Electrocardiography (ECG or EKG) | EH Heart Specialist

Electrocardiography (ECG or EKG) is a non-invasive test that measures the heart's electrical activity. This diagnostic test allows cardiologists to detect arrhythmias, myocardial infarctions, and other heart issues.

What Is an Electrocardiogram (ECG or EKG)?

An electrocardiogram (ECG or EKG) is a quick and painless test that evaluates the heart's electrical activity and detects abnormalities in rhythm and structure. It works by measuring the heart's electrical impulses and converting them into a visual format that healthcare professionals can analyse.

Types of Machines Used in Electrocardiography

Several machines are used to monitor heart activity, each serving different purposes. Common machines used in electrocardiography include:

Resting 12-Lead ECG – The standard ECG machine that uses 12 electrodes attached simultaneously to the chest, arms, and legs. This is often part of routine screenings, allowing for the detection of heart conditions sometimes before the onset of any symptoms.

Holter Monitor – A portable device worn by the patient for 24 to 48 hours to continuously record the heart's electrical activity. It provides a comprehensive view of heart function over an extended period.

Implantable Loop Recorder – A small device implanted under the skin to continuously monitor heart rhythms for up to three years. It is particularly useful for detecting infrequent arrhythmias that shorter-term monitoring might not capture.

Why Is an ECG Performed?

An electrocardiogram (ECG or EKG) is a crucial diagnostic tool used for a variety of purposes, such as:

To Look for the Cause of Chest Pain – An ECG can help determine if chest pain is due to a heart attack or other cardiac issues.

To Evaluate Problems That May Be Heart-Related – It investigates symptoms such as severe tiredness (fatigue), shortness of breath, dizziness, or fainting, which may indicate underlying heart conditions.

To Identify Irregular Heartbeats – The test helps detect arrhythmias and abnormalities in the heart's rhythm, which, if untreated, could lead to serious complications.

To Help Assess the Overall Health of the Heart – After procedures like heart surgery or cardiac catheterisation, an ECG can evaluate the heart's function and recovery progress.

ECG Tests Singapore

An electrocardiogram (ECG or EKG) is a non-invasive and pain-free test that requires no downtime. Hence, patients can resume their normal activities immediately after the test. Various types of ECG tests are available to diagnose and monitor heart conditions. Here is what you can expect during the ECG procedure.

Resting ECG

A resting electrocardiogram is performed while the patient rests. It is useful for detecting arrhythmias, myocardial infarctions, and other cardiac issues. During the test, the patient will be asked to lie down and relax while technicians attach electrodes to their chest, arms, and legs (some areas might be shaved for better contact). These electrodes connect to an ECG machine that records the heart's electrical activity for a few minutes. It is essential to stay still and refrain from talking to prevent any interference with the results. Once done, the electrodes are removed, and any remaining gel is wiped off.

Exercise ECG (Stress Test)

This type of ECG test records the heart's electrical activity during physical activities. It helps identify problems like exercise-induced arrhythmias or ischemia that may not be apparent at rest.

To prepare for the stress test, the patient will be advised to avoid food and caffeinated drinks for three hours beforehand. In some cases, the cardiologist may also advise to temporarily stop certain medications that could affect the results.

During the test, the patient exercises on a treadmill or stationary bike while an ECG monitors their heart rate. After the exercise, they will be asked to stand still briefly and then lie down as the doctor monitors the patient’s heart rate and breathing as they recover. The entire procedure typically takes about an hour.

Holter Monitor (Ambulatory ECG or EKG)

This test uses a portable device worn for 24 to 48 hours to continuously record the heart's activity. An ambulatory ECG is useful for detecting irregularities over an extended period that might be missed during a shorter test.

While wearing the Holter monitor, the patient will be asked to stick to their normal routine, but avoid strenuous exercise or heavy lifting. Bathing, swimming, and showering are also prohibited during the 24- or 48-hour period. To help analyse the recordings, the patient will be asked to keep a diary of their activities and record any heart symptoms like chest pain or palpitations.

ECG Results

Several key aspects are analysed during the interpretation of ECG results to diagnose heart conditions properly. These include:

Heart Rate – The ECG measures the number of heartbeats per minute. Tachycardia refers to a heart rate that is too fast, while bradycardia refers to a heart rate that is too slow.

Heart Rhythm – The rhythm should be regular and consistent between each heartbeat. Any irregularities could indicate arrhythmias or other cardiac issues.

Waveform Analysis – The ECG waveform includes various segments and intervals, representing the heart's electrical cycle phases. Each segment provides specific information about the heart's function.

Understanding Normal and Abnormal ECG Findings

Your cardiologist will assist in interpreting your ECG results, recommend further diagnostic tests (if needed) and determine the appropriate treatment plan if any abnormalities are detected.

Normal ECG Findings:

Regular heart rate and rhythm
Standard waveform shapes and intervals
No unusual spikes or dips in the waveform

Abnormal ECG Findings:

Arrhythmias: Irregular heart rhythms, such as atrial fibrillation
Myocardial Infarction: Indicated by specific changes in certain segments and waves
Electrolyte Imbalances: Causes abnormal changes in the ECG waveform
Heart Enlargement: Identified by unusually large or small waves

FAQs on Electrocardiography

An ECG records the heart's electrical activity to detect irregularities in rhythm and rate. In contrast, an echocardiogram uses ultrasound waves to create detailed images of the heart's structure and function, providing more information on heart anatomy and blood flow.

The cost of an ECG in Singapore can vary depending on the specific clinic or hospital, and whether the test is conducted in a public or private facility.

ECG tests are safe and non-invasive. Some patients may experience slight discomfort from the adhesive electrodes, but no major side effects are associated with the procedure.

Electrocardiography