Normal ECG not indicative of healthy heart

Dr Mohd Ezam from the RIPAS Hospital Cardiology Division delivering a lecture on 'What is Normal ECG' at the annual ECG Workshop at The Empire Hotel and Country Club yesterday. Picture: BT/Low Leng May

Monday, December 19, 2011

A NORMAL electrocardiogram (ECG) does not necessarily indicate one is free from heart problem, said a cardiology expert yesterday.

Dr Mohmad Ezam Emran, from the Cardiology Division of Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, delivered a lecture "What is Normal ECG?" at the Annual ECG Workshop at The Empire Hotel and Country Club yesterday.

ECG is an "investigative tool" used to measure the electrical activity of the heart over a period of time, Dr Mohmad Ezam explained.

Electrical leads will be attached to the patients' body, predominantly on the chest, hands and legs, and the ECG will be recorded with an external device to the body.

"Normally, any diseases or any problems with the heart will give rise to electrical conduction of the heart and this will manifest in the ECG," he said.

However, Dr Mohmad Ezam pointed out that it is difficult to define a "normal ECG" as there is a large variation in the ECG signal, which is in the form of a graph.

"But there are a specific signs or specific markers in ECG that we look for which will point us towards a possibility of problem in the heart."

Although ECGs are generally very reliable, Dr Mohmad Ezam pointed out that there are instances where a normal ECG tracing "does not exclude and underlying or a significant cardiac problem".

"There are those instances where people may have major cardiac issues with a normal heart tracing," he told the paper, adding that ECGs are normally correlated with patients' clinical presentation and clinical examination findings to confirm their heart conditions.

"If they don't (correlate), then we will revisit or we will repeat the test or we will do other test modalities to look into these possibilities (of heart problems)."

Dr Mohmad Ezam added: "If your ECG is normal, and if you have no specific signs and symptoms then you can be rest assured the ECG is accurate."

Among the symptoms to look out for, he said, are chest pains, shortness of breath, or heart palpitation, which is an abnormal condition where one is conscious of their heartbeat, whether it is too fast, too slow or at its normal frequency.

ECG tests are not done as a routine of a medical check-up for diseases such as hypertension and diabetes, he said. "Studies have shown that in certain conditions, such as hypertension and diabetes, can predispose to underlying cardiac problem so that's why we do ECG in these people, also in medical fitness we do ECG."

"Nobody can escape heart disease it can occur in any age group."

Normally, people above 45 years old are most at risk of coronary artery disease, blockage of blood vessels to the heart that can lead to heart attack.

However, Dr Mohmad Ezam pointed out that younger people may also be at risk if they have structural problems with the heart such as problems with the heart valve, or holes in the heart as they can occur in any age group.

The Brunei Times