Monday, November 24, 2008

Can Electrocardiogram Predict Heart Disease?

Angina is a common symptom of coronary artery disease. It is a condition characterized by sharp chest pain or discomfort. It occurs when an area of the heart muscle does not receive enough oxygen-rich blood. Sometimes, the pain may also occur in the neck, arms, shoulders, jaw or even back, and it can feel like indigestion too.

People usually regard electrocardiogram (or better known as ECG or EKG) as one that is given only to patients who are having attack of angina. It is estimated that about 1 in 50 people in Britain experience angina.

A paper published on November 14, 2008 in the British Medical Journal indicated that a routine examination by a doctor works almost as well as ECG in predicting heart disease.

During the ECG test, electrodes are placed on a patient’s skin and the electrical activity of the heart is recorded over time so that abnormal rhythms could be detected. Although ECG has been shown to be effective in revealing damage, its ability in predicting future heart disease was unknown.

As such, a team of researchers at the London Queen Mary's School of Medicine and Dentistry carried out a study that examined 8,176 patients with suspected angina but with no prior history of heart disease.

A standard clinical assessment, which looked at criteria including age, sex, ethnicity, duration of symptoms, description of chest pain, smoking status, and history of hypertension (high blood pressure) and medicines, was carried out on all the patients.

ECG was given to all the patients while they were at rest, and some 60 percent of them were arranged to have an exercise ECG that was performed while they were in motion. All the patients were monitored during the following year.

The researchers found that half of all heart incidents, which occurred during that period, happened in patients whose ECG tests had not shown any indication of heart disease. Meanwhile, they also found that a routine clinical assessment was almost as good an indicator of future heart problems.

Such findings might highlight the importance of taking a detailed medical history and making a thorough physical examination. ECG might be helpful for some patients by the additional information it provides, but it is a pity that it does not predict heart disease risk for everyone.

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