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Having an Electrocardiogram

Why Does Your Doctor Schedule an EKG

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Updated June 06, 2008

Having an Electrocardiogram

Having an EKG

Photo © A.D.A.M.
As the life span of HIV positive people increases, certain illnesses and conditions are becoming of concern that just weren't an issue during the early years of the epidemic. As medications became better at slowing the destructive powers of HIV, people began to live longer. With these longer lives came new conditions that had to be dealt with. Experts are seeing evidence of this trend in the hearts of HIV-infected people. Heart disease is becoming a problem, even in younger men and women. One of the many ways to identify potential heart problems is to use of electrocardiogram or EKG.

Understanding the Heart

In order to understand EKGs, we have to understand a little about the heart. How does the heart work to pump blood to every tissue in the body?

Our heart is a muscle that pumps oxygen-rich blood to the tissues of the body; providing those tissues with the nourishment they need to function normally. Two chambers on the right side of the heart collect blood that has been depleted of oxygen. This blood is pumped to the lungs where it is re-oxygenated. This oxygen-rich blood is collected by two chambers on the left side of the heart and is then pumped throughout the body, nourishing the tissues and organs along the way.

With so much going on within the heart, one has to wonder how the heart coordinates the function of four separate chambers expanding and contracting in a very specific pattern. The key is the heart's electrical system; impulses that travel within heart muscle in a specific sequence, causing the coordinated contraction and relaxation of the chambers, pumping blood in the process.

What Is an EKG?

The electrocardiogram (EKG or ECG) is a recording of the electrical impulses within the heart. The electrical impulses are recorded as waves on a recording device, with peaks and valleys that change with each contraction and relaxation of the heart. A normal heart with normal electrical activity produces a very distinct EKG wave pattern.

In a heart that is abnormal in some way (one that has diminished blood flow, for example), the EKG pattern looks different than that of a normal heart. Specially trained nurses and doctors can look at the wave patterns and identify possible abnormalities of the heart. Changes in the electrical activity of the heart indicate abnormalities in heart function or structure. For instance, if the heart muscle's blood supply is compromised because of blood vessels narrowed by cholesterol, the heart muscle will die. This dead tissue no longer conducts electrical impulses, meaning the electrical impulses learn a new path. This new electrical path causes a change in the EKG pattern. Professionals that specialize in interpreting EKGs can identify these changes in EKG pattern and can in turn identify abnormalities of the heart.

Why Would I Need an EKG?

Simply put, an EKG is a simple and non-invasive test that can be used as a test to identify heart ailments. If you have been having chest pain, shortness of breath, or other symptoms that may be related to an abnormal heart, your doctor may order an EKG. Surgeons will often order an EKG to make sure you have a healthy heart prior to surgery. While most heart ailments require other, more invasive studies to be diagnosed, the EKG is a quick, simple way to start the diagnostic process.

Understanding Heart Disease

What Should I Expect?

An EKG is a very simple test that requires very little from you. From the time you lie flat on the table until the time you get up and put your shirt back on, an EKG will take between five and ten minutes. You should expect the following:

  • The EKG technician will ask you to remove your shirt or blouse. Women will have to take off their bra as well. Don't worry; EKG technicians will make certain your are fully covered to maintain your modesty.

  • Several areas on the chest, on each calf, and on each arm must be prepared for application of adhesive EKG electrodes to the skin. Men with hairy chests may have to have some of that hair shaved so the EKG electrodes will adhere to the skin.

  • One adhesive electrode is applied to each upper arm and calf. One electrode is positioned on each side of the sternum. The remaining 4 electrodes are positioned in an arc-like pattern that starts below the left nipple, passes under the left breast, and ends on the left side below the armpit. In all, 10 electrodes are applied to the skin.

  • Each electrode has an electrically conductive tab. Conductive cables are attached to each of the 10 electrode tabs with a metal clip. These 10 cables attach at the opposite end to the EKG machine. Because the electrodes and cables conduct electricity, electrical energy from the heart passes through the skin, the electrode tabs, the cables, and then to the EKG machine.

  • The electrodes are very sensitive to movement and electrical energy within the body. The technician will ask you to relax and lie very still in order to minimize "artifact" (electrical interference from muscle movement). By minimizing or eliminating artifact, the EKG printout will be a true representation of the heart's electrical activity. Artifact interferes with the EKG printout, making it less useful as a diagnostic tool.

  • The technician may print out more than one EKG. This is an attempt to get the best possible EKG and does not mean there is necessarily a problem with your heart.

  • After the best possible EKG with the least amount of artifact is printed, the electrodes and cables are removed and the test is completed.

What Happens After My EKG?

After your EKG is done, a cardiologist (heart doctor) will interpret your EKG. You will usually get the results of your EKG within a day or two, unless a serious problem is identified. In that case, you will be notified sooner and will likely be referred for more testing.

Source:

Dowshen, S.; EKG (Electrocardiography); The Nemours Foundation; Sept. 2007.

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