ECG often known as Electrocardiogram or EKG in many of the instances can diagnose a coronary heart assault and helps decide the correct remedy relying on the kind of coronary heart assault. The medical take a look at data {the electrical} exercise of the center. The coronary heart produces electrical impulses that regulate its rhythm and coordinate the contraction of its totally different chambers. An ECG measures and graphically represents these electrical indicators. However, there are occasions when ECG fails to detect a heart attack and many individuals could consider that their coronary heart assault signs may very well be resulting from another purpose and fail to get the required remedy. (Also learn: Cardiologists on why doctors could be at higher risk of heart attack; suggest heart care tips)
Noted heart specialist Dr Gaurav Gandhi who died of coronary heart assault on Tuesday morning had felt chest discomfort at 2 am and acquired an ECG completed which got here regular; Dr Gandhi mistook the signs as acidity and took an injectable for a similar, reported Indian Express. After staying within the hospital for a while, he went again dwelling and was discovered collapsed on the toilet ground at 6 am within the morning.
"Yes. Whenever a patient comes in with an emergency of a heart attack 70% of the time, the initial ECG is not normal, but in 30% cases the ECG can be normal. So, the patient thinks that they are normal and that they can go home. But that is not the case. Patients who have critical blocks in the blood vessels of the heart or patients with major heart attacks can have a normal ECG when the report to hospital for the first time. ECG must be repeated in regular intervals every 15-30 minutes for up to 2-3 hours after the initial attack. The patient should stay in the hospital for the repeat ECGs and other necessary investigations like ECHO and blood tests. Sometimes all may be normal and only coronary angiogram can reveal a critical lesion in a patient with chest pain," says Dr. V. Vinoth Kumar, Senior Consultant Interventional Cardiologist, CARE Hospitals, Hi-Tec City, Hyderabad.
"During a heart attack, also known as myocardial infarction, the blood supply to a part of the heart is severely reduced or completely blocked. This blockage usually occurs due to a blood clot that forms in a coronary artery. An electrocardiogram (ECG) is a medical test used to measure the electrical activity of the heart and can be a valuable tool in diagnosing a heart attack. However, it is possible for an ECG to appear normal during a heart attack in some cases," says Dr. Dixit Garg, Consultant - cardiology, Manipal Hospital, Gurugram.
Dr Garg explains that in lots of situations of a coronary heart assault, the ECG will present attribute adjustments that point out an issue and these adjustments could embody ST-segment elevation, ST-segment melancholy, or the looks of irregular Q-waves. These abnormalities on the ECG counsel {that a} coronary heart assault is going on or has lately occurred.
"However, there are situations where an ECG can be normal during a heart attack. This phenomenon is more likely to occur in the early stages of a heart attack or in certain circumstances," he provides.
Dr Garg lists the explanation why an ECG could seem regular throughout a coronary heart assault embody,
Timing: The ECG could also be carried out through the preliminary levels of a coronary heart assault when the adjustments on the ECG could not have totally developed but. It takes time for {the electrical} adjustments to grow to be obvious on the ECG.
Location: The ECG leads might not be positioned accurately to detect the precise space of the center affected by the center assault. Depending on the situation of the blockage, the adjustments on the ECG could also be refined or not current within the leads being monitored.
Silent coronary heart assault: Some coronary heart assaults could also be 'silent' or 'asymptomatic,' which means the particular person doesn't expertise the everyday signs of a coronary heart assault. In these instances, the ECG could also be regular, or the adjustments could also be so refined that they don't seem to be simply detectable.
Coronary artery collateral circulation: In uncommon situations, an individual could have developed different blood provide pathways referred to as collateral vessels, which may present some blood circulate to the affected space of the center. This collateral circulation will help keep the ECG inside regular limits regardless of the presence of a coronary heart assault.
"ECG can be absolutely normal in a case of heart disease you have, you can have all the three arteries blocked and yet your ECG can be absolutely normal. The accuracy of ECG to predict a heart attack is only 33%. An abnormal ECG has a lot of significance but a normal ECG in presence of chest pain can be misleading and it can mask a significant heart attack also. We have seen patients with absolutely normal ECGs but they have major heart attacks. So do not go by a normal ECG, specially single ECG. It is always better to get the ECG repeated after one hour or two hours if you have a strong suspicion and let your doctor decide about it," says Dr Sanjeev Chaudhary, Director - Cardiology at Marengo Asia Hospitals, Gurugram.
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