Yak on the EKG shows myocardial infarction. Diagnostics in case of myocardial infarction: clinical and EKG signs, photo with deciphering

Myocardial infarction (necrosis of the tissue of the heart) can be severe, asymptomatic, as well as with swelling characteristic pains.

At a large number of people who become ill at any stage, there is a planned situation on the electrocardiograph before an hour.

Daniy is an addict, who is victorious in cardiology for accurate diagnostics over the course of a hundred years, building information about the stage of illness, its gravity, and also a quick way to get rid of the ear.

• All information on the site is aware of the nature and is NOT critical to the day!
• Provide an EXACT DIAGNOSIS you can only LIKAR!
• We ask you not to engage in self-abuse, but sign up before fakhivtsya!
• I wish you health and your loved ones!

describe the methodology

Electrocardiographer is a tse set, like a building restructuring of electric impulses. Human organi vipuskayut strumi duge low springs Therefore, for їх designation of the device for safety, we use it, as well as a galvanometer, which can be used to wipe it out.

Otrimanі danі nadhodhodya on a mechanic recording pristіy. On the day of the strumming, which will be embraced by a human heart, there will be a cardiogram, on the presentation of which a car can be given an accurate diagnosis.

The rhythm of the robot will be given a special fabric for the heart, as it is called the wire system of the heart. Vaughn is a special rank of innervated degeneration of the fiber, which sends commands about speed and weakness.

Gostria transmural myocardial infarction in the lower stage of the LS, acceleration of AV blockade of stage II type

The clientele of a healthy heart will receive electrical impulses from the wired system, they will speed up, and the electrocardiograph will reestablish weak strumms.

The apparatus captures the impulses that passed through the tissue of the heart. The health of the fiber may be due to the electrical conductivity, so as in the case of young adults, the parameter will change very quickly.

On the electrocardiogram, there are signs, information about what kind of work and information, and the stench itself is in its own information about the transfer of such a disease, like an infarction.

Basic EKG signs for myocardial infarction

Diagnostics is based on the number of electrical connections around the heart. The parameter of the infusion is not only the stanchion of meat fibers, but the electrolytic exchange in the body as a whole, which breaks down in case of some forms of gastritis or cholecystitis. At the sound of the cymbals are not irresistible, if EHC results put a grave diagnosis about the manifestation of an infarction.

See the chotiri of the infarction stages:

Gostriy transmural anterior-septal myocardial infarction with a possible transition to the top of the heart

In leathers from cich periods, the physical structure of the cell membranes of the meat tissue, as well as chemistry warehouse For this reason, the electrical potential also grows quite naturally. EKG decoding additional help precisely to start the stage of infarction of the same development.

The most frequent infarction is a strong livy slunker, that diagnostic value I can see the numbers of cardiograms, on which the Q, R and S waves are displayed, as well as the S - T interval and the T wave itself.

The teeth characterize the following processes:

The electrodes are fixed on the small dalyans of the tila, which show the projections of the singing dalyans of the heart meat. For the diagnosis of myocardial infarction, there may be significant indicators that are removed from six electrodes (input) V1 - V6, installed on the breasts of malice.

The development of myocardial infarction on the EKG is most often manifested by the onset signs:

• increase, change, visibility or adjustment of the R wave over the infarction zone;
• pathological S wave;
• Change directly to the T wave and change to the S - T interval from the isolation.

When a zone of necrosis is established, a ruinous cell of the heart is observed and the formation of a cell is the main electrolyte.

The electrical performance in the day of the day changes rapidly, so that the cardiogram is displayed from that introduction, as it is rooted in the middle over the necrotic design. About the size of the zone and those who introduce pathology are to speak about.

Large-scale infarction of myocardial infarction of the lower stage of LSh is developing

Indicators of prescription and periodicity

Diagnostics of a state of health infarction will take place in the first 3-7 days, if there is an active confirmation of zones and diseases, zones and diseases. At the end of the period, the electrocardiographer has a maximum battle zone, a part of it in the future will be reborn into necrosis, and a part will be renewed.

At the dermal stage of an infarction, there is a specific pattern of diagrams from the introduction, which are spread without a forehead over the infarction:

Velikovognischevny anterior-septal-upper-bichny myocardial infarction, acceleration by a complete blockade of the right lower left bundle of His, AU blockade of the first stage and sinus arrhythmia

Significant loss of blood circulation

It is possible to locate the area of ​​the heart muscle tissue, if you know how the body can be seen on the skin insertion. Roztashuvannya elektrodiv є standard, I will get a report to the end of my heart.

