ECG - Electrocardiogram (assessment tests)



The electrocardiogram (ECG) is an easy to perform diagnostic test, which involves the use of an instrument capable of recording and graphically reporting the rhythm and electrical activity of the heart.

Through sensors (electrodes), positioned on the skin at the level of the arms, legs and chest, the electrical signals produced by the heart at each beat are picked up and recorded by a machine, the electrocardiograph, which transforms them into a visible path on an electronic (video) or paper support; some electrocardiographs also provide the result (report) of the examination. However, it must always be checked by the doctor to verify that there are no irregularities.

The ECG may be requested by the family doctor, cardiologist or other specialists who suspect the presence of a heart problem. It can be prescribed by the sports doctor before issuing the certificate of fitness to practice sport at a competitive or non-competitive level. Generally, it is performed in public or private clinics or by the general practitioner.

When performing the Electrocardiogram (ECG)

The ECG is often performed together with other tests for the assessment (diagnosis) and treatment of cardiovascular diseases.

It may be requested to investigate disorders that suggest a heart disease such as, for example, chest pain, suddenly noticeable beats (palpitations), dizziness and difficulty in breathing.

The ECG can be useful for identifying:

  • arrhythmias, occur when the heart beats too slowly (bradycardia), too fast (tachycardia) or irregularly
  • ischemic heart disease, appears when the blood supply to the heart is blocked, or interrupted, due to the narrowing of the coronary artery due to a spasm or occlusion
  • myocardial infarction, occurs when the blood supply to the heart suddenly stops
  • cardiomyopathies, consist in the "thickening or dilation of the walls of the heart

The ECG can be repeated to follow the evolution of cardiovascular diseases over time, to verify the effectiveness of treatments or to check for any harmful effects on the heart of drugs used for other diseases.

The exam

There are multiple ways to do an electrocardiogram (ECG). Typically, the exam is carried out by attaching small sensors, electrodes, to the arms, legs and chest. The electrodes can be adhesive or suction cup. Before applying them, the skin is cleaned with a cotton swab soaked in water (good conductor of electrical impulses) or with an electroconductive paste (gel). The electrodes are connected via cables to a machine (electrocardiograph) which records the impulses.

In the thirty minutes prior to carrying out the ECG, it is advisable to refrain from eating, smoking and intense physical activity.

The exam lasts a few minutes and, in general, it is possible to go home, or to the hospital ward if you are hospitalized, immediately after its conclusion.

Types of Electrocardiograms (ECG)

There are three main types of ECGs:

  • Resting ECG, performed in the supine position (the person is lying on the bed face up) relaxed and comfortable
  • ECG under strain, performed while performing physical exercise with increasing intensity, generally using an exercise bike or treadmill
  • Dynamic ECG, performed by a small portable electrocardiograph attached to a belt or shoulder strap and connected by electrodes to the person undergoing it in order to record the activity of the heart and its beating for one or two days (cardiac holter)

The type of ECG recommended depends on the disorders (symptoms) and the type of heart problem suspected. The exercise ECG can be prescribed by the doctor if the symptoms (symptoms) appear while exercising; the dynamic ECG can be indicated in the case of occasional and unpredictable disorders.


The ECG is a quick, safe and painless diagnostic test and during its execution there is no administration of electric shocks.

There may be some slight discomfort when removing the electrodes, similar to peeling a patch from the skin, and in some cases, there may be a slight redness where they were applied.

The stress caused to the heart during an exercise ECG, albeit rarely, can cause chest pain, irregular heartbeat and, in some cases, more serious problems. The person who undergoes the examination is monitored carefully for the duration of the effort and, in the event of disturbances or anomalies in the path, the examination can be interrupted at any time.

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Tachycardia consists of an increase in the number of heart beats which occurs even in conditions of rest and in the absence of physical activity, stress