An electrocardiogram (also known as an EKG or ECG) is a quick, non-invasive and painless test. The EKG records the heart’s electrical activity from the body surface.
“It might be used when a patient has chest pain or discomfort, shortness of breath, heart palpitations or an irregular heartbeat. It also may be used for a pre-operative evaluation, sports participation evaluation or for monitoring chronic cardiac conditions,” said Dr. Somto Nwaedozie, cardiology fellow with Marshfield Clinic Health System.
When getting an electrocardiogram done, the patient is asked to lie down. Small tabs with sensors (electrodes) are attached to the skin with a sticky paper. The electrodes are placed around the patient’s body on their shoulder, chest, wrists and ankles. These connect to a monitor and record the electrical signals that make the heart beat.
While the EKG is recording, the patient is asked to remain still.
A standard EKG takes just minutes.
What does an EKG show?
An EKG test can provide immense clinical information about:
- Heart rate and rhythm, whether it’s normal or irregular, or fast or slow
- Evidence of ongoing heart attack or previous heart attacks
- Conduction delays or blocks, which indicates potential issues in the heart’s conduction or electrical pathways
- Heart enlargement (changes in the size of the heart chambers)
- Changes in the electrolytes in the blood (such as how potassium affects the heart)
An electrocardiogram can compare a patient’s tracings over time, which can help determine changes. Comparing EKGs for the same patient from two different times may give cardiologists an idea of what changed and when it happened in the heart.
EKG information is interpreted by a machine and drawn like a graph. The graph shows:
- Heart rate: Shown by the number of waves per minute
- Heart rhythm: Shown by the distance between the waves
- How well the heart’s electrical impulses are working, the size of the heart and how the parts of the heart are working: Shown by the shapes of the waves
- Heart damage: Shown by the consistency of the waves
EKGs can be interpreted quickly
“The findings of an EKG can be interpreted quickly after the tracing is recorded, as long as a trained provider is available to interpret it,” said Dr. Nwaedozie. “Making a definitive diagnosis and determining the course of action might vary based on the clinical scenario.”
In emergencies, like a suspected heart attack, EKG findings can lead to rapid decision-making and initiation of treatment within minutes.
In non-urgent cases, the results might be part of a broader diagnostic process that includes other tests or evaluations.
“Your results will be interpreted in the context of your overall symptoms, clinical signs and the results of any other test done,” said Dr. Nwaedozie.
An echocardiogram is a valuable, widely-available tool
“While they provide valuable information, they are just one component of a comprehensive cardiac evaluation,” said Dr. Nwaedozie.
Clinical history, physical examination and other diagnostic tests complement EKG findings.
“Additionally, continuous EKG monitoring, called Holter monitors or event recorders, may be necessary for intermittent issues not captured in a standard surface EKG.”
To learn more about an EKG, talk a Marshfield Clinic Health System provider.
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