As a result of the fact that the introduction of the fiksun description is direct signs, it is possible to increase the risk of infarction:

Here it is pointed in the general community of the zone, so as an infarction can be found in the right slit, and in the back of the heart. When diagnosing it is even more important to take more information from the given information, so that the localization will be as accurate as possible. For the first time diagnostics of the guilt, it is confirmed by the data as a minimum of three entries.

breadth of the region

The breadth of the headquarters of the ear is determined by itself, like the first localization. Intellectually, the electrodes will "shoot" the heart in twelve straight strands, rewinding in the center.

how to continue right side Then you can add up to qih 12 in a straight line. For staging a diagnosis of myocardial infarction, it is necessary to overconfuse a minimum of three dzherel.

When the size of the display is made, it is necessary to respectfully vivify the data from the introduction, which are removed in the immediate proximity to the beginning of the necrosis. Around the top fabrics, there is the Ushkojen zone, and near it, the ischemia zone.

The skin of the regions has a characteristic EKG picture, which may indicate the size of the affected area. A spontaneous development of an infarction begins at the stage of congestion.

Transmural anterior-septal-superior myocardial infarction with the transition to the secondary wall of the LS

glybin to necrosis

Would you like to be healthy until you get rid of it? Do not start a necrosis of a vinikє for all products, more often than not for an internal diagnosis. calling parties, Inodі of stitching in the center.

On the EHC you can vpevneno signify the nature of the roasting. The teeth of S and T will change their shape and size in the fallowness because of the fact that the region is affected by it.

Cardiologists see advancing types of necrosis growth:

possible folding

EKG in case of myocardial infarction wants to be used as an effective diagnostic method, however, in case of myocardial infarction, it seems to be folding. For example, it is even easier to correctly diagnose people with an overworldly mass of tila, so how the rosette of the heart meat is changed for them.

If the electrolyte exchange in the body is damaged, or if the slurry and the chuck's micur are affected, it can also cause noise when the diagnosis is made.

Deyakі will become a heart, for example, the appearance of scars or aneurysms to reduce the new age of ice. Physiological features of the budget and the wiring system and also make it impossible to accurately diagnose infarctions in the middle partitions.

Hostrii velikovognischeviy myocardial infarction of the lower stage of the LS with the transition to the septum and the upper heart, the lower wall of the LS, acceleration of blinking tachyarrhythmia and blockade of the right lower bundle of the hys

type of pathology

Regardless of the size and growth of the display, the characteristic of the baby on the page of the cardiograph is indicated. Diagnostics is carried out on the 11-14th day, tobto at the stage of congestion.

gigantic

This type of ear is characterized by an offensive picture:

subendocardial

Yaksho pozhkojennya jerked fabrics internal side Then the picture of the ma such viglyad is diagnostic:

intramural

In case of infarctions, which are rosted in the shluno stinka and does not cut off the shell of the heart meat, the graph of the EKG offensive:

Electrocardiography (EKG) is a widely expanded method for diagnostics of heart-vascular ailments. In the course of the process of restructuring the growth of electrical potentials, which are found in the cells of the heart with this robot.

With myocardial infarction on the EKG, a number of characteristic signs For those, you can let the ear for an hour get sick, the size and localization of the battle. The knowledge allows you to quickly diagnose and start diagnosing.

Show all

Cardiogram in normі

The EKG shows a difference in potentials, as a result of a broken heart when the heart is broken. The restoration of the impulses should be carried out behind the aid of the electrodes installed on the other parts of the building. You can see the information, how you see it between yourself and the little ones, from which you can see it.

breast information

Name the cardiogram in 12 entries:

• I, II, III - standard bipolar views;
• aVR, aVL, aVF - the strength of the single-pole type;
• V1, V2, V3, V4, V5, V6 - number of unipolar pectorals.

In the case of certain situations, the introduction of additional information is V7, V8, V9. The projection of the positive skin electrode has a singing part of the heart's heart. For the change of the EKG, in whatever the introduction, it is possible to let it go, in which organ it is located in the fire of the ear.



