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Diagnonistic Test

Venous Ultrasound of Upper & Lower Extremity Arterial Doppler Studies

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Introduction:
The Arterial Doppler ultrasound uses sound waves at a frequency that is higher than humans are able to hear to produce images on a monitor for the purpose of evaluating the arterial blood flow to the upper extremities (arms) and lower extremities (legs).

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This type of ultrasound shows if there is a blockage in arm orĀ  leg vein. Such blockages are usually caused by blood clots, which can be dangerous and even lifethreatening if they break loose and travel through the blood to the lungs. If you have pain or swelling in one leg, your doctor may order an ultrasound to determine whether your symptoms are caused by a blockage.

It is used to evaluate:
*Numbness and tingling sensations in the hands, arms, feet and legs
*Sensation of fatigue and heaviness in the arms and legs
*To investigate the possibility of thoracic outlet syndrome.

Procedure:

For the Arterial Doppler exam a blood pressure cuff is applied to each of the arms and legs and a pressure is recorded for each extremity cuff. The pulse is also taken and recorded for each of the extremities. The patient may then be exercised and blood pressure recordings repeated or an ultrasound may be performed to assess the arteries for the location and the amount of narrowing.

When evaluating for thoracic outlet syndrome of the upper extremities, the patient will be asked to perform a series of arm movements while recordings are documented.

The Arterial Doppler studies take approximately 60-90 minutes.

After squirting some clear jelly onto the inside of one of your arms or thighs to help the ultrasound sensor slide around easily, a technician or doctor places the sensor against your skin. Once it’s in place, an image appears on a video screen, and the technician or doctor moves the sensor up and down along your leg – from the groin to the calf – to view the veins from different angles. The examiner presses the sensor into your skin firmly every few inches to see if the veins change shape under pressure. He or she then checks your other leg in the same way. As the machine measures the blood flowing through a vein, it makes a swishing noise in time with the rhythm of your heartbeat. This test usually takes 15-30 minutes.Most people don’t feel any discomfort, but if your leg was swollen and sensitive to the touch before the test, the pressure of the sensor might cause some tenderness.

How do You prepare for the test? No preparation is necessary.

Risk Factors: There are no risks
How long is it before the result of the test is known?
A radiologist reviews a videotape of your ultrasound and checks for signs of blockages in the veins.Your doctor should receive a report within a few hours to a day.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/venous-ultrasound-of-the-legs.shtml
http://www.advanceddiagnosticimagingpc.com/vascular/extremity.htm

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Diagnonistic Test

Holter Monitor

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Alternative Names : Ambulatory electrocardiography; Electrocardiography – ambulatory

Definition
A Holter monitor is a machine that continuously records the heart’s rhythms. The monitor is usually worn for 24 – 48 hours during normal activity.It is a portable EKG device that records your heart rhythm over time, outside the hospital or doctor’s office.Whereas a regular EKG examines your heart’s electrical activity for a few minutes, the Holter monitor examines changes over a sustained period of time-usually a 24- to 48-hour period-while you go about your daily activities and even while you sleep. Doctors use it to evaluate symptoms that come and go and that might be related to heart-rhythm changes.

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How the Test is Performed ?
Electrodes (small conducting patches) are stuck onto your chest and attached to a small recording monitor. You carry the Holter monitor in a pocket or small pouch worn around your neck or waist. The monitor is battery operated.

While you wear the monitor, it records your heart’s electrical activity. You should keep a diary of what activities you do while wearing the monitor. After 24 – 48 hours, you return the monitor to your doctor’s office. The doctor will look at the records and see if there have been any irregular heart rhythms.

