ECG and Heart Disease

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By Dr. Al Fazir Omar.

Consultant Cardiologist

Gleneagles Kuala Lumpur


What is ECG?

ECG or electrocardiogram is basically a window into your heart. It’s a very basic test that looks at the vectors or shape of your heart. It looks at the electrical activity of your heart. From ECG, we are able to detect hypertension, heart disease, congenital heart defects, hypertrophic obstructive cardiomyopathy (HOCM). It gives you a clue of what is going on. Everyone needs an ECG and it is very easy to do. It takes about 5-10 minutes for the ECG to be taken and it is not painful. We will place electrodes on the chest to record the heart rhythm. So, from the ECG, like I say, we can diagnose many things. It is a very basic test but an important test.

Could the ECG be normal but the heart is not? How accurate is ECG?

ECG is a very basic test. For example, in a heart disease with 70% blockage, you may or may not see it on the ECG. ECG is normally done while resting and the blood flow is still normal when you are resting. 

If someone comes in with chest pain or history of chest pain, then what we will do a stress test, or a stress ECG. During a stress ECG, the patient would get go on a treadmill, and the treadmill will go faster and faster which stresses the heart. When we say we stresses the heart, it means the heart is beating faster and the heart demands more oxygen. Because of the 70% blockage, that blockage now becomes significant and it might not keep up with the heart’s oxygen demand. This will create ECG changes when the patient is stressing on a treadmill that will help in diagnosing the blockage. The accuracy of a stress test is only 80%. To confirm or to be more certain, we will need the help of more advanced diagnostic tools such as the CT or MRI scans or even coronary angiogram. For example, you have this pattern changes that suggest that you have an enlargement or a thickening of the cardiac muscles then you have to do another test to validate the finding. 

Is there anything the public should know about ECG and Echocardiogram?

I think the main thing is for them is to just do it. I think the main thing for them is to do an ECG. As I have said, an ECG is like a frosted window. I do not expect the public to interpret the ECG but anytime they have palpitation or chest pain or even during routine check-up, they should go for an ECG. I would also recommend an ECHO. I mean ECG is good to capture most things but nowadays we got better technology that I think you should go for an ECG and an ECHO because ECG looks at your heart like a frosted window whereas ECHO is like a clearer window. 

Any advice to the public on heart health?

I think when we talk about heart diseases, it is like how you maintain your car engine as well. You have to look after your heart. I think we take it for granted. I think we probably look after our car better than our heart. We send our car for service every 5000 km but not many people check their condition of their heart. One should do a check-up at least once a year.

Cardiology

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