arrhythmia:

1. A decoction of valerian root, calendula and cornflower. You need to take 1 tbsp. mix all the ingredients, add water and bring to a boil, then cool. Strain and take half a glass in the morning and evening throughout the day. Use this product with caution for people prone to allergies.
2. Horsetail infusion. Dry horsetail grass in the amount of 2 tbsp. it is necessary to brew with three glasses of boiling water and leave for 6 hours. Take the product 5-6 times a day, 1 tsp for a month. It is not recommended to use the infusion for patients who suffer from chronic renal failure.
3. Radish juice with honey. Raw radish must be grated and squeezed through cheesecloth. Add 1 tbsp to the resulting juice. honey Take 2 tsp. three times a day for a week.

Forecast and prevention of frequent ventricular extrasystole

The prognosis for the course of ventricular extrasystole depends on its form, the presence of morphological pathology of the heart tissue or hemodynamic disorders. Functional idiopathic and single extraordinary contractions of the myocardium do not pose a threat to the health or life of the patient. Extrasystole, which develops against the background of organic heart damage, in the absence of treatment, significantly increases the risk of developing organ failure, sudden death due to the development of tachycardia, atrial fibrillation and supraventricular arrhythmias, and fibrillation.

To prevent the development of frequent extraordinary contractions of the myocardium of the lower part of the heart, it is recommended to carry out the following measures:

1. If you have a genetic predisposition to heart disease, you should start seeing a cardiologist as early as possible.
2. Use medications with caution that affect heart rate and blood electrolyte composition (diuretics, glycosides).
3. If you have endocrine pathologies (diabetes mellitus, hyperfunction of the adrenal glands or thyroid gland), you should be examined for the development of cardiac pathologies.
4. Stop smoking and drinking alcohol.

Video

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

Classification of extrasystole

Any extrasystoles are characterized by many parameters, so the complete classification of extrasystoles includes more than 10 sections. In practice, only a few of them are used, which best reflect the course of the disease.

Types of extrasystole

1. By localization:

2. Time of appearance in diastole:

5. By frequency:

• Sporadic (random).
• Allorhythmic – systematic – bigeminy, trigeminy, etc.

6. On carrying out:

• Repeated impulse entry using the re-entry mechanism.
• Blockade of conduction.
• Supernormal conduction.

8. By number of sources:

Sometimes the so-called interpolated ventricular extrasystole occurs - it is characterized by the absence of a compensatory pause, that is, the period after the extrasystole when the heart restores its electrophysiological state.

The classification of extrasystole according to Lown and its modification according to Ryan gained great importance.

Classification of extrasystole according to Lown

The creation of the Lown classification of ventricular extrasystole is an important step in the history of arrhythmology. Using the classification in clinical practice, the doctor can adequately assess the severity of the disease in each patient. The fact is that PVC is a common pathology and occurs in more than 50% of people. In some of them, the disease has a benign course and does not threaten their health, but others suffer from a malignant form, and this requires treatment and constant monitoring of the patient. The main function of ventricular extrasystole, Lown classification, is to distinguish malignant from benign pathology.

Ventricular extrasystole gradation according to Laun includes five classes:

1. Monomorphic ventricular extrasystole with a frequency of less than 30 per hour.

2. Monomorphic PVC with a frequency of more than 30 per hour.

3. Polytopic ventricular extrasystole.

• Paired VES.
• 3 or more VES in a row – ventricular tachycardia.

5. VES type R on T. ES is assigned the fifth class when the R wave falls on the first 4/5 of the T wave.

Lown's classification of PVCs has been used by cardiologists, cardiac surgeons and doctors of other specialties for many years. Appeared in 1971 thanks to the work of B. Lown and M. Wolf, the classification, as it seemed then, would become a reliable support for doctors in the diagnosis and treatment of PVCs. And so it happened: until now, several decades later, doctors focus primarily on this classification and its modified version from M. Ryan. Since that time, researchers have not been able to create a more practical and informative gradation of VES.