It is very important that you accurately record your symptoms and activities so that the doctor can match them with your Holter monitor findings.
Why the Test is Performed ?
Holter monitoring is used to determine how the heart responds to normal activity. The monitor may also be used:

*After a heart attack
*To diagnose heart rhythm problems
*When starting a new heart medicine

It may be used to diagnose:
*Atrial fibrillation/flutter
*Multifocal atrial tachycardia
*Palpitations
*Paroxysmal supraventricular tachycardia
*Reasons for fainting
*Slow heart rate (bradycardia)
*Ventricular tachycardia

What happens when the test is performed?
A technician in your doctor’s office or a diagnostic lab fits you with a Holter monitor and explains how to use it. Five stickers are attached to your chest.Wires snap onto each of these stickers and connect them to the monitor. The wires detect your heart’s electrical pattern throughout the day, while the monitor records and stores the data for doctors to interpret later. You can fit the monitor into a purse or jacket pocket or wear it over your shoulder by its strap.

You can go about your normal activities with two exceptions. First, you can’t take a shower or bath during the period that you’re wearing the monitor. Second, you are given a small diary in which to note any worrisome symptoms you feel and record the time when they occur. The doctor will later review both your diary and the data about your heart’s activity from the monitor, to see if any symptoms you experienced were caused by some underlying heart problem. There are no side effects from the testing.
How to Prepare for the Test ?
There is no special preparation for the test. Your doctor will start the monitor. You’ll be told how to replace the electrodes should they fall off or become loose.

Tell your doctor if you are allergic to any tape or other adhesives. Make sure you shower or bathe before you start the test. You will not be able to do so while you are wearing a Holter monitor

Men with a lot of hair on their chest will probably have to shave it.

How the Test Will Feel?
This is a painless test. However, some people may need to have their chest shaved so the electrodes can stick.

You must keep the monitor close to your body. This may make sleeping difficult for some people.

You should continue your normal activities while wearing the monitor.

Risk Factors:
There are no risks.However, you should be sure not to let the monitor get wet.

MustĀ  you do anything special after the test is over?
You need only return the Holter monitor.

Normal Results:-
Normal variations in heart rate occur with activities. A normal result is no significant changes in heart rhythms or pattern.

What Abnormal Results Mean?
Abnormal results may include various arrhythmias. Changes may mean that the heart is not getting enough oxygen.

The monitor may also detect conduction block, a condition in which the atrial electrical activity is either delayed or does not continue into the ventricles of the heart.

How long is it before the result of the test is known?
It usually takes a few days for your recording to be printed out and examined.

Considerations :-
Electrodes must be firmly attached to the chest so the machine gets an accurate recording of the heart’s activity.

While wearing the device, avoid:
*Electric blankets
*High-voltage areas
*Magnets
*Metal detectors

It is very important for you to keep a diary of symptoms. The diary should include the date, time of day, type, and duration of symptoms.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/holter-monitor.shtml
http://www.nlm.nih.gov/MEDLINEPLUS/ency/imagepages/8810.htm
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/003877.htm

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Diagnonistic Test

Exercise Stress Test Or Treadmill Test(TMT)

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The exercise stress test, also known as the treadmill test or exercise tolerance test, indicates whether your heart gets enough blood flow and oxygen when it’s working its hardest, such as during exercise. Often, stress tests are given to people with chest pain or other symptoms who appear to have coronary artery disease, based on a medical exam and EKG. In addition, these tests are sometimes used for other purposes, from assessing the effectiveness of heart disease treatment to gauging the safety of a proposed exercise program.
……….click to see the picture
Stress tests are among the best tools for diagnosing heart disease, and some research suggests that they may also be useful in estimating disease risk in people who don’t have symptoms but have risk factors such as high cholesterol. If you are over age 40 and are at risk for coronary artery disease because you smoke or have high blood pressure or other risk factors, ask your doctor if you should have this test.

Preparing for the Regular Stress Test:
The following recommendations are “generic” for all types of cardiac stress tests:

*Do not eat or drink for three hours prior to the procedure. This reduces the likelihood of nausea that may accompany strenuous exercise after a heavy meal. Diabetics, particularly those who use insulin, will need special instructions from the physician’s office.

*Specific heart medicines may need to be stopped one or two days prior to the test. Such instructions are generally provided when the test is scheduled.

*Wear comfortable clothing and shoes that are suitable for exercise.

*An explanation of the test is provided and the patient is asked to sign a consent form.

