Heart of the Matter: Getting an EKG

If your doctor detected an irregular heart rhythm at your last physical, an electrocardiogram (EKG) could be in order to determine the cause of your heart issue.

DOs, or osteopathic physicians, focus on prevention by gaining a deeper understanding of your lifestyle and environment as they partner to help you get healthy and stay well. Below, Martin Burke, DO, an osteopathic cardiologist and professor of medicine at the University of Chicago, sheds some light on the various types of electrocardiogram tests.

Why get an EKG?

Every beat of your heart is triggered by an electrical impulse. An EKG measures these impulses and distinguishes a normal heartbeat from an abnormal one. Most people who get an EKG have a cardiovascular complaint or condition, such as irregularities in heart rhythm or a previous heart attack.

“An EKG can determine very specifically what the problem is with your heart and help your doctor decide next steps for treatment,” Dr. Burke explains.

When reviewing the findings of an EKG, your doctor is looking for a consistent, even heart rhythm between 50-100 beats per minute.

The speed of your heart rate can help your doctor diagnose any issues with your heart, including:

• Evidence of previous heart attack
• Structural abnormalities
• Heart conditions, such as an unusually fast (tachycardia) or unusually slow (bradycardia) heartbeat

Resting EKG

The majority of patients get a resting EKG. After you lie down on an exam table, about a dozen electrodes will be attached to your chest, arms and legs.

During the exam, you will be asked not to talk or move so the baseline of the heartbeat remains pure. The exam takes about 12-15 minutes.

While some people worry about the risk of electrocution during an EKG, Dr. Burke assures that the electrodes only record the electrical activity of your heart and do not emit electricity.

Other types of EKG

If a standard EKG cannot capture an irregular heartbeat, your doctor might recommend another type of EKG:

Exercise – Also known as a stress test, an exercise-based EKG entails walking on a treadmill or riding a stationary bike while wearing the electrodes. This type of exam is used if your heart problems tend to occur during exercise. The exam can take anywhere from 3-20 minutes.

Ambulatory – This exam, also known as Holter monitoring, records heart rhythms for a specified period (usually 24 hours) to detect abnormal rhythms during the course of a normal day. Wires from electrodes on your chest connect to a battery-operated recording device. You’ll also keep a journal recording your activities and symptoms, which your doctor will use to compare with the ambulatory EKG findings.

Event recorder – If your symptoms don’t occur often, an event recorder tracks your heart rhythm only when symptoms are happening. The EKG readings can be sent to your doctor online or through an app on your smartphone.

After the exam

Most physicians can read the results of your EKG on the day of the exam.

Depending on the findings, your physician might order additional tests. Treatment could be overseen by a cardiologist, Dr. Burke adds.