However, attempts to introduce something new have been made repeatedly. For example, the already mentioned modification from M. Ryan, as well as the classification of extrasystoles by frequency and form from R. J. Myerburg.

Classification of extrasystole according to Ryan

The modification made changes to grades 4A, 4B and 5 of ventricular extrasystole according to Lown. The complete classification looks like this.

1. Ventricular extrasystole grade 1 according to Ryan – monotopic, rare – with a frequency of less than 30 per hour.

2. Ventricular extrasystole grade 2 according to Ryan – monotopic, frequent – ​​with a frequency of more than 30 per hour.

3. Ventricular extrasystole grade 3 according to Ryan – polytopic VES.

4. The fourth class is divided into two subclasses:

• Ventricular extrasystole grade 4a according to Ryan – monomorphic paired VVCs.
• Ventricular extrasystole grade 4b according to Ryan is a paired polytopic extrasystole.

5. Ventricular extrasystole grade 5 according to Ryan – ventricular tachycardia – three or more VVCs in a row.

Ventricular extrasystole - classification according to R. J. Myerburg

The Myerburg classification divides ventricular arrhythmias depending on the shape and frequency of PVCs.

Frequency division:

1. Rare - less than one ES per hour.
2. Infrequent - from one to nine ES per hour.
3. Moderate frequency - from 10 to 30 per hour.
4. Frequent ES - from 31 to 60 per hour.
5. Very frequent - more than 60 per hour.

Division by shape:

1. Single, monotopic.
2. Single, polytopic.
3. Double.
4. Ventricular tachycardia lasting less than 30 seconds.
5. Ventricular tachycardia lasting more than 30 seconds.
6. R. J. Meyerburg published his classification in 1984, 13 years later than B. Lown. It is also actively used, but significantly less than those described above.

Classification of extrasystole according to J. T. Bigger

The diagnosis of VES in itself does not say anything about the patient’s condition. Much more important is information about concomitant pathologies and organic changes in the heart. To assess the likelihood of complications, J. T. Bigger proposed his own version of the classification, on the basis of which one can draw a conclusion about the malignancy of the course.

In the J. T. Bigger classification, PVCs are assessed according to a number of criteria:

• clinical manifestations;
• VES frequency;
• the presence of a scar or signs of hypertrophy;
• the presence of persistent (lasting more than 30 seconds) or unstable (less than 30 seconds) tachycardia;
• left ventricular ejection fraction;
• structural changes in the heart;
• influence on hemodynamics.

A PVC with pronounced clinical manifestations (palpitations, fainting), the presence of scars, hypertrophy or other structural lesions, a significantly reduced left ventricular ejection fraction (less than 30%), a high frequency of PVC, the presence of persistent or non-sustained ventricular tachycardia, a minor or pronounced effect is considered malignant. on hemodynamics.

Potentially malignant PVC: mildly symptomatic, occurs against the background of scars, hypertrophy or other structural changes, is accompanied by a slightly reduced left ventricular ejection fraction (30-55%). The frequency of PVCs can be high or moderate, ventricular tachycardia is either unstable or absent, hemodynamics suffer slightly.

Benign PVC: not clinically manifested, there are no structural pathologies in the heart, the ejection fraction is preserved (more than 55%), the frequency of ES is low, ventricular tachycardia is not recorded, hemodynamics do not suffer.

The extrasystole criteria of the J. T. Bigger classification give an idea of ​​the risk of developing sudden death - the most dangerous complication of ventricular tachycardia. Thus, with a benign course, the risk of sudden death is considered very low, with a potentially malignant course - low or moderate, and the malignant course of VES is accompanied by a high risk of developing sudden death.

Sudden death refers to the transition of PVCs to ventricular tachycardia and then to atrial fibrillation. With the development of atrial fibrillation, a person goes into a state of clinical death. If resuscitation measures are not started within a few minutes (best defibrillation using an automatic defibrillator), clinical death will be replaced by biological death and it will become impossible to bring the person back to life.

