ECG — electrocardiogram

Proven content

EKG (electrocardiography) is a non-invasive test used to diagnose diseases of the heart muscle based on its bioelectrical activity. In the ECG examination, thanks to electrodes placed on the skin in specific places, electrical impulses related to the work of the heart are recorded and presented in the form of a paper printout.

The ECG of the heart is a very simple test that can be performed even outside the hospital or clinic (e.g. in an ambulance). It has many advantages, it is above all a generally available, common and relatively cheap test. During the examination, the doctor is able to determine the work of the heart, its rhythm and possible problems with ischemia, conduction disorders and, most importantly, the features of the heart attack. In addition, a specialist is able to assess whether the electrical impulse that stimulates our heart to work is reaching the sinus node. It is also useful in recognizing the so-called blocks, or disturbances in electrical conduction in the heart. Thanks to this, a decision to implant a pacemaker is made without additional diagnostics.

Electrocardiography is used in the diagnosis of many heart diseases, e.g. arrhythmia, coronary artery disease or myocarditis.

The work of the heart and the EKG

The heart works like a pump that pumps blood into the vessels of the entire body. Electrical pulses flow through the heart muscle during each contraction and diastole. The pulses that constrict the myocardial bundles come from the sinoatrial node. It is a natural pacemaker. In the ECG examination, thanks to electrodes placed on the skin in specific places, electrical impulses related to the work of the heart are recorded and presented in the form of a paper printout. We call it an electrocardiogram (EKG). On its basis, it is possible to diagnose various heart diseases.

EKG test over the phone

The telephone ECG consists in entering the patient’s data as well as information about the patient’s disease and current test results (including ECG) into the computer database of the facility responsible for such a service. The patient then receives an EKG machine home. In order to check the work of the heart, the patient has to call the facility where specialists are on duty XNUMX hours a day from a mobile or landline telephone. After making the call, the doctor will ask the patient to put the telephone receiver to an EKG imitating a sound signal, which he reads on the monitor screen as an EKG trace.

Thanks to this examination, it is possible to detect cardiac arrhythmias or ischemic heart disease. Its advantage is also the possibility of obtaining quick advice, for example regarding increasing the dose of the drug, and in a life-threatening situation – a quick call for an ambulance. Most importantly, the telephone ECG allows you to pick up incidents that may go unnoticed during traditional diagnostics.

In our country, there are several centers that conduct ECG tests by phone, among others in Łódź, Sopot, Warsaw and Szczecin.

In people under 45 years of age, who do not report any symptoms suggesting cardiovascular diseases, and their family has no history of heart disease, there is no indication for regular ECG performance. ECG examination is also recommended for people with pacemakers and taking antiarrhythmic preparations (evaluation of the results of their use).

1. There are no restrictions on food or fluid intake before the test is performed. However, it is not recommended to drink very cold drinks (this may cause changes in the ECG record – T wave abnormalities) and coffee just before taking the ECG. In addition, it is not recommended to smoke an hour prior to the test. It is worth eating medication and a small meal so that an overfilled stomach does not increase pressure in the abdominal cavity.
2. Exercise just before taking an EKG (such as climbing stairs) can make your heart rate much faster. Therefore, make sure that you do not make any effort for at least 5 minutes before the test. Try to rest and calm your muscles down.
3. The day before the examination, it is not recommended to drink alcohol, especially high-alcohol alcohol, because it rinses out potassium and magnesium from the body, which in turn causes low strength of the heart muscle and arrhythmia.
4. Before having an ECG test, inform your doctor about your neurological diseases, mental disorders, hypothyroidism, recent strokes, hyperthyroidism and gallbladder stones.

1. Depending on the type of electrodes used, the places where they will be attached will be rinsed with an alcohol-based solution beforehand, and then the nurse will apply a gel to them.
2. There will be electrodes attached to your arms and legs (one on each limb). Another 6 electrodes will be attached to your chest (for men with profuse hair, you may need to shave this area to help conduct electrical impulses). The electrodes can be attached to the chest with small suction cups, adhesive patches, etc. The standard number of leads on a diagnostic ECG is 12 to 15. However, sometimes only 3 or 5 electrodes can be used to monitor the heartbeat. The electrodes may feel cold to you at first. After a while, however, this feeling wears off – so you don’t need to report it to the nurse.
3. After attaching the electrodes, lie down still and do not move. During the examination, the nurse may ask you to temporarily hold your breath. Try to relax, this part of the test will not take more than 1 minute.
4. After the ECG is complete, the nurse will detach the electrodes. You can then ask her for lignin, with which you can dry the skin from the previously applied gel, and you can ask where and when you should receive the results.
5. Remember that only a doctor is authorized to analyze and describe the ECG. You will also get information on any further recommendations from him.
6. The above description does not apply to the so-called An exercise ECG, which is performed, for example, while riding a specially adapted stationary training bike or treadmill.

Based on the ECG graph, you can detect:

1. abnormal heart rate and its abnormal rhythm;
2. impaired blood flow to the heart and impending heart attack;
3. disturbances in the level of electrolytes (potassium, calcium, magnesium) in the blood;
4. traces of a past heart attack;
5. disturbance of electrical conduction in the heart, which may be the result of heart disease or a metabolic disease of the body (e.g. an overactive thyroid gland);
6. the effects of other diseases that affect the condition of the heart muscle (e.g. hypertension, thyroid disease);
7. symptomatic of a current heart attack;
8. some congenital heart defects;
9. symptoms of inflammation of the heart muscle or the pericardial sac.

Even with normal ECG results, the presence of certain heart diseases cannot be excluded. Therefore, in order to determine the causes of the disease and its extent, the doctor may recommend additional tests, e.g. a radioisotope examination of the heart muscle (the radioisotope marker will indicate the best and the least blood supply to the heart muscle) or angiography (x-rays of the arteries).

In addition, the ECG examination will not reveal any cardiac arrhythmias that have appeared the day before and remain normal during the examination. Even if the patient experiences severe chest pain, the test does not necessarily show that the heart is ischemic. A similar situation occurs with vasospasm – the ECG will be perfectly normal when the blood vessels relax, which does not mean that the heart is completely healthy and there is no need to worry. It should also be mentioned that the EKG test is often carried out in very obese or even emaciated people, which is why it does not fully tell the truth about the work of the patient’s heart. In obese patients, the ECG picture may be altered due to the large layer of fat which reduces the signal from the heart to a great extent. On the other hand, thin patients may have problems with accurately attaching the electrode (if part of it is on the bone, the ECG result will be false).

1. Chest pain may occur during an exercise ECG test. It usually clears when you stop exercising. This examination should be performed in the presence of a doctor. In the room where the stress test is carried out, there are appropriate drugs and equipment needed in the event of any disturbing symptoms. Under certain circumstances, such as if you develop severe chest pain, ECG changes, blood pressure drops, or your target maximum heart rate is reached, the test will be stopped.

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