EKG Testing

An electrocardiogram (EKG) measures your heart’s electrical activity. This noninvasive test can measure many aspects, from how fast the heart beats to how well its chambers conduct electrical energy.  An abnormal EKG can mean many things.

What can EKG detect?

An EKG can help physicians diagnose a real-time emergency, such as a heart attack in progress, but it can also help detect patterns that emerge over time.  For example, if you have high blood pressure, the EKG may show that your heart has become enlarged due to the extra work of pumping blood under higher pressure.

Overview – Electrocardiogram

An electrocardiogram records the electrical signals in your heart. It’s a common test used to detect heart problems and monitor the heart’s status in many situations.  Electrocardiograms — also called ECGs or EKGs— are often done in a doctor’s office, a clinic or a hospital room. And they’ve become standard equipment in operating rooms and ambulances.

An ECG is a noninvasive, painless test with quick results. During an ECG, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes your limbs. These sensors are usually left on for just a few minutes.

Your doctor may discuss your results with you the same day as your electrocardiogram or at your next appointment.

An electrocardiogram (EKG or ECG) is a painless, noninvasive way to help diagnose many common heart problems in people of all ages. Your doctor may use an electrocardiogram to detect:

• Irregularities in your heart rhythm (arrhythmias)
• If blocked or narrowed arteries in your heart (coronary artery disease) are causing chest pain or a heart attack
• Structural problems with your heart’s chambers
• A previous heart attack
• How well certain ongoing heart disease treatments, such as a pacemaker, are working

You may need a heart rhythm test if you experience any of the following signs and symptoms:

• Heart palpitations
• Rapid pulse
• Chest pain
• Shortness of breath
• Dizziness, lightheadedness or confusion
• Weakness, fatigue or a decline in ability to exercise

**  The American Heart Association doesn’t recommend using electrocardiograms to assess adults at low risk who don’t have symptoms. But if you have a family history of heart disease, your doctor may suggest an electrocardiogram as an early screening test, even if you have no symptoms.

Risks of an EKG

An electrocardiogram is a safe procedure. You’ll have no risk of getting an electrical shock during the test because the electrodes placed on your body don’t emit electricity. They only record the electrical activity of your heart.

You may have minor discomfort, similar to removing a bandage, when the electrodes are removed. Rarely, a reaction to the electrode adhesive may cause redness or swelling where the patches were placed.

A stress test may lead to irregular heart rhythms and, rarely, a heart attack. These effects are brought on by the exercise or medication, not the ECG itself.

A Holter monitor may cause some skin irritation if you don’t move the electrodes each day.

An implantable loop recorder has a slight risk of infection because it involves a minor surgical procedure. And some people may experience a reaction to the device that causes inflammation.

How you prepare:

No special preparations are necessary for a standard electrocardiogram. Do tell your doctor about any medications and supplements you’re taking because some can affect the results of your test.

What you can expect

During the ECG

An electrocardiogram can be done in a doctor’s office or hospital and is often performed by a technician. You may be asked to change into a hospital gown. Then you’ll lie on an examining table or bed.

Electrodes — typically 10 — will be attached to chest and sometimes to your limbs. The electrodes are sticky patches applied to help record the electrical activity of your heart. Each one has a wire attached to a monitor. If you have hair on the parts of your body where the electrodes will be placed, the technician may shave the hair so that the patches stick.

You can breathe normally during the electrocardiogram. Make sure you’re warm and ready to lie still. Moving, talking or shivering may distort the test results. A standard ECG takes a few minutes.

As you lie on the examination table or bed, the electrodes will record the impulses that make your heart beat. The impulses are recorded by a computer and displayed as waves on a monitor or printed on paper.

After the ECG

You can resume your normal activities after your electrocardiogram.

Your doctor will look at the waves recorded during your test to see if the impulses are traveling normally. He or she will be able to tell you the results of your ECG the same day it’s performed or at your next appointment.

If your electrocardiogram is normal, you may not need any other tests. If the results show an abnormality with your heart, you may need another ECG or other diagnostic tests, such as an echocardiogram. Treatment depends on what’s causing your signs and symptoms.

Results

Your doctor will look for a consistent, even heart rhythm and a heart rate between 50 and 100 beats a minute.  Having a faster, slower or irregular heartbeat provides clues about your heart health, including:

• Heart rate.  Normally, heart rate can be measured by checking your pulse. An ECG may be helpful if your pulse is difficult to feel or too fast or too irregular to count accurately. An ECG can help your doctor identify an unusually fast heart rate (tachycardia) or an unusually slow heart rate (bradycardia).
• Heart rhythm.  An ECG can show heart rhythm irregularities (arrhythmias). These conditions may occur when any part of the heart’s electrical system malfunctions. In other cases, medications, such as beta blockers, cocaine, amphetamines, and over-the-counter cold and allergy drugs, can trigger arrhythmias.
• Heart attack.  An ECG can show evidence of a previous heart attack or one that’s in progress. The patterns on the ECG may indicate which part of your heart has been damaged, as well as the extent of the damage.
• Inadequate blood and oxygen supply to the heart. An ECG done while you’re having symptoms can help your doctor determine whether chest pain is caused by reduced blood flow to the heart muscle, such as with the chest pain of unstable angina.
• Structural abnormalities.  An ECG can provide clues about enlargement of the chambers or walls of the heart, heart defects and other heart problems.

If your doctor finds any abnormalities on your ECG, he or she may order additional tests to see if treatment is necessary.