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One of the major diagnostic tools for heart disease is known as electrocardiogram (EKG). How can it be used to diagnose heart disease?

Thanks to the advances in medicine and technology, we are able to get a proper picture of what is going on inside our bodies. This has been especially beneficial for coronary heart disease, one of the most common causes of death in the world. Fortunately, even if you have coronary heart disease, there are ways to prevent getting a heart attack. However, the first challenge is getting diagnosed.

Thankfully, there are several different tests that can help diagnose coronary heart disease, one of which an electrocardiogram (EKG). If your family doctor or your cardiologist suspects that you have may have heart problems, then they can ask you to undergo an EKG. It may also be part of a routine physical that you take part in ever year.

What is an EKG?

An EKG is a test that detects the electrical rhythm of your heart, results of which can relay how well your heart is functioning. For an EKG, a technician or another medical professional will place small electrode patches to regions of your body, mainly your chest, arms and legs. These electrodes are sensors that will detect and record your heart’s rhythm and electrical activity every time your heart beats. These signals, which are recorded onto a machine, will then be looked at by a doctor to see if they are normal.

You probably won’t get your results right away as the recordings will have to be seen by a specialist (likely a cardiologist) to determine if there are any potential problems. If so, you will be asked to come back in and conduct other tests.

What can an EKG tell me about my heart condition?

There are several pieces of information that an EKG can communicate to you, including:

  • If your heart rhythm is normal or stable
  • How well your blood flows through the coronary arteries (the blood vessels that supply blood to the heart muscle)
  • If you have experienced or are experiencing a heart attack
  • If you heart has any other abnormalities, such as an enlarged heart

What conditions can the EKG help diagnose?

There are several diseases that are characterized by abnormal EKG readings. These include:

  • Coronary heart disease, in which the blood supply that goes to the heart is blocked due to a clot or a build of fat in the arteries.
  • Arrhythmias, which is a condition in which the heart rhythm is off. It either beats too quickly, too slowly or irregularly.
  • Heart attacks, which is when the artery that supplies the heart with oxygen-rich blood becomes blocked.
  • Cardiomyopathy, which is when the heart walls are thick or become too big.

So what actually happens during an EKG?

When you go in for an EKG, you first have make sure that you don’t put on any oily or greasy creams on your body as that can interfere with contact between the electrodes and skin. You should avoid wearing full-length hosiery, as the electrodes will be placed onto your legs. Finally, you should wear a shirt that can be easily taken off in order to put the electrodes on the chest.

During the EKG, the medical professional, usually a technician, will put 10 electrodes that have adhesive pads onto your skin. This will be on your chest, arms and legs. In some cases, men may have their chest hair shaved so the connection is better. Then, you will be asked to lay back flat while the computer records your electrical pulses onto graph paper. This is known as your resting EKG. You may be asked to do this when you exercise, which will be your stress test.

Usually, the whole test will only take approximately 10 minutes, which is the time it takes to attach the electrode and finish the test. The recording is usually only about a few seconds. At the end, your EKG records will be saved in order to compare with any future readings. For more details, you can ask your doctor.

What is a Holter monitor?

Often, in addition to the conventional EKG, you may be asked to do a specialized EKG test which includes a Holter monitor, a portable EKG that helps monitor your heart’s electrical activity for 24 hours a day. This is usually given for one to two days. Generally, it is given to patients whom the doctor suspects have an abnormal heart rhythm or a blockage in the blood vessels. Similar to an ECG, for a Holter monitor, electrodes are taped to your skin for a few days. There are very few restrictions with the Holter monitor. Other than showering, you can do all your normal activities. Furthermore, you have to keep a diary of all your activities and symptoms.

What is an event monitor?

If you find that your symptoms are indicative of heart disease but that these symptoms are quite infrequent, then your doctor can suggest an event monitor which is a device in which when you find yourself experiencing heart symptoms, you push a button and it will start to detect and store the heart’s electrical activity for a few minutes at a time. The doctor will give you the event monitor for about a month, after which the information that the event monitor has gathered will be sent to the doctor for analysis.

  • Fratini, A., Sansone, M., Bifulco, P., & Cesarelli, M. (2015). Individual identification via electrocardiogram analysis. Biomedical engineering online, 14(1), 78.
  • Wachter, R., Groeschel, K., Gelbrich, G., Hamann, G. F., Kermer, P., Liman, J., ... & Messerschmid, A. (2017). Holter-electrocardiogram-monitoring in patients with acute ischaemic stroke (Find-AFRANDOMISED): an open-label randomised controlled trial. The Lancet Neurology, 16(4), 282-290.
  • Galloway, C. D. C., & Albert, D. E. (2016). U.S. Patent No. 9,254,095. Washington, DC: U.S. Patent and Trademark Office.
  • Photo courtesy of SteadyHealth

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