ECG Tests for Heart Disease: Early Detection for Better Heart Health

By Dr. Al Fazir Omar.

Consultant Cardiologist

Gleneagles Kuala Lumpur

What is an ECG (Electrocardiogram) Test?

An ECG (also known as an Electrocardiogram test or EKG test) is a quick, non-invasive, painless test used to measure the electrical activity, including its rate and rhythm, of your heart. By placing small electrodes on the chest, we look at the electrical activity of your heart. From an ECG test, we can detect hypertension, heart disease, congenital heart defects, and hypertrophic obstructive cardiomyopathy (HOCM). An ECG is typically quick and easy, taking just about 5-10 minutes to complete. It’s an essential, basic test that provides important insights into your heart health, even if you have no symptoms.

Types of ECG Tests

Depending on your symptoms or heart concerns, we may use different types of ECG tests to get a clearer picture of your heart health. Each of these ECG tests serves a specific purpose in assessing heart health. The resting ECG offers an immediate snapshot of your heart’s activity, while the stress ECG evaluates your heart under physical strain, and the portable ECG provides extended monitoring to detect abnormalities over time. Together, these tests provide a comprehensive view of your heart's condition, helping doctors diagnose and treat heart disease more effectively.

Resting ECG

This is the most common type of ECG, done while you're lying down and relaxed, while we attach sticky patches (called electrodes) on your arms, legs, and chest. These are attached to the ECG machine. It helps us assess the electrical activity of your heart at rest. The resting ECG test helps detect issues like arrhythmias and heart rate abnormalities.

Stress ECG (Stress Test):

If you’re experiencing chest pain or have a history of heart issues, we may recommend a stress ECG. In this test, you’ll walk on a treadmill while we monitor how your heart reacts to physical exertion. This test helps us diagnose conditions like coronary artery disease by observing how well your heart responds under stress.

Portable ECG:

For longer-term monitoring, we may use a portable ECG device such as a Holter monitor or event monitor. We will attach adhesive patches, known as electrodes, to your chest and secure them with tape. These electrodes are connected to a small portable ECG recorder, which you wear on a belt around your waist. These portable devices continuously record your heart's electrical activity for 24 to 48 hours, helping us detect irregularities that may not be apparent in a brief test. This long-term monitoring is essential for detecting intermittent heart issues..

Why is an ECG Done?

We recommend an ECG if you're experiencing symptoms like chest pain, shortness of breath, or palpitations. It’s also a standard part of checking for heart disease, including:

• Detecting arrhythmias (irregular heartbeats)
• Assessing heart function after a heart attack
• Evaluating conditions like hypertension and coronary artery disease
• Identifying congenital heart defects or hypertrophic obstructive cardiomyopathy (HOCM)

Can an ECG Be Normal Even If There’s Heart Disease?

While an ECG test is a fundamental diagnostic tool, it does have limitations. For instance, in cases of heart disease with 70% artery blockage, the ECG may not always reveal the issue, especially if the patient is at rest and blood flow is still normal. The ECG test primarily captures the heart’s activity during a resting state.

If someone comes in with chest pain or history of chest pain, a stress test, also known as a stress ECG, which is often recommended. During a stress ECG, the patient exercises on a treadmill that gradually increases in speed to induce stress on the heart. As the heart rate increases, the heart requires more oxygen to function properly. If there is a 70% blockage in the arteries, the heart may struggle to meet this increased oxygen demand, leading to changes in the ECG. 

These changes during the stress ECG can help identify areas of blockage; however, the accuracy of a stress test is approximately 80%. To obtain a more precise diagnosis, additional diagnostic tools such as CT scans, MRI scans, or coronary angiograms may be necessary. If the stress ECG shows signs of cardiac muscle enlargement or thickening, further tests are required to validate these findings and ensure an accurate diagnosis. 

What Should the Public Know About ECG and Echocardiogram?

The most important thing to know is that ECG and Echocardiograms (ECHO) are essential diagnostic tools for assessing heart health. An ECG is a quick, simple test that helps detect heart issues like palpitations, chest pain, and irregular heart rhythms. If you experience any of these symptoms, or even as part of a routine check-up, it’s recommended to get an ECG.

While an ECG provides valuable insights, it’s like looking at your heart through a frosted window. For a clearer and more detailed view, an Echocardiogram is highly recommended. The ECHO provides a more in-depth look at the heart’s structure and function, allowing for the detection of conditions like valvular heart disease and heart failure. Combining both tests offers a more comprehensive approach to understanding and diagnosing heart conditions. 

Preparing for an ECG Test

Preparing for an ECG test is straightforward. Here’s what you need to know:

• Wear comfortable clothing that allows easy access to your chest area for electrode placement.
• Avoid caffeine and heavy meals, especially before a stress ECG, as they can affect the results.
• Make sure not to use body lotions, oils, or powders on your skin, as they can interfere with the electrodes sticking properly.

ECG Results and What They Mean

After the test, we’ll review the ECG results to understand your heart’s electrical activity. Based on what we find, you may need further testing or treatment:

• We monitor your heart rate and rhythm to check for conditions such as tachycardia (a fast heart rate) or bradycardia (a slow heart rate).
• Changes in the heart’s electrical pattern can reveal issues like heart attacks or coronary artery disease.
• If there’s any indication of heart muscle enlargement or other abnormalities, we may recommend additional tests, such as an Echocardiogram or stress test.

Risks and Safety Information of an ECG Test

An ECG test is a safe and non-invasive procedure. There is no risk of electric shock during the test, as the electrodes only record the heart’s electrical signals. While most patients experience no discomfort, some may feel mild irritation or discomfort where the electrodes are placed, but this usually subsides once they’re removed.

Heart Health Advice: Take Care of Your Heart Like You Do Your Car 

Maintaining heart health is just as important as maintaining any valuable asset, such as your car. We often take our hearts for granted, yet we regularly service our cars, but many neglect to check their heart health. Just like a car needs regular servicing, your heart needs regular check-ups. It’s recommended to have a heart health check-up at least once a year to catch potential issues early. Regular screenings help detect conditions such as heart disease, high blood pressure, and high cholesterol, ensuring your heart remains in optimal condition.

Book Your ECG Test Today and Take Control of Your Heart Health

An ECG is a quick, simple, and important test that provides valuable information about your heart health. Whether you're experiencing symptoms or just need a routine check-up, this test helps us catch potential heart issues early. If you’ve been experiencing chest pain, palpitations, or other heart-related symptoms, don’t hesitate to schedule an ECG Test at Gleneagles Hospital Kuala Lumpur. Your heart health matters, and we’re here to help.