ECG Basics: Before, During and After the Procedure

illustration of wave form on checked ecg graphIf you have been prescribed an ECG, or electrocardiogram, by your doctor, you might be wondering what the procedure entails and what your physician is hoping to find through the results. This article was designed to help you understand ECG basics.

ECG Basics: What is an ECG?

An ECG, also referred to as an EKG, is a painless procedure ordered by doctors for patients who might have exhibited or who might be prone to heart conditions. This procedure checks the electrical activity of a patient’s heart through the use of small electrodes that are attached at one end to the patient and at the other end to a device that records the readings on paper.

The readings, or tracings, are shown as waves. These waves allow the doctor to note how the heart is pumping and working. Sometimes the ECG test is performed in a doctor’s office or in the hospital. At other times, the patient may wear a monitor to track the heart’s electrical activity over a short period of time.

This course looks more in-depth at the cardiovascular and blood system, while the remainder of this article will focus on the ECG test specifically.

ECG Basics: Why Do I Need an ECG?

Doctors order ECGs to track a patient’s heart’s electrical activity. This can tell your doctor a lot about the health of your heart. Your doctor may order an ECG if you are experiencing:

  • Chest pain
  • Dizziness
  • Shortness of breath
  • Fainting
  • Irregular heart beat

Your doctor may order the ECG for other reasons as well. These might include potential/possible side effects from medications that interrupt the normal activity of the heart, high blood pressure, or a family history of heart disease. If you were born with a heart defect or if you have been diagnosed with coronary artery disease your doctor may want to check the functioning of your heart with an ECG.

In some cases, if you have been taken to the hospital for chest pains or other potential heart problems, your doctor will want to track your heart’s activity on a continuous basis. While this article focuses more on those who go into the doctor’s office for an ECG, the procedure and results are the same. The only difference: if you are in the hospital because you are experiencing problems, the ECG will be conducted for a longer period of time, likely throughout the course of your stay.

ECG Basics: How is an ECG Performed?

The ECG is a painless test that does not require surgery or extensive recovery. The test takes only a few minutes (unless you are asked to wear a monitor home), and other than some possible mild discomfort when the electrodes are removed from the skin, you will not experience any pain during or after the procedure.

To start, avoid exercising the morning of the ECG, since exercise can change your heart rate. (Below we will discuss the stress test, which is another form of an ECG that is often done when patients complain of heart problems during exercise. In this case, you will exercise during the test but you will not exercise the morning of the test on your own.) You will also be asked to avoid drinking ice-cold water directly before the procedure, since this can also alter test results.

You may have the ECG test performed at a hospital, or your doctor might be able to perform the test in his or her office.

Upon arrival, a provider or assistant will place small electrodes, which may be referred to as leads, at various points along your arms, legs and chest. Electrodes are small patches that are attached to a machine with wires. These electrodes are responsible for telling the machine what your heart is doing during the test. The electrodes are attached to your body through the use of gel, which helps transmit the signals to the machine. In some instances, the assistant may need to shave small areas of hair if the hair will interfere with the electrodes sticking to the skin. (This is more true for men.)

The ECG will take just five to ten minutes or so to conduct. You will need to remain still during the procedure, since movement can change the heart rate and, therefore, alter the results of the ECG. In some instances you may be asked to hold your breath.

During the test, the electrodes will pass along information about your heart’s electrical activity to the machine to which it is strapped. The machine will turn these impulses into waves, which are recorded for your doctor to view. The waves tell the doctor what your heart is doing as it beats.

ECG Basics: The Results

The results of your ECG are ready immediately. Your doctor will view the tracings made by the machine, looking for a consistent and steady heartbeat with a heart rate from 60 to 100 beats per minute. An abnormal ECG would show inconsistencies within the tracings. If your ECG findings are abnormal, discuss the next step with your physician.

ECG Basic Tests: Alternatives

In some instances, the changes in your heart rate may not be observed during a short, in-office ECG. Your doctor may then want to perform an alternative form of ECG to thoroughly view the electrical activity of your heart.

Some of these alternative ECG tests include:

  • Holter monitor, or an ambulatory ECG, which you wear for a twenty-four hour period. Holter monitors use a recording device that keeps track of the electrical activity of your heart while you keep a twenty-four hour journal of the activities you are doing as you wear the monitor.
  • Event recorders are used for people whose heart problems don’t occur on a regularly basis. These can be used as the symptoms occur. The event recorder would then record your heart’s activity at that time.
  • Stress tests are often used for those people who experience heart problems during exercise. You will be asked to exercise on a treadmill or stationary bike as the ECG is performed. The doctor will track your heart’s activity to note any changes that occur during the time your heart is under stress due to exercise.

Moving Forward with Your Health

If your physician does not find abnormalities in your ECG and other tests, you might want to look at alternatives to your diet (and see this course for strengthening your mind) to remain healthy, strong and pain free. Certain foods and exercises, along with meditation, have been shown to reduce stress, which in turn can result in a healthier heart and spirit.