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Electrocardiograms (EKGs): When You Need Them and When You Don’t

Has your heart ever skipped a beat or fluttered? There are a lot of odd things that our heart can do when we are stressed, scared and even in love. But what happens if something just doesn’t feel right?  Is it time to get your heart checked out?

Diagnostic testing is a critical component in detecting and managing cardiovascular disease, and one of the most common tests that doctors recommend are electrocardiograms (EKGs).

What is an electrocardiogram?

An EKG measures the electrical impulses or activity of the heart. They are performed in doctor’s offices or hospitals, where you’ll be asked to lie down as sticky pads called electrodes are attached to your arms, legs and skin of your chest. The pads are connected to wires that send readings to a monitor to record the electrical signal or activity. The test is completely painless and can help your doctor determine if your heart is receiving enough oxygen or beating at an abnormal rate.

“An EKG can identify many cardiac problems—the range is wide,” said Shane Rowan, MD, a cardiac electrophysiologist with the CardioVascular Institute of North Colorado Cardiology Clinic in Northern Colorado. “It can show problems with the heart rhythm (like atrial fibrillation), thickening of the heart muscle, enlargement of the chambers of the heart and signs of heart attacks. Often, if the EKG suggests a problem, other tests are then used to confirm the finding.”

Reasons you need an electrocardiogram

In some cases, it’s important to have an EKG test. Some of the symptoms or signs that may suggest you need an EKG, include:

  • Chest pain
  • Shortness of breath
  • Heart palpitations or abnormal heart rhythm
  • Dizziness, confusion, fatigue and weakness

When you don’t need an electrocardiogram

An EKG or monitor may be appropriate if you’re already having symptoms that could be related to heart disease. However, they aren’t useful in routine checkups for those who don’t have risk factors for heart disease, like high blood pressure, or symptoms of heart disease, like chest pains.

Types of electrocardiograms

If your symptoms come and go, they may not be captured in a standard EKG. That’s because an EKG records the heartbeat for only 10 seconds and may miss symptoms that occur a few times a day, week or even less often. In this case, your doctor may recommend a remote or continuous monitoring EKG such as a Holter monitor or event monitor.

  • A Holter monitor records your heartbeat for a longer period of time, usually one to five days. Sticky pads attached to your chest record information on a portable, battery-operated device, and your doctor will use this information to determine what is going on with the heartbeat when someone has symptoms.
  • An event monitor also uses sticky pads attached to your chest, but recording isn’t continuous. “Unlike a Holter monitor, event monitors don’t record every heartbeat during the monitoring period,” Dr. Rowan said. “The patient pushes a button or activates a recording when they feel symptoms or when symptoms trigger a recording, such as a very fast or slow heartbeat.”

Are electrocardiograms safe?

Yes, there are few, if any, risks related to an EKG. You may experience some skin irritation where the sticky pads were placed, but the test itself is harmless. An EKG only monitors the electrical activity of your heart and doesn’t produce any electricity.

What will my doctor do with the information?

Monitors and EKGs are usually ordered to make a diagnosis about why you are feeling something. With the information from these tests, your doctor may be able to recommend treatments or determine how the heart problem might affect you.

If they find any problems, they may order additional testing to see if treatment is necessary. If your EKG is normal, you may not need any additional testing.

Understand your risk for heart disease

Heart disease is still the leading cause of death in the U.S., so it’s important to discuss your risk with your doctor and continue to make healthy lifestyle decisions. Need a doctor? Visit bannerhealth.com to find a Banner Health specialist near you.

To learn more about your heart health, take our Heart Age Test.

Recommended reading:

Heart Health Imaging