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DIAGNOSTIC INVESTIGATIONS: ELECTROCARDIOGRAM

Q. Can we please proceed with the various tests and techniques, starting with the electrocardiogram ?

A. The electrocardiogram is an electrical recording of the action of the heart. It is the most important single tool in the armoury of the physician and is the most widely used investigative technique on heart patients.

Q. How do you record the ECG ?

A. The recording is made by an instrument called the electrocardiograph on a strip of heat-sensitive paper, after the patient's limbs and chest are connected by wires to the instrument.

Q. What are the limitations of the ECG ?

A. In spite of the great importance of the ECG in the diagnosis and management of a heart attack, it is not at all unusual to have a normal or near-normal recording although the patient may be critically ill. And later, after a few hours or days, when unmistakable changes of infarction do develop in the electrocardiogram, the patient may actually be doing better. Similarly, in a case of angina, it is quite common to have a perfectly normal ECG taken when the patient is at rest. Only after sufficient exercise and exertion may changes of ischaemia appear. Conversely, there may be extensive changes of old infarction sustained some years ago, but at the time of the ECG recording the patient may be quite well and cheerful.

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Cardio & Blood