How far can an ECG test go towards diagnosing a heart condition?

Question

what are the limitations of an ecg, can they show signs for the majority of heart conditions? I have been experiencing rapid heart rates at random times with intermittent chest pain on occasions. I have a slight tightness in my chest too. I had an episode when i was walking through town where i felt light headed and my lips went blue apparently, my heart started to race, it calmed down after 2 minutes or so. I went to the hospital where i was given an ecg and told i was ok and to go home. I have spoken to my doctor about this before but am always met with reluctance to refer me on for other tests, they just say its anxiety, but they never give me any answers. My ECG's are all fine but i am not convinced.

I have had 3 ecg's and they have all come back ok

Answer 1

I agree, with you that there is lot of misinterpretations on acute myocardial infarction or on ACS protocol.There are many others too. This research article will help you out:

The objective of the study was to determine the concordance of emergency physicians' and cardiologists' interpretations of emergency department (ED) electrocardiograms (ECG), to evaluate the impact of ECG misinterpretation on patient management, and to determine error rates as a function of the level of physician training and the specific ECG diagnoses. ECG interpretations were registered prospectively using a programmed-response data sheet. A second blinded interpretation by a staff cardiologist was assumed to be correct. Only ECG discrepancies with potential or probable clinical importance were considered as errors. The ED management of patients with ECG misinterpretations was reviewed by the investigators. The study was performed at an urban university hospital using 300 consecutive ED ECGs. The analysis found 154 errors of interpretation of which nine had probable clinical significance, and 56 had indeterminant significance. The concordance was weak at 0.69 (Kappa = 0.32, weighted Kappa = 0.30) with a significant discordance (McNemar Chi 2:P < 0.05). Error rates did not differ significantly between the diverse categories of physicians. In two cases, interpretation errors impacted patient management decisions but not patient outcomes. The most frequent errors involved repolarization abnormalities, ventricular hypertrophy and hemi-blocks. While discordance was significant, errors in ECG interpretation rarely impacted patient management. Prospective evaluation of ECG interpretation may be a useful means of gauging physician skills. It can also serve to focus educational activities on problem areas in electrocardiography.
In my opinion you better report to a cardiology ER. They will sort out your problem.

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

The accuracy of the ECG varies with the condition being tested. Some heart conditions are not detectable all the time, and others may never produce any specific ECG changes.
A person who suspects heart disease or has had a heart attack may need more than one ECG. There is no reason for healthy people to undergo annual testing unless they have inherited risks or a medical condition.
It is important to be relaxed and relatively warm during ECG recording. Any movement, including muscle tremors such as shivering, can alter the tracing.
Holter monitoring is continuous monitoring and recording of the ECG, BP, or both for 24 or 48 h. It is useful for evaluating intermittent arrhythmias and, secondarily, for detecting hypertension. The Holter monitor is portable, enabling patients to participate in normal daily activities; it may also be used for sedentary hospitalized patients if automated monitoring is unavailable. Patients are asked to record symptoms and activities so that they may be correlated with events on the monitor. The Holter monitor does not automatically analyze the ECG data; a physician does so at a later date.
Please see the web pages for more details on Electrocardiography.

Answer 4

ECG (electrocardiogram) test is 99.9% reliable in diagnosing heart conditions. this is used as a concluding diagnostic after the preliminary diagnostics have been done (e.g stress test). any blockage in the vessels of the heart which hampers blood supply or damage of the cardiac parenchyma can create a significant rhythm change that is why a cardiac condition can be detected right away. take for example the ECG pattern of the patient with Myocardial Infarction. he has an S-T wave elevation, T wave inversion and pathologic Q wave. S-T changes shows the point of ischemia. T elevation id due to the point of myocardial injury and on the other hand the pathologic Q wave is the point of infarct/ necrosis. to insure the reliability and correctness of the ECG result, such measures should be done and followed.
1. avoid extraordinary movements bcoz it can alter the result. 2. before undergoing the ECG monitoring, you should avoid strenuous activities. it can increase the cardiac activity; thus it can be mistakably interpreted as a disorder.
3. avoid coffee, colas and caffeinated beverages.
4. avoid cardiac drugs like ACE inhibitors, Captopril, digitalis, nitroglycerin, adrenergics, cardiac glycosides, diuretics, beta-blockers, Ca+ blockers, psychotropic drugs and many others.
5. you should be assured by the nurse first that the procedure is not painful. the reason? to avoid anxiety which causes the activation of your sympathetic response. as we all know, sympathetic response results to increase temperature, breathing. blood pressure and most especially heart beat.
many patients mistakably think that the procedure is painful and is invasive. let me tell you my friend that the procedure is safe, non-invasive and not painful. you should be calm.


that's all. hope i have answered your questions and cleared your doubts. email me at [e-mail] for more questions. pls do me a favor. may you rank my answer please? thanks.

Answer 5

Resting ECGs can be falsely reassuring. You could be suffering from an intermittent dysrhythmia. To exclude this you need at least a 24 hour ambulatory ECG, and possibly a cardio-memo ( a transmitter which you activate when the problem occurs so that your ECG can be looked at when the problem is occurring.

Answer 6

My daughter suffered with something similar to this. It turned out it was svt. supra ventricular tachycardia. It was diagnosed on ecg but only whilst she was having an episode ,her ecg was normal at other times.But her heart would race for hours and had to be reverted with adenosine.
Try having a really cold fizzy drink, the coldness can return the heart to its normal rythmn. Avoid too much caffiene and try and learn some relaxation techniques as it could be anxiety related.

Answer 7

Most of the time, an ECG can tell if you have had a heart attack in the past and if your heart is out of rhythm but there are a lot of other things it cannot tell. If I was concerned, I would make my doctor listen to me....after all they work for you......you are paying them to find out what is wrong with you....you can check with your insurance and see if you have to have a referral to a Cardiologist (a heart specialist) if you feel strongly about it......I have been in the medical field for over 16 years, and if I were you, I would rely on my gut instinct, if I felt something were wrong, I would find out......Good Luck to you......

Answer 8

You need to wear a Holter monitor for a few days to try and capture the event. ECG's show electrical activity and are limited in their study. For someone who is experiencing episodic arrthymias, Holter monitoring is the way to go.

Answer 9

no ,ecg gives specific findings only for a few conditions,,but in a no. of cases it might still be normal.but it could be enough to tell that one didnt had an infarct..ur symptoms are going towards decreased blood pressure.but cant say anything about the tightness in chess....i will advice u to buy a blood pressure instrument and record it in morning and evening along with ur heart rate and give a months list to ur doc..this might give him enough to understand.

Answer 10

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