*Wear comfortable, loose-fitting clothing and athletic shoes. Let the doctor performing the test know if you think that you won’t be able to walk on a treadmill for any health reason, such as arthritis. Also let the doctor know if you have diabetes; since exercise can lower blood sugar, he or she may want to check your blood sugar level before the test begins, to be sure it is not too low (see “Diabetes alert,” below). It’s also important to tell the doctor or other health professional in the testing room if you’ve had any chest pain or pressure on the day of the test. Try to avoid eating a large meal right before the test, which could make exercising uncomfortable.

Total timing isĀ  approximately one hour for the entire test, including the preparation.

What happens when the test is performed?
First you have an EKG both while lying down and standing up. Your blood pressure is taken. Several plasticcoated wires, or leads, are taped to your arms and one leg so that your heart’s electrical pattern can be detected while you exercise.Your blood pressure and heart rate also are monitored during the test. You are asked to walk on a treadmill for about 10 minutes. The speed and steepness of the treadmill will increase several times while you exercise. Let the person who is monitoring you know immediately if you feel chest pain or heaviness, shortness of breath, leg pain or weakness, or other unusual symptoms, or if you think you can’t continue exercising.After the exercise period is completed, your blood pressure will be checked again.

A variation of this test uses a radionuclide to visualize parts of the heart that are not getting enough blood. This test is called either an exercise-thallium test or exercise-MIBI test (depending on the radionuclides used). If you have this test, you will probably need to repeat it on a day when you have not been exercising hard, for the sake of comparison.

An exercise stress test strongly suggests coronary artery disease if walking on the treadmill produces symptoms such as chest discomfort, shortness of breath, or dizziness, and these symptoms are accompanied by EKG changes that indicate inadequate blood flow to parts of the heart. A test is considered normal if you can perform a normal amount of exercise without symptoms or EKG changes. Many people have chest discomfort but no EKG changes, or vice versa. In these cases, the exercise test is of less help, and the result will be interpreted as consistent with coronary artery disease, but not conclusive. Further testing may then be required.

Must you do anything special after the test is over?
If your blood pressure becomes unusually high, or if it suddenly drops during exercise, a nurse will recheck your blood pressure a few minutes after the test and may continue to monitor your EKG. If you develop chest pain, you might be given some nitroglycerin tablets to relieve the pain and lower the demand on your heart by dilating your blood vessels.

What is the reliability of a Regular Stress Test?

If a patient is able to achieve the target heart rate, a regular treadmill stress test is capable of diagnosing important disease in approximately 67% or 2/3 rd of patients with coronary artery disease. The accuracy is lower (about 50%) when patients have narrowing in a single coronary artery or higher (greater than 80%) when all three major arteries are involved. Approximately 10% of patients may have a “false-positive” test (when the result is falsely abnormal in a patient without coronary artery disease).

How quickly will you may get the results and what will it mean?

The physician conducting the test will be able to give you the preliminary results before you leave the exercise laboratory. However, the official result may take a few days to complete. The results of the test may help confirm or rule out a diagnosis of heart disease. In patients with known coronary artery disease (prior heart attack, known coronary blockages, previous treatment with angioplasty, stents or bypass surgery, etc.), the study will help confirm that the patient is in a stable state, or that a new blockage is developing. The results may influence your physician’s decision to change your treatment or recommend additional testing such as cardiac catheterization, Echo Stress test, or a nuclear stress test.

Risk Factors:
The risk of the stress portion of the test is very small and similar to what you would expect from any strenuous form of exercise (jogging in your neighborhood, running up a flight of stairs, etc.). As noted earlier, experienced medical staff is in attendance to manage the rare complications like sustained irregular heart beats, unrelieved chest pain or even a heart attack.

If you have cardiac disease, you might develop chest pain during the test. Because this is a sign that your heart isn’t getting enough oxygen and could be in danger of damage, it’s important that you alert the medical staff immediately so that the test can be stopped. While many people worry that an exercise stress test could be dangerous to someone with heart disease, it is extremely safe if doctors examine patients beforehand to make sure that they are healthy enough for it.