Responsibilities of the housing office and housing and communal services department that you should know about

It is difficult to imagine that just a few decades ago, many homes did not have access to regular hot water, electricity and heating during the winter season. And failure to comply with sanitary standards due to ignorance or the inability to do this led to real epidemics.

And even now, having all the above-mentioned amenities, we don’t often think about how it all functions? How do such large flows of water, electricity, and natural gas find appropriate and regulated use?

Responsibilities of housing and communal services

Everything related to social infrastructure falls within the competence of housing and communal services. This sector of the economy regulates the full functioning of residential buildings and provides comfortable living conditions.

The voiced service and its divisions have long been known to many, because a similar hierarchy developed back in the days when Belarus was part of the Soviet Union. Now the entire range of services and responsibilities is concentrated within the Housing Repair and Maintenance Associations.

Separate activities are carried out by the Housing Maintenance Service or the Housing Maintenance Section (several housing and communal services units combined into one division), and their responsibility is the maintenance of the housing stock and the maintenance of courtyard areas, which includes landscaping and cleaning.

The functions of ZhREO, ZhES and, in general, housing and communal services imply:

• Ensuring uninterrupted supply of electricity and natural gas; supply of hot water and thermal energy; energy saving – control over electricity consumption.
• Sewage work - wastewater disposal, laying and repair of water pipes; ensuring uninterrupted supply of water, including hot water.
• Accounting for the consumption of utility resources and housing and communal services.
• Ventilation and centralized air conditioning.
• Control of elevator facilities.
• Maintenance of low-current networks: television and telephone communications;
• Regular waste removal: monitoring the condition of garbage chutes; sorting, processing and disposal of household waste.
• Installation of lightning rods and grounding.
• Monitoring the fire protection system for buildings and structures and fire safety (fire escape, alarm, fire extinguishing equipment).
• Monitoring the condition of building structures.
• Major repairs and modernization of buildings.
• Sanitary and epidemiological treatment of common areas (including deratization and disinfestation). Improvement of local areas

Exactly fifty-nine mandatory procedures are included in the list of maintaining engineering systems in working order and thirty-nine in the list of maintaining structural elements in good condition. They are performed at varying frequencies, most as needed. Such important ones as checking the technical condition of the heating system, sewerage system, electrical devices in public places, foundation and basement walls - twice a year. A complete list can be obtained by calling your local ZhREO.

Housing and utilities services

Responsibilities for maintaining residential buildings and courtyard areas in accordance with established sanitary and technical standards include: maintenance of multi-apartment buildings, timely removal of garbage and its safe disposal, maintaining the operation of the elevator.

It is necessary to consider in more detail the activities of housing services in apartment buildings. The mandatory list includes:

• Cleaning of the first three floors once a day.
• Comprehensive cleaning and disinfection of all floors twice a week.
• Work to maintain cleanliness in the basement and technical floor once a month.
• Cleaning windows in the entrance every six months.
• Emptying trash containers once a day;
• Wet cleaning of the garbage disposal chamber once a week;
• Cleaning the garbage loading system in the garbage chute twice a month;
• Disinfect the garbage disposal once a month.

There are a number of additional opportunities that can be used thanks to the activities of housing departments. They are carried out only on the basis of the voluntary consent of the customer, after the conclusion of the contract. Installation and further maintenance of intercoms and video surveillance; organization of concierge work; rental and replacement of special stain-resistant carpets; landscaping and subsequent maintenance of the courtyard area - all this falls under the definition of additional services. No one has the right to charge you for them without concluding an agreement.

Calling an electrician, plumbing work and other paid assistance from housing and communal services

The most important advantage of municipal services is their fixed price, accessible to everyone. The following are carried out on a paid basis:

• Work of plumbers (replacement of toilets, bathtubs, gaskets and faucets; installation of meters; cleaning of sewers).
• Repair of windows and doors, their replacement.
• Wallpapering walls; painting walls, windows and doors.
• Electrical installation work.

