Electrocardiogram, ECG or EKG

An electrocardiogram or EKG is a very common diagnostic procedure that is performed as part of routine physical exams, stress tests, and medical workups associated generalized symptoms or more severe heart disease. EKGs may be performed by your primary care physician, specialist or cardiologist.

Types of EKG

• EKGs may be performed as part of a single test to take a snapshot of your heart’s electrical activity. This is a standard office-based procedure that will be described below.
• Your cardiologist may want to monitor your heart continuously for up to 2 days using a portable Holter Monitor. At your follow-up appointment, your cardiologist will review and discuss the results with you.’
• Lastly, if cardiac issues seem to be an intermittent event, you may be fitted with an event monitor. This allows you to define when the machine reads your heart’s activity. When you notice symptoms, you canpush a button to begin recording.

How is an EKG Performed?

EKGs are minimally invasive and only require the placement of 10 to 12 leads on the body (typically four on the extremities and 6-8 on the chest) to monitor electrical impulses and activity of the heart. Leads are placed in predefined locations to collect the impulses needed to make an accurate diagnosis.

Leads are then attached to a machine that processes the electrical impulses and prints a graph that your physician can read to check for abnormal heart activity. This test can be performed at rest or during exercise, depending on your symptoms.

The entire EKG procedure lasts about 5 minutes with a few minutes on either side for placement and removal of leads.

Limitations of the EKG

While the EKG is a very effective diagnostic tool, it also has several limitations:

1. It is simply a snapshot in time. If the patient is not experiencing symptoms during the time they are undergoing an EKG, the condition or conditions may not be accurately detected. For longer-term monitoring, patients may be sent home with a specialized recording device known as a Holter Monitor or Event Monitor.
2. Abnormal readings may not be indicative of a condition or disease. We all have variances in our heart rhythm patterns. This requires specialized knowledge on the part of your cardiologist.
3. A normal EKG does not completely rule out heart disease. Some heart conditions may not have obvious signs on an EKG. Therefore, the EKG is one part of a larger heart health workup.

EKGs are non-invasive, important diagnostic tools that can detect heart disease early. While it is not a perfect diagnostic tool, its invention has saved countless lives. As our specialty continues to refine the process, EKGs are becoming more accurate and helpful diagnostic tools.