EKG – Electrocardiogram

Congestive Heart Failure ekg

What is an EKG?

An electrocardiogram, abbreviated as an ECG or an EKG, measures the electrical activity in the heart. This helps to find out any abnormalities in the activity of the heart. The process of EKG is based on the fact that every beat of the heart is accompanied by electrical impulses traveling through it.

These signals which control the activity of the heart muscles and thereby the heartbeat is generated from the sinoatrial node located at the right atrium. The EKG device measures these electrical signals at different points on the skin surface and plots them in a graphical pattern.

The initial wave called “P-wave” is generated in the upper chambers of the right and left atria. This is followed by a flat wave after which the right and left bottom chambers or ventricles generate the next wave called the “QRS complex.” The last wave called “T wave” indicates a return to the resting state for the heart.

The study of the EKG provides details about the rhythm of the heart and also about the size of the chambers of the heart. Being a simple and easy-to-perform test, EKG is used in a wide variety of patients to study the condition of the heart.

Why do I need to undergo an EKG?

The EKG test is done to monitor the condition of the heart and check for any related disorders. It is often done as part of a routine health check-up for middle-aged and senior individuals who are at a greater risk of heart disease. The doctor can ask you to undergo and EKG for the following reasons.

– Irregular heartbeat, also known as arrhythmia.
– Blocked arteries or blood clots in the heart.
Heart failure.
– Condition of enlargement of the heart or any inflammation in the tissues surrounding the heart called pericarditis.
– To detect any case of a heart attack, damage in heart muscles or coronary artery blockage.
– To monitor recovery from a heart attack and to judge the effectiveness of certain heart medications or a pacemaker.
– To detect any abnormalities in the heart.
– It is also used to diagnose other conditions such as electrolyte imbalances and lung disease.
– To check heart health before any surgical procedure.

In case you have a family history of heart disease, the doctor can order the test as a precautionary measure. In many cases, the doctors check for certain symptoms of heart disorder and order an EKG. These symptoms may include one or more of the following.

– Chest pain accompanied by palpitation.
– Rapid or irregular heartbeat.
– Arrhythmia, which often feels like the fluttering of the heart.
Shortness of breath accompanied by a rapid pulse.
– Dizziness, light-headedness, and fatigue.

What are the different types of EKG?

In general, an EKG collects information from 12 different areas of the heart. The fact that electrical signals generated in the heart do not travel evenly over the skin is used in the case of a 12-lead EKG. Comparing the signals from the 12 different leads, the doctors can point out the exact location of a problem in the heart.

The EKG test can be done in three formats.

A resting EKG: This test is done when a person is resting on a bed and is in a calm or relaxed state. Most EKGs are conducted in this manner.

An exercise EKG: In this case, the electrical impulses in the heart are measured when you are in an active state. It is done to check the reactions of your heart when it is placed under activity. This generally involves running or riding a bike and the amount of exertion is gradually increased. The test is stopped if any irregularity in the heart patterns is observed.

A Holter monitor: In some special cases, the rhythm of the heart is measured continuously for a period of 24 hours. The electrodes attached to the chest are connected to a recording device that is worn on the body with a belt. The data is later transferred to a computer and analyzed by the doctor. Sometimes an event monitor is used which can be kept on the body for longer periods, like a month. It does not record data continuously and you can switch it on when you feel any symptom of a heart problem.

How is an EKG performed?

The process for the normal or resting EKG is safe, non-invasive, painless and simple. It involves the following steps.

– You will be asked to remove any jewelry and might also be asked to change into a hospital gown.

– You will lie comfortably on a table or bed.

– The technician will attach some electrodes or sensors to your chest, arms and legs through suction cups or adhesive patches. For men, it might be necessary to shave the chest hair for better results. The number of electrodes varies between 12 and 15.

– The electrodes are attached to a computer that will record the activity of the heart.

– The actual test takes a few minutes and the entire procedure may take anywhere between 10 to 15 minutes.

– You can return back to your normal activities after the test is over. Since no anesthetics are used, there is no need for any recovery time after the test.

There are no special preparations needed for the test and since the electrodes only measure the flow of electricity, there is no chance of receiving an electric shock. There might be some minor discomfort after the electrodes are removed from the skin and some people may get skin rashes. It is best to inform the doctor about any supplements or medications that you are taking, which can interfere with the test.

What is the price of an EKG in India? 

The price of an EKG in India can vary from Rs 200 to Rs 2000 depending on the location and the facilities used.

When will I get the test results?

The test results can be delivered on the same day or the following day.

What is the normal range for an EKG?

The normal values for EKG results are mentioned in the chart below.

Heart rate 60 – 100 bpm
PR interval
 
0.12 – 0.20 s
QRS interval ≤ 0.12 s
QT interval
< half RR interval (males < 0.40 s; females < 0.44 s)
P wave amplitude (in lead II) ≤ 3 mV (mm)
P wave terminal negative deflection (in lead V1) ≤ 1 mV (mm)
Q wave < 0.04 s (1 mm) and < 1/3 of R wave amplitude in the same lead

What do the results mean?

When the results of the test are not normal, it can indicate any one of the following heart disorders.

– Arrhythmia resulting in an irregular heartbeat pattern
– Heart damage or blocked arteries.
– Congenital defects or any abnormalities in the heart.
– Inadequate blood supply to the muscles of the heart, which may be due to cholesterol clogging up the arteries.
– Heart inflammation which can be pericarditis or myocarditis.
– Enlargement of the heart.
– A cardiac arrest which may have occurred in the past or occurring at present.
– Malfunction in the conducting system of the heart.

The doctor will make the necessary diagnosis from the EKG report and suggest the right course of treatment involving medications and lifestyle changes. Further tests may also be ordered as needed.

Do I need to fast for the EKG?

No fasting is required before an EKG test.

What else do I need to know before I appear for an EKG?

Here are a few points to keep in mind before appearing for an EKG test.

– Avoid using oily and greasy skin creams and lotions before the test as they can interfere with the functioning of the electrodes.

– Wear a shirt that can be easily removed so that your upper body can be accessed. In case you will undergo an exercise EKG, wear the right pair of shoes for the activity.

– In case EKG is being done on a child, the parent may stay with the child to offer assurance.

– It is important to lie still during the test to get fast and accurate results.

It is often suggested to avoid a caffeinated drink prior to the test as that might impact the normal working of the heart. Check with your doctor for further details.

Can pregnant women undergo an EKG?

Pregnant women can easily undergo an EKG test.

Is the EKG test possible for new-born babies?

There are no restrictions on new-born babies appearing for EKG tests.

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