The full list is approved at various intervals, depending on the demand by the population. It usually contains about thirty-five positions. You can check with your local housing authority for more details.

Non-cash subsidy

You can compensate for the costs of paying for housing and communal services if they exceed twenty percent of the total income of a family or an individual citizen. For rural residents, this figure will be fifteen percent.

Homeowners or tenants of public housing space can receive a subsidy if consumption volumes do not exceed established standards.

This type of government assistance will be denied to owners of several residential premises or shares in other apartments, landlords and owners of apartments in which a private enterprise is registered.

To apply for a subsidy, you must contact the executive committees or village councils at your place of residence.

Where to complain about housing and communal services in Belarus

If you want to clarify the list of services and current tariffs, or seek help from utility services, keep in mind that there is a general contact center at the short number 115, where you can find out all the missing information and leave a complaint.

There is a charge for calls to this phone number. In the catalog of the information service blizko.by you can find a free contact number for your local administration. But what to do if your complaints or requests remain unanswered?

If you are dissatisfied with the services, you should contact the service provider directly. If you are not satisfied with the temperature of the heating batteries, contact the representative office of Minsk Heating Networks. If you are not satisfied with the quality of sewer water or its periodic absence, contact the Minskvodokanal employees. You can always contact the Minsk Housing and Communal Services directly so that your requirements are heard and fulfilled in a timely manner.

1. Independent parts of speech:

• nouns (see morphological norms of nouns);
• verbs:
• • participles;
  • participles;
• adjectives;
• numerals;
• pronouns;
• adverbs;

2. Functional parts of speech:

• prepositions;
• unions;
• particles;

3. Interjections.

The following do not fall into any of the classifications (according to the morphological system) of the Russian language:

• the words yes and no, if they act as an independent sentence.
• introductory words: so, by the way, total, as a separate sentence, as well as a number of other words.

Morphological analysis of a noun

• initial form in the nominative case, singular (with the exception of nouns used only in the plural: scissors, etc.);
• proper or common noun;
• animate or inanimate;
• gender (m,f, avg.);
• number (singular, plural);
• declination;
• case;
• syntactic role in a sentence.

Plan for morphological analysis of a noun

"The baby drinks milk."

Baby (answers the question who?) – noun;

• initial form - baby;
• constant morphological features: animate, common noun, concrete, masculine, 1st declension;
• inconsistent morphological features: nominative case, singular;
• when parsing a sentence, it plays the role of subject.

Morphological analysis of the word “milk” (answers the question of whom? What?).

• initial form – milk;
• constant morphological characteristics of the word: neuter, inanimate, real, common noun, II declension;
• variable morphological features: accusative case, singular;
• direct object in the sentence.

Here is another example of how to make a morphological analysis of a noun, based on a literary source:

"Two ladies ran up to Luzhin and helped him get up. He began to knock the dust off his coat with his palm. (example from: “Luzhin’s Defense”, Vladimir Nabokov)."

Ladies (who?) - noun;

• initial form - queen;
• constant morphological features: common noun, animate, concrete, feminine, first declension;
• fickle morphological characteristics of the noun: singular, genitive case;
• syntactic role: part of the subject.

Luzhin (to whom?) - noun;

• initial form - Luzhin;
• faithful morphological characteristics of the word: proper name, animate, concrete, masculine, mixed declension;
• inconsistent morphological features of the noun: singular, dative case;

Palm (with what?) - noun;

• initial shape - palm;
• constant morphological features: feminine, inanimate, common noun, concrete, I declension;
• inconsistent morpho. signs: singular, instrumental case;
• syntactic role in context: addition.

Dust (what?) - noun;

• initial form - dust;
• main morphological features: common noun, material, feminine, singular, animate not characterized, III declension (noun with zero ending);
• fickle morphological characteristics of the word: accusative case;
• syntactic role: addition.

