Or ECGs as I’ve seen it a few times in recent years (i.e. electroCardiograms).
A friend just had a semi-surgical procedure (anesthesia, but no cutting) and she said for the pre-procedure workup, she had an EKG - and that was the first she’d ever had. She’s mid 50s, same age as I am. Slightly better health in some ways than me, though much more overweight. Apparently she did NOT have one, 20+ years ago, when she had fairly major surgery for something else.
My first one was at age 29ish before surgery, but I’ve had them at semi-random times since then. My last doc ordered them every year or two.
Anyway, I’m just curious. For folks who have semi-regular contact with medical people for one reason or another, is an EKG something rare or something that your doc requests every couple of years?
EKGs really aren’t all that useful for screening asymptomatic patients. The US preventive services task force last year recommended against doing routine resting or stress EKGs on low risk folks without symptoms: Avoid screening EKGs in healthy low risk people
They also concluded that evidence is lacking to recommend that same screening even for intermediate or high risk symptom-free people.
The EKG is very helpful in evaluating people with symptoms or signs which may be consistent with heart disease, of course.
Obviously the USPSTF bases their results on the statistics, and one data point is just an anecdote, but I will say that if it weren’t for an offhand comment about an EKG taken for an unrelated surgery, I might still have untreated WPW. I was symptomatic, but didn’t know it. A particularly severe episode might have been… bad.
We do them in the ER at the drop of a hat, and pre-operatively on a lot of pts. I’m not sure what the criteria the surgeons go by, but it’s some kind of shotgun approach. After a certain age everyone gets chest xray, EKG, and basic blood work before the OR. Non-emergent surgeries, that is.
I bow to the Mercotan, of course, but there’s not much down side to an EKG, it’s fast, painless and non-invasive.
Once when being admitted to the ER with chest pains
Again, a month later, when I took a stress test
Otherwise, I’ve been to the ER and to doctors for various reasons over the years, including several kidney stones, and a case of Bell’s Palsy (which was, at first, feared to be a stroke). EKGs were never given for those.
There’s not much evidence that doing an EKG as part of a routine preop evaluation unless you’re undergoing a fairly high risk procedure or you’ve got some risk factors. Still, every surgeon I know wants one as part of a preop eval regardless of the procedure or the patient.
Folks with high blood pressure should have one at diagnosis to establish a baseline and to look for a few relatively uncommon heart conditions. There’s no real answer about whether that should be repeated at any interval.
Other than that, the only time you truly need to have one is when you’re having symptoms.
It’s quick, noninvasive, and relatively cheap, so of course we always err on the side of doing one.
My Dad is 84 and I don’t think he has ever had an EKG. His heart beats like a metronome. I get a minimum of one a year, but I have an unusual heart beat and have had heart surgery. I get my heart from my mother’s side. Mom had an angiogram this morning.
In my cynical opinion, the reason that so many people get them routinely is that insurance pays for them so traditionally doctors have done them yearly. While there is no evidence for routine screening EKGs in healthy people, this is what I do (and my reasoning):
My patients get a baseline EKG at 40. Not only does this pick up some conditions that would otherwise be missed (like WPW or HCM) but more important it gives me a baseline so that when they show up 10 years from now with chest pain I have something to compare it to.
Patients with hypertension get a baseline EKG to determine whether there are signs of cardiac damage or hypertrophy.
Patients with diabetes for more than a few years get a baseline because diabetics can have asymptomatic heart disease.
Aside from that-nobody gets a routine EKG unless they have symptoms such as chest pains, shortness of breath or an irregular heartbeat.
As far as I know, I’ve only missed one significant case this way; i had an athlete who was getting winded at the end of his exercise. His heartrate was absolutely regular and strong. I did send him for a stress test and the Cardiologist gave me hell when he found out he was in a 4:1 atrial flutter. So now I also get an EKG if I feel somebody needs a Cardiologist.
Is the above consistent with the best evidence-based medicine? To be honest, no. I probably do too many screening EKGs. So if your doctor is doing this many or more they are probably not all necessary.
I had open-heart surgery this past August, and have had several EKGs since I started seeing a cardiologist a few years ago. Also have had a couple since the surgery.
Thanks for all the responses - interesting stuff! In my own case, I do have hypertension (controlled with meds) so the occasional one isn’t unreasonable, though perhaps they’ve been done “more than necessary”. I did have one after I had symptoms of something (sudden attack of syncope) which seemed like a good idea.
My husband has hypertension but IIRC only had one when he went into the ER with heatstroke.
I had one but it was self-administered; I was getting certified to do simple EKGs for research studies and didn’t want to convince a coworker to strip nude to the waist for a test subject. (Sinus rhythm, woot!)
I’ve had one each time I’ve gone for a physical. Right now I get one roughly every 2 years.
It was good that I had it – some years ago it discovered that, at some point in my life, I apparently had an asymptomatic mild heart attack of some sort.
Tangential story - one year a young lady in the latter stages of nursing school was setting up my EKG under the watchful eye of the regular nurse. She stuck all the leads on me, went to the terminal and pressed a button to start the printout. At that precise instant I yelped and acted like I was being electrocuted. SHE almost had a heart attack right there! The regular nurse fussed at me, but only after she was done laughing.
There is a place near the bottom of my heart that doesn’t work anymore. It isn’t an issue for me, it just is. The doctor keeps an eye on it by EKGing me every other year or so during my annual physicals, but to date it never changes. I suppose when it does, life will get a little more interesting.
What test is it where they attach a bunch of electrodes all over your body? If that is an EKG, then I have one once a year as a precautionary measure at the neurological institute at which I am a patient due to the prescription medications I must take to prevent migraine headaches.