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An electrocardiogram (EKG) test is a simple, painless, and quick test that records your heart’s electrical activity. Each time your heart beats, an electrical signal travels through your heart. The signal triggers your heart’s four chambers to contract (squeeze) in the proper rhythm so that your heart can pump blood to your body.

An EKG recording of these signals looks like wavy lines. Your provider can read these lines to look for abnormal heart activity that may be a sign of heart disease or damage.

An EKG can show:

  • How fast your heart is beating
  • Whether the rhythm of your heartbeat is steady or irregular
  • The strength and timing of the electrical signals passing through each part of your heart

Sometimes information from an EKG can help measure the size and position of your heart’s chambers.

An EKG is often the first test you’ll have if you have signs of a heart condition. It may be done in your provider’s office, an outpatient clinic, in a hospital before surgery, or as part of another heart test called a stress test.

An EKG test is also called an ECG. EKG is based on the German spelling, elektrokardiogramm. EKG may be preferred over ECG to avoid confusion with an EEG, a test that measures brain waves.

Other names: ECG test, Holter monitor, ambulatory electrocardiography, continuous electrocardiograms, transtelephonic event monitors

What is it used for?

An EKG test is used to help diagnose and monitor many types of heart conditions and their treatment. These conditions include:

  • Arrhythmia
  • Cardiomyopathy
  • Coronary artery disease
  • Heart attack
  • Heart failure
  • Heart valve diseases
  • Congenital heart defects

EKG tests are mainly used for people who have symptoms of a heart condition or have already been diagnosed with a heart condition. They are not generally used to screen people who don’t have symptoms unless they have an increased risk of developing heart disease. Your provider can explain your risk for heart disease and let you know if need to have an EKG test. In certain cases, your provider may have you see a cardiologist, a doctor who specializes in heart diseases.

Why do I need an EKG test?

You may need an EKG test if you have symptoms of a heart condition, including:

  • Chest pain
  • Rapid or irregular heartbeat
  • Shortness of breath
  • Dizziness
  • Fatigue
  • A decrease in your ability to exercise

You may also need an EKG to:

  • Find out if you had a heart attack in the past but didn’t know it
  • Monitor your heart if you have a known heart condition
  • Check how well your heart treatment is working, including medicine and/or a pacemaker
  • Check your heart health:
    • Before having surgery
    • If you have an increased risk for developing heart disease because:
      • Heart disease runs in your family
      • You have another condition, such as diabetes, that makes your risk higher than normal

      What happens during an EKG test?

      An EKG test only takes a few minutes. It generally includes these steps:

      • You will lie on an exam table.
      • A provider will place several electrodes (small sensors that stick to your skin) on your arms, legs, and chest. The provider may need to shave body hair to make sure the electrodes stay on.
      • The electrodes are attached by wires to a computer or a special EKG machine
      • You will lie very still while your heart’s electrical activity is recorded on a computer or printed on paper by an EKG machine.

      Will I need to do anything to prepare for the test?

      You don’t need any special preparations for an EKG test.

      Are there any risks to the test?

      There is very little risk to having an EKG. You may feel a little discomfort or skin irritation after the electrodes are removed. The EKG doesn’t send any electricity to your body. It only records electrical signals from your heart, so there’s no risk of electric shock.

      What do the results mean?

      Your provider will check your EKG results for a steady heartbeat and rhythm. If your results are not normal, it may be a sign of a heart condition. The specific condition depends on which part of your EKG wasn’t normal.

      You may need to have other heart health tests before your provider can make a diagnosis. Your provider can explain what your test results mean for your heart health and treatment.

      Is there anything else I need to know about an EKG?

      An EKG is a “snapshot” of your heart’s activity over a very short time. If you have heart symptoms that come and go, a regular EKG may not catch the problem. In that case, your provider may recommend that you wear a small portable EKG monitor that can record your heart for days or longer while you do your normal activities. You may also need a longer EKG recording if your provider wants to check how well your heart is working after a heart attack or to see if treatment is helping you.

      There are many types of long-term EKG monitors. The two main groups are Holter monitors, which can be worn for up to two days, and event monitors, which may record your heart activity for weeks to years depending on the type.

      A Holter monitor is about the size of a small camera. You usually wear it on a belt or strap around your neck for a day or two. Wires under your clothes attach to electrodes that stick to your chest. The monitor records your heart’s electrical signals the whole time you’re wearing it. You may be asked to keep a diary of your symptoms during the test period. After the test period, you remove the monitor and return it according to the instructions. A provider will review the recording of your heart’s electrical activity from the monitor.

      An event monitor records your heart’s electrical activity when you press a button or when the device detects abnormal heart activity. There two main types of event monitors:

      • Event monitors that you wear or carry with you. You wear some monitors on your chest or wrist. Other monitors are designed to carry. If you have symptoms, you hold the monitor to your chest. These event monitors may be used for weeks to months. Some of them wirelessly transmit information about your heart to a provider. Others must be returned so a provider can examine the recorded information.
      • Event monitors that are inserted under the skin of your chest. These are called implantable event monitors. They are put under your skin during minor surgery that’s often done in a doctor’s office. These monitors can track your heart’s electrical activity for years. You may need this type of EKG monitor if you had a stroke or frequent fainting, and your provider hasn’t found the cause. Implantable monitors wirelessly transmit the information they record so your provider can regularly check it.