EKG in normal, teeth, intervals and segments

When the heart meat (myocardium) is relaxed, a straight line is shown on the cardiogram - isoline. The passage of the damage is seen on the page at the view of the teeth, which fix the segments and the complex. It’s like the tooth of the rosette of the vysheizolinia, the win is positive, but the bottom is negative. The appearance between them is called an interval.

Prong R shows the process of speeding up the right and left atrium, the QRS complex restructuring the build-up and dissipation of damage in the slings. The RS-T segment and the T wave are showing, as opposed to myocardial weakening.



EKG for myocardial infarction

Myocardial infarction is a disease, when a bend (necrosis) of a part of the tissue of the heart is seen. The reason for this is that the blood flow in the vessels is damaged, and the myocardium is alive. The development of necrosis is changed by werewolves - ischemia and ischemic development. Signs that are in power to the countries can be fixed on the EKG on the cob of ailment.



Fragment of ECG with ST segment pidyoma, coronary T

With ischemia, the structure and shape of the T wave, the position of the RS-T segment, change on the cardiogram. The process of renewing the target potential in the cells of the shlunochkiv in the case of the deteriorated harvesting against the increase. At the junction of the cym, the T wave becomes large and wide. Yogo is called Coronary T. It is possible to restore the negative T in the breast insertions, in the fallowness of the glybin and in the loss of the heart.

Triviality of blood flow in the myocardium to produce up to the ischemic condition. At the EKG, it is possible to see the RS-T segment near the viewer, which is normally located on the Isolation. In case of growing localizations and cases of pathological process, it will either grow or descend.

Heart meat infarction develops in the scallions. If necrosis is overwhelmed by a large myocardium, talking about a large focal lesion. With the presence of an impossibility of other vognisch - about small focal. The loss of indications when deciphering by cardiograms will appear in the introductions, a positive electrode of a kind of retouching over the mice of the bend of the clitin. Mirror-reciprocating changes are often re-structured in other entries.



gigantic infarction

The bend of the myocardium does not speed up. In the cases fixed over the area of ​​necrosis, changes appear to the QRS complex - an increase in the Q wave and a decrease in the R wave.

Velikovognischeviy process can cover the entire myocardium of any part, which is due to epicardium or endocarditis. It is totally poshkojennya called transmural. The head is familiar with the QS complex and the visibility of the R wave.

In case of infarction, there are three pathological processes at once, which occur at once - ischemia, ischemic lesion and necrosis. In the course of the year, the infarction zone expands beyond the rakhunok bend klin, as they passed in the camp of the ischemic battle. When the blood flow is renewed, the ischemia area changes.

The changes registered on the EKG plyvtsi, lie down at an hour to develop an infarction. stages:

1. 1. Gostra - the period from many years to two days for a heart attack.
2. 2. Subacute - the period up to 1.5-2 months per ear of disease.
3. 3. Rubtsova - the stage, before the hour of what is the case m'yazova fabric to be replaced with a favorable one.



gostra stadiya



Zminy on EKG with infarction behind the stages

After 15-30 minutes of heart attack, a zone of subendocardial ischemia appears in the myocardium - a damaged blood supply of myazovykh fibers, which is associated with endocarditis. On the EKG there are high coronary T waves. Whenever there is a disease, it is rare to reestablish ailments, as a rule, patients do not go to waste for medical assistance.

After a few years, when it reaches the epicardium, the RS-T segment shrinks up the hill towards the isolation and gets angry at T, settling into a gently sloping curve. Distant in cases, developed endocarditis, is in evidence of necrosis, which quickly grows in size. Start to form pathological Q. In the world of enlargement of the zone and infarction, Q is lost and increased, RS-T goes down to isola, and the T wave becomes negative.

subacute stage

The delay in necrosis is stabilized, the delay in the ischemic ear changes for the loss of some cells and renewal of blood flow in them. On the cardiogram, there are signs of infarction and ischemia - pathological Q or QS, negative T. The step zone ischemia changes and the amplitude T decreases, it smoothes or becomes positive.

cicatricial stage

A good fabric, which replaced the bend of the meat, did not take part in the work. Electrode, which is located above the scar, fix the Q wave or the QS complex. Such a viewer of the EHC is able to hold out with a handful of rocky, for all the life of the sick. RS-T is on ізолінії, Т smoothing or weakly positive. Negative T waves are also often observed over the replaced area.