How long is it before the result of the test is known?
It usually takes several days for the doctor to completely evaluate the printout of your heart’s electrical pattern.

Resources:
http://www.heartsite.com/html/regular_stress.html
https://www.health.harvard.edu/fhg/diagnostics/exercise-stress-test.shtml

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Diagnonistic Test

Electrophysiological Testing of the Heart

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Definition:
An electrophysiology (EP) study is a test that records the electrical activity and the electrical pathways of your heart. This test is used to help determine the cause of your heart rhythm disturbance and the best treatment for you. During the EP study, your doctor will safely reproduce your abnormal heart rhythm and then may give you different medications to see which one controls it best or to determine the best procedure or device to treat your heart rhythm.
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Sometimes doctors will recommend a treatment called ablation that can be done during EPS testing. Ablation uses electricity to kill the cells in the heart muscle that seem to cause the abnormal rhythm.

You may click to see:->Electrophysiology Study

 

Why Do you Need an Electrophysiology Study?
*To determine the cause of an abnormal heart rhythm.

*To locate the site of origin of an abnormal heart rhythm.

*To decide the best treatment for an abnormal heart rhythm.

Sometimes an EP study is conducted before implantable cardioverter/defibrillator (ICD) placement to determine which device is best and afterwards to monitor treatment success.

How do you prepare for the test?
*You will need to sign a consent form giving your doctor permission to perform this test. Tell your doctor if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist’s office. Also tell your doctor if you have ever had an allergic reaction to any heart medicines.

*Talk with your doctor ahead of time if you are taking insulin, or if you take aspirin, nonsteroidal antiinflammatory drugs, or other medicines that affect blood clotting. It may be necessary to stop or adjust the dose of these medicines before your test. Most people need to have a blood test done some time before the procedure to make sure they are not at high risk for bleeding complications.

*Your doctor may tell you not to eat anything for 12 or more hours before the test. A few people require an anti-anxiety medicine which occasionally causes nausea, and therefore some doctors prefer to have you come with an empty stomach. You might need to plan to spend the night in the hospital afterwards for recovery.

*Ask your doctor what medications you are allowed to take. Your doctor may ask you to stop certain medications one to five days before your EP study. If you have diabetes, ask your doctor how you should adjust your diabetes medications.

*Do not eat or drink anything after midnight the evening before the EP study. If you must take medications, take them only with a small sip of water.

*When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home.

*Your doctor will tell you if you can go home or must stay in the hospital after the procedure. If you are able to go home, bring a companion to drive you home.

What happens when the test is performed?
The test is done by a specialist using equipment and cameras in the cardiology department. You wear a hospital gown and lie on your back during the procedure. You have an IV (intravenous) line placed in a vein in case you need medicines or fluid during the procedure. Your heart is monitored during the test.

A catheter (a hollow, sterile tube that resembles spaghetti) is inserted through the skin into a blood vessel-typically in your groin, but possibly in the neck or arm. Before the catheter is placed, medicine through a small needle is used to numb the skin and the tissue underneath the skin in that area. The numbing medicine usually stings for a second. A needle on a syringe is then inserted, and some blood is drawn into the syringe, so that the doctor knows exactly where the blood vessel is located. One end of a wire is threaded into the blood vessel through the needle and the needle is pulled out, leaving the wire temporarily in place. This wire is several feet long, but only a small part of it is inside your blood vessel. The catheter can then be slipped over the outside end of the wire and moved forward along it like a long bead on a string, until it is in place with one end inside the blood vessel. The wire is pulled out of the catheter, leaving the catheter in place. Now the catheter can be moved easily forwards and backwards inside your blood vessel by the doctor, who holds the outside end of the catheter while using special controls to point the tip of the catheter in different directions. The doctor carefully moves the catheter to the large blood vessels in your chest and into the chambers of your heart.