(c) Coat (Why?) - noun;

• the initial form is a coat;
• constant correct morphological characteristics of the word: inanimate, common noun, specific, neuter, indeclinable;
• morphological features are inconsistent: the number cannot be determined from the context, genitive case;
• syntactic role as a member of a sentence: addition.

Morphological analysis of the adjective

An adjective is a significant part of speech. Answers the questions Which? Which? Which? Which? and characterizes the characteristics or qualities of an object. Table of morphological features of the adjective name:

• initial form in the nominative case, singular, masculine;
• constant morphological features of adjectives:
• • rank according to the value:
  • • - quality (warm, silent);
    • - relative (yesterday, reading);
    • - possessive (hare, mother);
  • degree of comparison (for quality ones, for which this feature is constant);
  • full/short form (for quality ones, for which this sign is constant);
• inconsistent morphological features of the adjective:
• • qualitative adjectives vary according to the degree of comparison (in comparative degrees the simple form, in superlative degrees - complex): beautiful - more beautiful - the most beautiful;
  • full or short form (qualitative adjectives only);
  • gender marker (singular only);
  • number (agrees with the noun);
  • case (agrees with the noun);
• syntactic role in a sentence: an adjective can be a definition or part of a compound nominal predicate.

Plan for morphological analysis of the adjective

Example sentence:

The full moon rose over the city.

Full (what?) – adjective;

• initial form – full;
• constant morphological features of an adjective: qualitative, full form;
• inconsistent morphological characteristics: in a positive (zero) degree of comparison, feminine (consistent with the noun), nominative case;
• according to syntactic analysis - a minor member of the sentence, serves as a definition.

Here is another whole literary passage and morphological analysis of the adjective, using examples:

The girl was beautiful: slender, thin, blue eyes, like two amazing sapphires, looking into your soul.

Beautiful (what?) - adjective;

• initial form - beautiful (in this meaning);
• constant morphological norms: qualitative, brief;
• inconstant signs: positive degree of comparison, singular, feminine;

Slender (what?) - adjective;

• initial form - slender;
• constant morphological characteristics: qualitative, complete;
• inconsistent morphological characteristics of the word: full, positive degree of comparison, singular, feminine, nominative case;
• syntactic role in a sentence: part of the predicate.

Thin (what?) - adjective;

• initial form - thin;
• morphological constant characteristics: qualitative, complete;
• inconsistent morphological characteristics of the adjective: positive degree of comparison, singular, feminine, nominative case;
• syntactic role: part of the predicate.

Blue (what?) - adjective;

• initial form - blue;
• table of constant morphological features of the adjective name: qualitative;
• inconsistent morphological characteristics: full, positive degree of comparison, plural, nominative case;
• syntactic role: definition.

Amazing (what?) - adjective;

• initial form - amazing;
• constant characteristics of morphology: relative, expressive;
• inconsistent morphological features: plural, genitive case;
• syntactic role in a sentence: part of the circumstance.

Morphological features of the verb

According to the morphology of the Russian language, a verb is an independent part of speech. It can denote an action (to walk), a property (to limp), an attitude (to be equal), a state (to rejoice), a sign (to turn white, to show off) of an object. Verbs answer the question what to do? what to do? what does it do? what did you do? or what will it do? Different groups of verbal word forms have heterogeneous morphological characteristics and grammatical features.

Morphological forms of verbs:

• the initial form of the verb is the infinitive. It is also called the indefinite or unchangeable form of the verb. There are no variable morphological features;
• conjugated (personal and impersonal) forms;
• inconjugated forms: participles and participles.

