How far does an ECG go towards diagnosing Heart failure, does a normal ECG mean it is not present?

Question

I have been having problems sleeping, an uneasy feeling accompanied by bouts of chest tightness and increased heart rate when i try to sleep. I went to my GP who said the symptoms were stress related as I had chest pains and a pressure headache which have now ceased. Recently I have developed a build up of mucus that is lining the back of my mouth and throat. I am not wheezing and do not have a cough, there are no apparent areas of swelling on my body. When i physically exert myself i have no pain, I have a slight noticable increase in heart rate, more than before but thats it. I have had an ECG which was fine, is an ECG enough to diagnose heart failure on its own? any ideas about what else it could be?

Answer 1

EKG/ECG is at times a highly deceptive test, sometimes the process of myocardial infarction is going on and the EKG/ECG is normal.
In any case of chest pain, the patient should be hospitalized and ACS protocol is to be carried out viz, cardiac baseline enzyme tests including tropinin and trop T,CKMB AND ISOKET is to be started. In case of any change in the tropinin or tropT is positive standby for streptokinase or SK should be instituted.
In some of the cases Ecg/Ekg changes occur after 24 to 48 hours,i.e when the job is done.
Kindly see a good cardiologist or report to ER (cardiac) or call your help line.

Answer 2

When diagnosing a medical condition, a single investigation is of little use. Investigations are used to confirm a diagnosis that has already been made from taking a history and examining the patient. An ECG is very cheap to perform and doesn't convey any risk to the patient. It looks at the electrical pattern that your heart produces and can give details to an experienced interpreter of both the structure of your heart and to some extent the conduction system of your heart. The symptoms that you describe may be due to anxiety, but they may also be due to a fault in the conduction system in your heart which makes it beat very fast intermittently. Depending on the cause of the fault this can sometimes be picked up by an ECG when you are not suffering an attack, however in the majority of cases it will not. The only way to diagnose a heart conduction problem is to have an ECG at the time of the attack. Portable ECG machines exist that you wear. They can either record your heart rate and rhythm over a 24 hour period, or you can wear them for longer and then activate the machine when you are having an attack. My advice would be that if the attacks continue, go and see your doctor explaining how worried you are, and if possible take a friend or relative that has witnessed an attack. A sensible doctor would refer you to a cardiologist who would offer a portable ECG machine to diagnose your problem. The alternative is the next time you suffer an attack, call an ambulance, they normally have an ECG machine which will capture the rhythm.

Answer 3

I am not a doctor, but my wife has been battling heart failure for a while, so I've picked up a bit of knowledge on the subject. I hope that any doctors here can correct me if I make any major mistakes here.

First, as one answer mentioned, you need an echocardiogram to diagnose or rule out cardiomyopathy/congestive heart failure. Anyone who says you should be having specific symptoms is full of crap. If you wait to experience severe symptoms, you do yourself a grave disservice. Catch it early, and you have a much better chance. Some people in heart failure experience no fluid retention, while others suffer horribly from it. Some have shortness of breath, some don't. Some go into kidney failure first. About the only tell-tale sign of heart failure is a lack of endurance. If you struggle to keep up with your peers, particularly if that struggle has become more acute recently, that's a cause for concern.

Now, if you're worried about a heart attack (myocardial infarction), there is a relatively simple blood test that would help to rule out damage to the heart muscle. Ask your doctor about a BNP test. They are simple and inexpensive. If you are in heart failure, you will tend to have elevated levels of BNP, but if you are experiencing an MI, the levels will be quite high.

An ECG would catch any arrhythmia that you happen to be experience during the short period that you are being monitored. A better approach is probably a 24-hour monitor. An ECG might also catch a left bundle branch block (LBBB), which indicates an electrical blockage in the signals that tell the left ventricle to pump. However, only about 1/3 of all cases of cardiomyopathy are accompanied by an LBBB.

A more likely scenario than heart failure might be sleep apnea, but again, I'm not a doctor.

I hope this helps.

Answer 4

Hi Mark The fact that you have been given an echo cardiogram suggest that your Dr is concerned about the health of your hart muscle. The pointers towards an ineffective blood pump are changes in body color and pain's in the chest or arms and shortness of breath.
Heart failure has two causes either oxygenated blood is not getting to the hart muscle because of an arterial blockage. This causes muscle to die from lack of oxygen and the hart to fail. Or the chambers of the hart rupture and the blood is pumped through the rupture and not round your body.
An ECG provides both a visual representation and a map of the electronic activity in the hart muscle. By analysis of the low range sound it can supply skilled operators with an understanding of your harts arterial health.
The next step up the testing process is the much more invasive angio-grame a probe / camera and dye are inserted into the hart through veins in the groin, and the trans esophageal echo cardiogram were echo equipment is placed down the throat and readings taken to provide surgeons with a clearer picture of what needs correcting.

If you manage to get out with a normal ECG then there is a very good chance that your hart is fine.

Answer 5

You dont have signs of heart failure. Signs of failure would be difficulty laying flat, shortness of breath even at rest, swelling of the legs, non productive cough. EKG would not necessarily diagnose heart failure, but you can often see it on a chest xray - fluid on the lungs will appear. An echo or a lab test called BNP also part of diagnosing. It kind of sounds like you have anxiety. If you dont believe your doctor, go get a second opinion.

Answer 6

Sounds more like anxiety/panic attacks to me.
An ECG would show if you have had a heart attack or angina which could eventually lead to heart failure. ECG trace the electrical activity of your heart but if yours came back normal then I wouldnt worry. Increased heart rate on exertion is normal.

Answer 7

To make a better diagnosis, a 24 hour halter monitor should be performed vs. a normal 12 lead ekg/ecg...........you also should talk to the Doctor about getting a sleep study, there could be cardiac problems that are occurring while you sleep, from another related problem such as sleep apnea.

Answer 8

One of the commonest symptoms of anxiety is chest tightness accompanied by increased heart-rate etc.

If you are really worried still then see your GP again but, honestly, I think if you were heading into heart-failure it would have been picked up - and your symptoms would be quite definite and severe.

My doctor once told me that serious heart conditions are never subtle.

Answer 9

EKG alone cannot diagnose heart failure. An echocardiogram would be the least invasive way to do it by measuring what is called the ejection fraction. However, from what you described, it does not sound like heart failure...