As your physician maneuvers the catheter, he or she watches a live video x-ray to know exactly where the catheter is. Instruments on the tip of the catheter allow it to sense electrical patterns from your heart and also to deliver small electrical shocks to the heart muscle (or a stronger electrical burn if you are having ablation). The electrical shocks, too small for you to feel, are used to “tickle” the heart muscle in different places to see if your abnormal rhythm is triggered by one sensitive area of your heart. If the rhythm changes, your doctor gives you small doses of different medicines through this catheter to see which ones work best to change the rhythm back to normal. In some cases the doctor may need to give your heart some additional mild shocks to get it back into a normal rhythm. Because this catheter is in place inside your heart and can give the shocks directly to the heart muscle, very small amounts of electricity are used.

After the catheter has been pulled out, a pressure bandage (basically a thick lump of gauze) is taped tightly to your groin to reduce bleeding. The test usually requires one to two hours to perform.

Many patients are able to feel palpitations (an irregular or fast heartbeat) from the rhythm changes. A few patients also experience shortness of breath or dizziness when they are not in a normal heart rhythm. Other than the brief sting of the numbing medicine and some soreness in your groin area afterward, you are not likely to feel any pain. For some people, the procedure provokes anxiety. Some patients also have a difficult time lying still for the time it takes to perform this test.
What Can you Expect During the Electrophysiology Study?
*You will lie on a bed and the nurse will start an intravenous (IV) line into your arm or hand. This is so you can receive medications and fluids during the electrophysiology study. You will be given a medication through your IV to relax you and make you drowsy, but it will not put you to sleep.

*The nurse will connect you to several monitors.
Your groin will be shaved and cleansed with an antiseptic solution. Sterile drapes are used to cover you, from your neck to your feet. A soft strap will be placed across your waist and arms to prevent your hands from coming in contact with the sterile field.

An electrophysiologist (a doctor who specializes in the diagnosis and treatment of abnormal heart rhythms) will numb your groin with medication and then insert several catheters into the vein in your groin. Guided by the fluoroscopy machine, the catheters are threaded to your heart. The catheters sense the electrical activity in your heart and are used to evaluate your heart’s conduction system. The doctor will use a pacemaker to deliver the electrical impulses through one of the catheters to increase your heart rate.

You may feel your heart beating faster or stronger. Your nurses and doctor will want to know about any symptoms you are feeling. If your arrhythmia occurs, your doctor may give you medications through your IV to test their effectiveness in controlling it. If necessary, a small amount of energy may be delivered by the patches on your chest to bring back a normal heart rhythm. Based on the information collected during the study, the doctor may continue with an ablation procedure or device implant (pacemaker or ICD).

The EP study takes about two to four hours to perform. However, it can take longer if additional treatments such as catheter ablation are performed at the same time.

Risk Factors:
There are significant risks from this procedure. Most important, some abnormal heart rhythms (arrhythmia) can be life-threatening, and your doctors will purposefully cause you to go through a few extra episodes of arrhythmia during the testing. If your doctors recommend electrophysiologic testing, they feel that this is a risk worth taking because it will allow them to take better care of you in the future. Because you are right in the lab and attached to a monitor while you undergo the rhythm changes, it is easy for them to treat you should your arrhythmia occur and cause you symptoms.

Ablation has some additional risks, because it intentionally causes some scarring of a small part of the heart muscle. Complications are rare, but new rhythm changes can occur. A very rare complication occurs if the ablation instrument burns a hole through the heart muscle. This causes bleeding and may require immediate surgery.

There are some more minor risks from the test. Among them is bleeding from the place where the catheter was inserted. If bleeding occurs but the blood collects under the skin, it can form a large painful bruise called a hematoma. A few people are allergic to the medicines used in the procedure, and this can cause a rash or other symptoms.

Must you do anything special after the test is over?
You will need to lie flat for around six hours after this procedure. If you received anti-anxiety medicine through your IV during the procedure, you might feel sleepy at the end of the procedure and you might not remember much of the test. You should not drive or drink alcohol for the rest of the day.

Depending on what happened during your test, you might need to wear a heart monitor in the hospital for a few hours or overnight.