DRIBNOVOGNISCHEVYINFARKT



Signs of infarction in case of development of glybin of myocardium

Small stripes in the heart will not disrupt the process of stimulation. On the cardiogram, pathological Q and QS complexes will not appear.

In case of small-focal infarction, changes on the EKG plexus are accompanied by an increase in ischemic and ischemic changes in the myocardium. There is a decrease in the RS-T segment, or negative T waves in the insertions, when there is a hand with necrosis. Often there are two-phase T waves with a swinging negative component. With the bend of the myazovykh clitins, rostasvanih in the posterior end, there may be only reciprocal changes - coronary T in V1-V3. The introduction of V7-V9, on which the project is designed for the area, but not included in the standard of diagnostics.

Expansion of necrosis of the anterior part of the lavage louse is manifested in all insertions of the breasts, in I and aVL. Reciprocal changes - decrease in RS-T і high positive T, fixed in aVF і III.

The upper windows of the front and the other sides are located behind the boundaries of the restored entries. In general, the setting of the diagnosis is foldable, signs of illness appear in I and aVL or only in aVL.

Back to school

The posterior diaphragmatic, or infarction of the lower stage of the livochka, is diagnosed according to III, aVF and II indications. Reciprocal signs are possible in I, aVL, V1-V3.

Posterior-basal necrosis develops more and more. Ischemic changes are fixed when additional electrodes V7-V9 are applied from the side of the back. The admission about the infarction of the localization process can be caused by the presence of mirror manifestations in V1-V3 - a high T, an increase in the amplitude of the R wave.

The stripping of the rear-side part of the lug can be seen at the insertions V5, V6, II, III and aVF. In V1 -V3 reciprocal signs are possible. With an extended process, the worms receive III, aVF, II, V5, V6, V7 -V9.

Myocardial infarction on the EKG can be characterized by a number of characteristic signs, which add to the differentiation of this type of malformation of the heart meat. It is even more important to carry out the EKG-diagnostics in the first few years of the attack, to correct the data about the level of battle, the steps of the functional deficiency of the heart, the mobility of the localization of the headquarters. To that the cardiogram is aware of the power in the carriage of great help, and if such power is dumb, then immediately after the arrival of the patient to the stationary.

EKG signs of myocardial infarction

The electrocardiogram depicts the electrical activity of the heart - interpreting the data of such a previous experience can be interpreted complex views about the robot of the wire system of the heart, its health until it is fast, pathological problems of life, and so on.

First I will acquaint, on what a trace of beastly respect, є deformation of the QRST complex, zokrem, meaning a change in the R wave or more of its visibility.

A classic picture of the EKG is stored from decilkokh dalyanoks, as you can poke on a normal page. The skin from them is considered to be a process in the heart.

1. P wave- visualization of a fast frontal head. For its strength and form, one can judge about the front of the heart, about the good robots from the bottom of the heart.
2. Interval PQ- showing the widening of the impulse from the anterior to the shlunochki, from the sinus node down to the atrioventricular. The increase in the interval to indicate the deterioration of the performance.
3. QRST complex- a skewer complex, which I will give information about the camp of the most important chambers of hearts, skewers. Analysis and description of the whole part of the EHC the most important part of diagnostics of an infarction, the main data of which are involved.
4. ST segment- an important part, as in the norm є izoliniy (straight horizontal line on the main axis of the EKG, but not enough teeth), in case of pathologies of the general sinking and passing. Tse can be evidence of ischemia of the myocardium, i.e., Insufficient blood loss of the heart.

Whether there are changes in the cardiogram and the appearance of the norms of connection with pathological processes in the heart tissue. In case of infarction - with necrosis, that is, necrosis of the myocardial cells and then replacing them with the resulting tissue. If you are stronger and if your ears are bigger, if you have a wider zone of necrosis, then it will be less likely that there will be a change on the EKG.

First I will acquaint, on what a trace of beastly respect, є deformation of the QRST complex, zokrem, meaning a change in the R wave or more of its visibility. Tse witness about the destruction of shlunochk_v (electrophysical process, which leads to a fast heart).

Whether there are changes in the cardiogram and the appearance of the norms of connection with pathological processes in the heart tissue. In case of infarction - from the dead cells of the myocardium with a substitute for another tissue.

