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Electrocardiogram and Disorders of Heart

Electrocardiograms (ECGs) are a simple way of checking the electrical activity and rhythm of the heart.
Electrocardiogram
Electrocardiograms (ECGs) are a simple way of checking the electrical activity and rhythm of the heart. Each time your heart beats, there are sensors attached to your skin that detect the electrical signals it produces. Doctors study these signals to determine whether they are abnormal, using a machine that records them. ECGs are requested by doctors who suspect that you might have a heart problem (cardiologists, general practitioners, etc.). An experienced healthcare professional can perform the test at your doctor's office, in a hospital, or a clinic. Echocardiograms, which are heart scans, have a similar name, but ECGs are not the same thing as them.

When to use an ECG
Symptoms of a possible heart problem can be evaluated using this test, such as chest pain, dizziness, shortness of breath, or palpitations (subtle heartbeats). You can detect the following with an ECG:
1. Arrhythmias - There are several types of arrhythmia, the most common being abnormal heartbeats.
2. Coronary heart disease - A heart condition results from blockages or interruptions of blood flow to the heart due to a build-up of fat in the arteries.
3. Heart attacks - If your heart's blood supply is suddenly interrupted, you can experience a heart attack.
4. Cardiomyopathy - Heart wall thickening or enlargement causes cardiomyopathy.

You can also take several ECGs over time if you are taking drugs that could affect your heart or have been diagnosed with a heart condition.
The process of taking an ECG

There are several different methods of obtaining an ECG. Sensors attached with small, sticky electrodes are typically applied to your arms, legs, and chest during the test. An ECG recording machine records your heartbeat from these electrodes. Preparing for the test does not require any special effort. Eating and drinking normally are perfectly fine before the test.

To attach electrodes, you typically have to remove the upper clothing, and you may have to shave your chest or clean it. As the electrodes take time to install, you may be given a hospital gown so you can cover yourself while they are in place. Most of the time, the test itself only lasts a few minutes, and you should be able to return home shortly afterward or to the hospital ward if you are already a patient.

There are several (three) types of ECGs that include,
1. A resting ECG - During a resting ECG, you lie down in a comfortable position while monitoring your heart rate.
2. An ambulatory ECG - Ambulatory ECGs can be performed at home using a small portable device worn at your waist, which connects electrodes to your heart so it can be monitored for one or more days remotely.
3. Stress or exercise ECG - An exercise or stress ECG is performed while you are working out on a treadmill or exercise bike.

The type of electrocardiogram depends on your symptoms and what kind of heart problem you are suffering from. If your symptoms are triggered by physical activity, you may be advised to undergo an exercise ECG, and if the symptoms emerge suddenly, you may be advised to undergo an ambulatory ECG.

Finding your results
Your heart rhythm and electrical activity are usually displayed as graphs on the screen or printed out on paper on an ECG recording machine. With an ambulatory ECG, your heart information will be stored electronically. Your doctor can access this information after the test is complete. If you take an ECG, you are unlikely to obtain the results immediately. To determine if signs of a potential problem are present on the recordings, it may be necessary for a specialist to examine them. Some additional tests may also be needed before you can understand whether something is wrong. Your results may require you to see a doctor a few days later at your local hospital, clinic, or general practitioner's office.

Could there be side effects or risks?
In a painless, quick, and safe way, an ECG can be performed. You do not receive any electricity during the procedure. In some cases, electrodes may cause some minor discomfort when they are taken off, like when you remove a plaster, and some people may also experience a slight rash where the electrodes were attached. During an exercise ECG, the participant is in a controlled environment. Inspecting you carefully during the test, and stopping the test if you develop any symptoms or begin to become ill is part of the process.
 
Disorders of heart
1. Heart (Cardiac) failure

The body has little time to make compensatory changes when heart failure occurs acutely, but when the heart fails over time, the following changes will probably occur to maintain cardiac output and perfusion of tissue, particularly that of vital organs: As cardiac muscle grows and increases in number, the walls of the heart chambers thicken and the volume of the heart increases as renal blood flow decreases, causing renin-angiotensin-aldosterone to be activated, leading to salt and water retention. The increased blood volume and workload increase the heart rate. Angiogenic angiotensin 2 directly constricts the arteries, increasing peripheral resistance and exerting further stress on the failing heart.
- Acute heart failure
- Chronic heart failure
- Right-sided (congestive cardiac) failure
- Resistance to blood flow through lungs
- Weakness of myocardium
- Left-sided (left ventricular) failure
- Stenosis
- Incompetence

2. Ischaemic heart disease
Ischemia occurs when one or more branches of a coronary artery are narrowed or occluded due to the effects of atheroma. The narrowing is caused by atheroma plaques. Plaques can occlude without thrombosis, or through thrombosis combined with plaques. If the coronary artery involved is narrowed or completely blocked, then how it affects the overall process differs. A narrowed arterial segment causes angina pectoris, while an occluded artery results in myocardial infarction. It is possible for collateral arterial blood supplies to develop and can effectively supplement or replace the original blood supply when atheroma develops slowly. Anastomotic arteries have a natural tendency to expand when they join with adjacent arteries. An analogous problem occurs when severe narrowing or occlusion of the anastomotic arteries causes them to dilate, but may not be enough to meet the needs of the heart.
- Angina pectoris
- Myocardial infarction

3. Rheumatic heart disease
Children and young adults are most commonly affected by rheumatic fever and inflammation that can follow a streptococcal throat infection. This is a type of autoimmune disease that damages tissue in the heart, joints, and skin due to antibodies produced in response to the infection. It is rare for people to die when their heart valves are damaged in the acute phase, but the damage may remain after recovery, eventually causing disability and possibly heart failure.
- Acute rheumatic heart disease
- Chronic rheumatic heart disease

4. Infective endocarditis
There are some pathogenic organisms, mainly bacteria or fungi, which can colonize different parts of the endocardium, but those located on the heart valves and along the margins of congenital heart defects are the most common. A fast-flowing bloodstream could cause mild trauma to these areas, exposing them to infection. Furthermore, it is a serious illness with high fatality rates without timely treatment. Bacteremia, depressed immune system, and abnormal heartbeat are the primary predisposing factors.
- Bacteraemia
- Depressed immune response
- Heart abnormalities
- Acute infective endocarditis
- Subacute infective endocarditis

5. Cardiac arrhythmias
Intrinsic impulses are normally generated in the SA node, determining our heart rate. As impulses pass through the conducting system, they determine the rhythm. A pulse is used to measure the heart rate, but an electrocardiogram is needed to determine the rhythm. Any abnormal heart rhythm or rate is known as a cardiac arrhythmia, which occurs as a result of abnormal conduction of impulses. As a result of every cardiac cycle, a normal sinus rhythm is established, which fluctuates between 60 and 100 beats per minute.
- Sinus bradycardia
- Sinus tachycardia
- Asystole
- Fibrillation
- Heart block

6. Congenital abnormalities
It is possible that the heart and great vessels at birth are deformed due to intrauterine developmental error or because the blood vessels and heart haven't adapted to life outside the womb. In some cases, no symptoms of abnormality are present early in life, and only complications lead to recognition of the condition.
- Patent ductus arterioles
- Artirial septal defect
- Coarctation of the aorta
- Fallot's tetralogy
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Ankur Choudhary is India's first professional pharmaceutical blogger, author and founder of Pharmaceutical Guidelines, a widely-read pharmaceutical blog since 2008. Sign-up for the free email updates for your daily dose of pharmaceutical tips.
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