What Happens After the EP Study?
The doctor will remove the catheters from your groin and apply pressure to the site, to prevent bleeding. You will be on bed rest for about one to two hours.

An EP study can be frightening, but this test allows the doctor to decide the best treatment for you. In many cases, EP testing and the therapy following can greatly reduce the likelihood of spontaneous arrhythmia. If you have any questions, do not hesitate to ask your doctor or nurse.

How long is it before the result of the test is known?
Your doctors can tell you how the testing went as soon as it is over. If you had ablation done, the results will not be certain until you have had some time to see if your arrhythmia seems to be under control after the treatment.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/electrophysiological-testing-of-the-heart.shtml
http://www.webmd.com/heart-disease/guide/diagnosing-electrophysiology

http://www.londoncardiac.ca/pages/bfs.html

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Diagnonistic Test

Electrocardiogram (ECG)

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Definition:
An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart’s electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves. See a picture of the EKG components and intervals.

The heart is a muscular pump made up of four chambers. The two upper chambers are called atria, and the two lower chambers are called ventricles. A natural electrical system causes the heart muscle to contract and pump blood through the heart to the lungs and the rest of the body. See a picture of the heart and its electrical system.

The coordinated pumping of your heart is controlled by natural electrical currents within the heart. An EKG (sometimes referred to as ECG) measures those currents. An EKG is especially useful for diagnosing heart attacks and rhythm abnormalities, but it can also provide many clues about other conditions.You should have an EKG every one to three years after age 40 if you have heart disease; if you are at risk for developing it because you have high blood pressure, high cholesterol, or diabetes; or if you are about to start a vigorous exercise program.

Why It Is Done
An electrocardiogram (EKG or ECG) is done to:

*Check the heart’s electrical activity.

*Find the cause of unexplained chest pain, which could be caused by a heart attack, inflammation of the sac surrounding the heart (pericarditis), or angina.

*Find the cause of symptoms of heart disease, such as shortness of breath, dizziness, fainting, or rapid, irregular heartbeats (palpitations).

*Find out if the walls of the heart chambers are too thick (hypertrophied).

*Check how well medicines are working and whether they are causing side effects that affect the heart.

*Check how well mechanical devices that are implanted in the heart, such as pacemakers, are working to control a normal heartbeat.

*Check the health of the heart when other diseases or conditions are present, such as high blood pressure, high cholesterol, cigarette smoking, diabetes, or a family history of early heart disease.

Click to see the pictures

How To Prepare
Many medicines may change the results of this test. Be sure to tell your doctor about all the nonprescription and prescription medicines you take. If you take heart medicines, your doctor will tell you how to take your medicines before you have this test.

Remove all jewelry from your neck, arms, and wrists. Men are usually bare-chested during the test. Women may often wear a bra, T-shirt, or gown. If you are wearing stockings, you should take them off. You will be given a cloth or paper covering to use during the test.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will indicate. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?) .

If you have a hairy chest, a nurse might have to shave several patches so that the stickers or suction cups used in the test can hold to your skin.

…….…Click to see the picture

The electrocardiogram (ECG, EKG) is used extensively in the diagnosis of heart disease, from congenital heart disease in infants to heart attack (myocardial infarction) and myocarditis (heart inflammation) in adults.
.How It Is Done
An electrocardiogram (EKG or ECG) is usually done by a health professional, and the resulting EKG is interpreted by a doctor, such as an internist, family medicine doctor, electrophysiologist, cardiologist, anesthesiologist, or surgeon.

You may receive an EKG as part of a physical examination at your health professional’s office or during a series of tests at a hospital or clinic. EKG equipment is often portable, so the test can be done almost anywhere. If you are in the hospital, your heart may be continuously monitored by an EKG system; this process is called telemetry.

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How do you feel During an EKG:
*You will lie on a bed or table. Areas on your arms, legs, and chest where small metal discs (electrodes) will be placed are cleaned and may be shaved to provide a clean, smooth surface to attach the electrode discs. A special EKG paste or small pads soaked in alcohol may be placed between the electrodes and your skin to improve conduction of the electrical impulses, but in many cases disposable electrodes are used that do not require paste or alcohol.