Longer changes to pick up the Q wave - winn’t become pathologically glitchy, so that we can tell about the broken robots in the rhythm - the universities of the special cells in the myocardium, which fix the fast mints.

Change in the ST segment - normally it is located on the isoline, or in case of an infarction, it may appear or descend lower. Such a vypadku to talk about the elevations and the depression of the segment, so I know the ischemia of the tissue of the heart. For this parameter, it is possible to determine the localization of the area of ​​the ischemic ear - the segment is seen in quiet areas of the heart, denecrosis of the most bends, and omissions in the opposite areas.

Also, in a dozen hour, especially closer to the stage of scarring, a negative, glibous tooth T appears. This tooth shows massive necrosis of the heart meat and allows the patient to get rid of the ear.

Photo of the EKG in case of myocardial infarction with a decryption allowing to see the description of the signs in detail.

The line can collapse from 50 to 25 mm per second, the diagnostic value is great, and the lower the speed from the short details. When staging a diagnosis of an infarction, it is not only changes in the I, II and III introductions, but also in the stronger ones. If the device allows you to record the breast information, then V1 and V2 will display information from the right views of the heart - the right little one and the front of the heart, as well as the top, V3 and V4 about the top of the V5 heart, a6

Nearer to the stage of scarring, a negative, glibous tooth of T is suppressed. This tooth shows massive necrosis of the heart meat and allows the patient to get rid of the ear.

Stages of myocardial infarction on the EKG

Infarction against in the few stages, and the skin period is designated by special changes on the EKG.

1. Ishemic stage (stage of training, naygostrish) tied with a rosette hostile lack circulation in the tissues of the heart. The stage is trivial, so it is not too long to rise up to the beginning of the construction on the lines of cardiograms; The T wave with a large increase, become stricken - it seems about a giant coronary T, which is a forerunner of an infarction. Then ST to move over the isolin, її the camp here is stiy, a little more can be done with the help. If the phase is trivial, it is even better and goes into a state of the art, it is possible to promote a change in the T wave, so that necrosis sometimes expands on the heart's big balls. You can reciprocate, lively snakes.
2. Gostra stadiya (necrosis stage) winy in 2-3 years, after the ear is attacked and trivial until decilkokh days. On the EKG, there are visible deformations, a wide QRS complex, which fixes a monophase curve, it is practically uncomfortable to see around the teeth. Chim glibshe on EKG prong Q, tim glibshі shari bully weakened ishemієyu. At this stage, it is possible to recognize a transmural infarction, a message about how it goes. Characteristic rhythm disturbance - arrhythmias, extrasystoles.
3. Distribution of ear of food stage possible by stabilization of the ST segment. If you turn to the isola, the infarction does not progress any more as the ischemia, the renewal process will be resumed. The most significant in the whole period is the increase in the number of sharp T-waves with cob. It can be either positive or negative, but it will not turn over to the isolin in sync with the firing process. Secondary loss of the T wave in the pre-building stage, indicate about firing near the zone of necrosis and triple, if correct drug therapy, not so good.
4. At the stage of scarring The R prong is known to grow to the power of their indicators, and T also to be on the isola. In total electrical activity the heart is weakened, and the part of the cardiomyocytes is bent and replaced with good cloth, Yaka is not good for performance and speed. Pathological Q, with its manifestation, normalizes. Tsya stage triva to decilkoh mіsyatsіv, іnodі pіvroku.

It is even more important to carry out the EKG-diagnostics in the first few years of the attack, to correct the data about the level of battle, the steps of the functional deficiency of the heart, the mobility of the localization of the headquarters.

Main types of infarction on the EKG

In clinics of infarction, it is classified as fallow in the size and localization of the head. The price is significant in lycuvanne and preventive maintenance.

Regularly from the size of the list of applications:

1. Velikovognischevy, or Q-infarction. This means that the blood circulation was going on in a great coronary vessel, and a great deal of tissue was knocked out. I am familiar with the head є wide і extensions of Q, and the R-wave is uncomfortable to poke. If the infarction is transmural, so that all the vertices of the heart, the ST segment is raised high above the insulin, during the period of the period, the glibous T.
2. Dribnovognischevy, not-Q-infarction. Ischemia has developed in the areas where the coronary arteries are endangered; With intramural infarction (when you do not go beyond the heart muscle), Q and R do not change, but a negative T wave is present. At the same time, the ST segment is located on the izoline. With subendocardial infarction (in the presence of the inner sheath), T is normal, and ST is in depression.

