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Electrocardiogram (ECG) Q&As

Published by Bupa's health information team, March 2009.

Answers to questions about electrocardiogram (ECG)

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How will the doctor know if there is something wrong with my heart?

The print-out that is produced at the end of your ECG can show up problems with the heart. This shows the electrical activity that is happening in your heart when it beats.

Explanation

An ECG recording looks like a wavy line, with a series of bumps and spikes that relate to the different phases of your heartbeat. In a normal heartbeat, the pattern of these bumps and spikes is similar in everyone.

However if you have a problem with your heart, these bumps and spikes may look abnormal - they may be too big or too small, too close together or too far apart, or some of the bumps may be missing. How the spikes look depends on what exactly is wrong with your heart.

Looking at the ECG recording can therefore give your doctor some idea of how your heart is functioning and what seems to be the problem. However, an ECG does have limitations in what it can show. Problems with your heart may not always show up on an ECG. On the other hand, your ECG may appear abnormal even if there isn't actually anything wrong with your heart. If your doctor suspects a problem, you will probably need further tests that give more information on the structure of your heart.

Sources

  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:90-163
  • Kumar P and Clark M. Clinical Medicine. 6th ed. New York: Elsevier, 2005:744-748
  • Tests for heart conditions. British Heart Foundation, May 2004, Health information series number 9. www.bhf.org.uk
  • Electrocardiograph - ECG. British Cardiac Patients Association, 2007. www.bcpa.co.uk
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005:310-313
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What could be wrong with me if I have an abnormal ECG?

You may have nothing wrong with you, even if you have an abnormal ECG. However, an abnormal ECG can also be a sign of a number of different problems to do with the heart.

Explanation

There are a number of things that can cause an abnormal ECG, including various heart conditions as well as other factors. These include:

  • abnormal heart rhythms (arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia and heart block
  • heart valve disease
  • heart failure or coronary heart disease - causing the heart to work under strain
  • diseases of the heart muscle (cardiomyopathy)
  • certain drugs, including beta-blockers and digoxin

However, remember that having an abnormal ECG doesn't necessarily mean you have a heart disease. It's possible to have an abnormal ECG recording when there's actually nothing wrong with you.

Sources

  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005:310-313
  • Tests for heart conditions. British Heart Foundation, May 2004, Health information series number 9. www.bhf.org.uk
  • Electrocardiograph - ECG. British Cardiac Patients Association, 2007. www.bcpa.co.uk
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What if I'm unable to cope with the exercise in the exercise ECG?

You can ask for the test to be stopped at any time. However, you should try to do as much as you possibly can to get the most value out of the test.

Explanation

An exercise ECG might make you feel uncomfortable as the exercise is gradually made harder (for example, the gradient or speed on the treadmill is increased). However, it shouldn't be too much for you. You can ask to stop the test if you don't feel able to carry on.

You will be constantly monitored while the test is carried out - the doctor or technician carrying out the test will ask you to stop if they record a sudden change in your blood pressure or heart rate. The test will also be stopped if you have any symptoms, such as severe chest pain, trouble breathing or if you feel dizzy.

If the technician or doctor carrying out the test has any concerns about symptoms you experience during the test, you will be examined by a doctor before you are allowed to go home.

Sources

  • Tests for heart conditions. British Heart Foundation, May 2004, Health information series number 9. www.bhf.org.uk
  • Protocol for cardiac physiologist managed exercise stress testing. British Cardiovascular Society, 2003. www.bcs.com
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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: March 2009

 

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