What are the limitations of an ECG?
- The ECG reveals heart rate and rhythm only during the time that the ECG is taken. If intermittent cardiac rhythm abnormalities are present, the ECG is likely to miss them. Ambulatory monitoring (Holter monitoring) is needed to record transient arrhythmias.
- The ECG can often be normal or nearly normal in patients with undiagnosed coronary artery disease or other forms of heart disease (false negative results.)
- Many "abnormalities" that appear on the ECG turn out to have no medical significance after a thorough evaluation is completed (false positive results).
Clinical indications for Stress Echo
Considering the limitations of an ECG, an important diagnostic and prognostic tool as a Stress Echocardiography can be used when patients present symptoms of coronary artery disease, including the classic anginal symptoms of chest pressure or pain which occurs with or without exertion.
Evaluation with Stress Echocardiography may be given to assess atypical or non-cardiac sounding chest pain and asymptomatic patients with risk factors for coronary artery disease such as diabetes. Patients with valvular disorders (except those with hemodynamically significant aortic stenosis) may undergo an echocardiography stress test to evaluate their functional capacity, the effectiveness of the treatment, or the need for surgical intervention.
Clinical indications for Ambulatory Monitoring
When symptoms, such as dizziness, fainting, low blood pressure, prolonged fatigue, and palpitations continue to occur without a definitive diagnosis obtained with a resting ECG, you may request an ECG tracing to be run over a long period of time using a Holter monitor and/or a Cardiac Event Recorder (Loop).
Please click here for a Requisition Form