It is always a good idea to start the process of starting an infarction:

1. Anterior-septal Q-infarction- change in 1-4 breast insertions, every day R if there is a wide QS, ST elevation. In I and II standard - the classic pathological Q for this type.
2. Bichny Q-infarction- Identical changes are accepted for 4-6 breast information.
3. Posterior, or diaphragmatic Q-infarction, in the same lower- pathological Q і high T in II and III introductions, as well as in a stronger one in the right leg.
4. Infarction of the middle partitions- in I standard gliboky Q, elevation ST and high T. In 1 and 2 chest pathologically high R, also A-V blockade is characteristic.
5. Anterior NOT-Q-infarction- in I and 1-4 chest T, the spine of the spared R, and in II and III, there is a decrease in all teeth at the same time with ST depression.
6. Posterior NOT-Q-infarction- in standard II, III and chest 5-6 positive T, a decrease in R and ST depression.

Video

A video clip on the same statistic will be projected before you look at it.

І. Mogelvang, M.D. Cardiologist in the field of intensive therapy to the Hospital Khvidovre one thousand nine hundred and fifty times

Ischemic ailment of the heart (ІХС)

The main reason for ІХС is obstructive ear of the head coronary arteries and hylocs.

The prognosis for ІХС starts:

the number of significant stenotic coronary arteries

functional myocardium

The EKG will give information about the myocardial stump:

potential ischemic myocardium

ischemic myocardium

myocardial infarction gostry (IM)

transfers of myocardial infarction

localization IM

glybin IM

size ІМ

Information, which is important for treatment, control and forecasting.

Livy sklunochok

In case of ІХС, the myocardium of the louse of the louse should be deteriorated beforehand.

Lіviy slunohok can be divided into segments:

septal segment

apical segment

lateral segment

posterior segment

Lower segment

The first 3 segments become the anterior wall, and the last 3 - the posterior wall. The lateral segment, such a rank can be found in anterior infarction, as well as posterior infarction.

LIVING SEGMENT

Introduction of the EHC

The introduction of the EKG can be unipolar (old single points), in which the stench comes from the letter "V" (from the cob letters of the word "voltage").

Classical introduction of the EKG is bipolar (two points). The stench is recognized by Roman numerals: I, II, III.

A: stronger

V: unipolar introduction

R: right ( right hand)

L: lіve ( liva hand)

F: leg ( liva leg)

V1-V6: unipolar breast presentation

The introduction of the EKG appears in frontal and horizontal areas.

EKG introduction at the frontal area

Introduction of the EKG in the horizontal area

MIRROR IMAGE(For specific diagnostic values, which appear in the entries V1-V3, div. Dal)

Transverse overriding of the right and left slings & Segments of the left slings:

Delivery between the EKG and the segments of the lithium

Glibina i rosemary

YAKISNI ZMINI EKG

Кілкісні ЗМІНИ ЕКГ

LOCALIZATION INFARKTU: FRONT WALL

LOCALIZATION INFARKTU: BACK WALL

V1-V3; THE NIGHT DIFFICULTY

Infarction and blockade of the Gissen beam (BNP)

BNP is characterized by a wide QRS complex (0.12 sec).

The blockade of the Right Nizhka (BPN) and the Left Nizhka (BLN) can be developed by the introduction of V1.

BPN is characterized by a positive wide QRS complex, and BLN is characterized by a negative QRS complex in the introduction of V1.

Most often, the EKG does not carry information about the infarction in LBB on the day of the LBF.

EKG changes in case of myocardial infarction in an hour

Myocardial infarction and nima EKG

Myocardial infarction can develop without the appearance of any specific changes on the EKG in the form of LBN, or even in those cases.

EKG options for myocardial infarction:

subendocardial IM

transmural IM

without specific changes

EKG with adolescence for ischemic ailment of the heart

Specific signs of ischemic ailments of the heart:

Ischemia / Infarction?

In case of infarction:

Subendocardial / transmural?

Localization and development?

Differential diagnosis

EKG-DIAGNOSTIC KEY FOR ICHEMIC HEART DISEASE