In this Article

• What is an electrocardiogram (ECG, EKG)?
• How is an ECG (EKG) performed?
• What is measured or can be detected on the ECG (EKG)?
• When is an ECG (EKG) performed?
• What conditions may be diagnosed with an ECG (EKG)?
• What are the limitations of the ECG (EKG)?
• Electrocardiogram (ECG or EKG) Index

What conditions may be diagnosed with an ECG (EKG)?

1. Abnormally fast or irregular heart rhythms.
   
   
2. Abnormally slow heart rhythms.
   
   
3. Abnormal conduction of cardiac impulses, which may suggest underlying cardiac or metabolic disorders.
   
   
4. Evidence of the occurrence of a prior heart attack (myocardial infarction).
   
   
5. Evidence of an evolving, acute heart attack.
   
   
6. Evidence of an acute impairment to blood flow to the heart during an episode of a threatened heart attack (unstable angina).
   
   
7. Adverse effects on the heart from various heart diseases or systemic diseases (such as high blood pressure, thyroid conditions, etc.).
   
   
8. Adverse effects on the heart from certain lung conditions (such as emphysema, pulmonary embolus (blood clots to lung), etc.).
   
   
9. Certain congenital heart abnormalities.
   
   
10. Evidence of abnormal blood electrolytes (potassium, calcium, magnesium).
    
    
11. Evidence of inflammation of the heart or its lining (myocarditis, pericarditis).

What are the limitations of the ECG (EKG)?

1. The EKG is a static picture and may not reflect severe underlying heart problems at a time when the patient is not having any symptoms. The most common example of this is in a patient with a history of intermittent chest pain due to severe underlying coronary artery disease. This patient may have an entirely normal EKG at a time when he or she is not experiencing any symptoms. In such instances, the EKG as recorded during an exercise stress test may reflect an underlying abnormality while the EKG taken at rest may be normal.
   
   
2. Many abnormal patterns on an EKG may be non-specific, meaning that they may be observed with a variety of different conditions. They may even be a normal variant and not reflect any abnormality at all. These conditions can often be sorted out by a physician with a detailed examination, and occasionally other cardiac tests (for example, echocardiogram, exercise stress test).
   
   
3. In some instances, the EKG may be entirely normal despite the presence of an underlying cardiac condition that normally would be reflected in the EKG. The reasons for this are largely unknown, but it is important to remember that a normal EKG does not necessarily preclude the possibility of underlying heart disease. Furthermore, a patient with heart symptoms can frequently require additional evaluation and testing.

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