*Several electrodes are attached to the skin on each arm and leg and on your chest. These are hooked to a machine that traces your heart activity onto a paper. If an older machine is used, the electrodes may be moved at different times during the test to measure your heart’s electrical activity from different locations on your chest. After the procedure, the electrode paste is wiped off.

*You will be asked to lie very still and breathe normally during the test. Sometimes you may be asked to hold your breath. You should not talk during the test.

*The electrodes may feel cool when they are put on your chest.

Risk Factors:
There is no chance of problems while having an electrocardiogram (EKG or ECG). An EKG is a completely safe test.The machine is measuring natural electrical activity in your body; it is not sending electricity into you. In most cases, there is no reason why you should not be able to get an EKG.

The electrodes are used to transfer an image of the electrical activity of your heart to tracing on paper. No electricity passes through your body from the machine, and there is no danger of getting an electrical shock.
Must you do anything special after the test is over?
Nothing.

Results:
An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart’s electrical activity into line tracings on paper. The spikes and dips in the line tracings are called waves.

The test usually takes 5 to 10 minutes to complete.

Your doctor will look at the pattern of spikes and dips on your electrocardiogram to check the electrical activity in different parts of your heart. The spikes and dips are grouped into different sections that show how your heart is working. See a picture that explains the EKG components and intervals.
How long is it before the result of the test is known?
The EKG must be reviewed by a trained professional. Your doctor can interpret an EKG right away.However, if a technician is taking the EKG and your doctor is not present, it may be one to three days before there is an official interpretation by a cardiologist.
Normal: The heart beats in a regular rhythm, usually between 60 and 100 beats per minute.

The tracing looks normal.

Abnormal: The heart beats too slow (less than 60 beats per minute).

The heart beats too fast (more than 100 beats per minute).

The heart rhythm is not regular.

The tracing does not look normal.

What Affects the Test:
Reasons you may not be able to have the test or why the results may not be helpful include:

*Not having the electrodes securely attached to your skin.

*Moving or talking during the test.

*Exercising before the test.

*Being anxious or breathing very deeply or rapidly.

What To Think About:-
*Sometimes your EKG may look normal even when you have heart disease. For this reason, the EKG should always be interpreted along with your symptoms, history, physical examination, and, if necessary, other test results.

*An electrocardiogram cannot predict whether you will have a heart attack.

*At first, an EKG done during a heart attack may look normal or unchanged from a previous EKG. Therefore, the EKG may be repeated over several hours and days (called serial EKGs) to look for changes.

*There are several other types of electrocardiograms, including telemetry, ambulatory monitoring (using a Holter monitor or event monitor), and exercise EKG testing. For more information, see the medical tests Ambulatory Electrocardiogram and
*Exercise Electrocardiogram.

*Sometimes EKG abnormalities can be seen only during exercise or while symptoms are present. To check for these changes in the heartbeat, an ambulatory EKG or stress EKG may be done.

*An ambulatory EKG is a type of portable, continuous EKG monitor. For more information, see the medical test Ambulatory Electrocardiogram.

*A stress EKG is a type of EKG done during exercise. A resting EKG is always done before an exercise EKG test, and results of the resting EKG are compared to the results of the exercise EKG. A resting EKG may also show a heart problem that would make an exercise EKG unsafe. For more information, see the medical test Exercise Electrocardiogram.

*Some doctors think that people older than age 35 need a baseline EKG before problems develop. This baseline EKG may be compared to later EKGs to see if changes have occurred. But a baseline EKG is expensive and may not be covered by insurance.
*Baseline EKGs may be most useful in people who have other conditions or diseases that increase their chances of having heart disease.

You may click to learn more in detail about electrocardiogram
Resources:
https://www.health.harvard.edu/fhg/diagnostics/electrocardiogram.shtml
http://www.webmd.com/heart-disease/electrocardiogram
http://adam.about.com/reports/ECG.htm

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