Morphological analysis of the verb

• initial form - infinitive;
• constant morphological features of the verb:
• • transitivity:
  • • transitive (used with accusative case nouns without a preposition);
    • intransitive (not used with a noun in the accusative case without a preposition);
  • repayment:
  • • returnable (there is -sya, -sya);
    • irrevocable (no -sya, -sya);
  • • imperfect (what to do?);
    • perfect (what to do?);
  • conjugation:
  • • I conjugation (do-eat, do-eat, do-eat, do-eat, do-ut/ut);
    • II conjugation (sto-ish, sto-it, sto-im, sto-ite, sto-yat/at);
    • mixed verbs (want, run);
• inconsistent morphological features of the verb:
• • mood:
  • • indicative: what did you do? what did you do? what does it do? what will he do?;
    • conditional: what would you do? what would you do?;
    • imperative: do!;
  • time (in the indicative mood: past/present/future);
  • person (in the present/future tense, indicative and imperative: 1st person: I/we, 2nd person: you/you, 3rd person: he/they);
  • gender (past tense, singular, indicative and conditional);
  • number;
• syntactic role in a sentence. The infinitive can be any part of the sentence:
• • predicate: To be a holiday today;
  • subject: Learning is always useful;
  • addition: All the guests asked her to dance;
  • definition: He had an irresistible desire to eat;
  • circumstance: I went out for a walk.

Morphological analysis of verb example

To understand the scheme, let’s conduct a written analysis of the morphology of the verb using the example of a sentence:

God somehow sent a piece of cheese to the crow... (fable, I. Krylov)

Sent (what did you do?) - part of speech verb;

• initial form - send;
• constant morphological features: perfective aspect, transitional, 1st conjugation;
• inconsistent morphological characteristics of the verb: indicative mood, past tense, masculine, singular;

The following online example of morphological analysis of a verb in a sentence:

What silence, listen.

Listen (what do you do?) - verb;

• initial form - listen;
• morphological constant features: perfective aspect, intransitive, reflexive, 1st conjugation;
• inconsistent morphological characteristics of the word: imperative mood, plural, 2nd person;
• syntactic role in a sentence: predicate.

Plan for morphological analysis of verbs online for free, based on an example from a whole paragraph:

He needs to be warned.

No need, let him know next time how to break the rules.

What are the rules?

Wait, I'll tell you later. In! (“Golden Calf”, I. Ilf)

Caution (what to do?) - verb;

• initial form - warn;
• morphological features of the verb are constant: perfective, transitive, irrevocative, 1st conjugation;
• inconsistent morphology of part of speech: infinitive;
• syntactic function in a sentence: part of the predicate.

Let him know (what is he doing?) - verb part of speech;

• initial form - know;
• inconsistent verb morphology: imperative, singular, 3rd person;
• syntactic role in a sentence: predicate.

Violate (what to do?) - the word is a verb;

• initial form - violate;
• constant morphological features: imperfect form, irrevocable, transitional, 1st conjugation;
• inconstant features of the verb: infinitive (initial form);
• syntactic role in context: part of the predicate.

Wait (what will you do?) - part of speech verb;

• initial form - wait;
• constant morphological features: perfective aspect, irrevocable, transitional, 1st conjugation;
• inconsistent morphological characteristics of the verb: imperative mood, plural, 2nd person;
• syntactic role in a sentence: predicate.

Entered (what did you do?) - verb;

• initial form - enter;
• constant morphological features: perfective aspect, irreversible, intransitive, 1st conjugation;
• inconsistent morphological characteristics of the verb: past tense, indicative mood, singular, masculine;
• syntactic role in a sentence: predicate.

ZhES

fat emulsifying ability

Source: http://www.ncstu.ru/content/_docs/pdf/_conf/biotechnology2/2/93.pdf

ventricular extrasystole

honey.

Source: http://www.cardio-burg.ru/magazin/2001_1/2001_1s3.htm

ZhES

housing maintenance service

ZhES

railway power station

railway, technical, energy

Dictionary: S. Fadeev. Dictionary of abbreviations of the modern Russian language. - St. Petersburg: Politekhnika, 1997. - 527 p.

ZhES

ventricular ectopic contractions

cardiology

honey.

Source: http://www.medass.ru/news/con_2006/p382_388.doc

Dictionary of abbreviations and abbreviations. Academician 2015.

See what “ZhES” is in other dictionaries:

ZhES- railway power station... Dictionary of Russian abbreviations

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