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An irregular electrocardiogram (EKG or ECG) can be the result of problems with the test or problems with the patient's heart. This test measures electrical activity in the heart and provides a graph of the activity for review by a doctor. If a patient has an irregular EKG, the doctor may interview the patient and recommend some additional tests to learn more, with the goal of determining what, if anything, needs to be done for the patient.
In this test, a technician attaches electrodes to the chest and briefly records the heart's electrical activity. If the patient is stressed or nervous, the results may be skewed. Likewise if someone exercised before the test or moves during the test. Sometimes, the technician fails to attach the leads correctly and the signals from the heart are not reliably recorded. All of these factors will be considered when a patient has an irregular EKG.
Heart abnormalities, whether congenital or acquired, may also lead to an irregular EKG. The patient could have heart block, where the electrical signals in the heart do not move smoothly and reliably through the heart, leading to irregular or mismatched contractions. Some patients have a rapid heart rate, known as tachycardia, or bradycardia, where the heart is beating too slowly. Sometimes, EKG irregularities are the result of premature contractions, a common phenomenon that is usually not a cause for concern, where the heartbeat is disrupted randomly and then returns to normal.
Having an irregular EKG does not necessarily mean there is a problem, and conversely, normal results do not always mean a patient is healthy. Sometimes, problems with the heart only appear at certain times, such as during exercise or periods of stress. If a patient is reporting heart problems, the doctor may recommend stress tests of the heart or request ambulatory monitoring, where the heart is recorded over several hours or days to see when the patient experiences problems.
A cardiologist can review an irregular EKG to find out more about the patient's heart rhythm and make treatment recommendations. The doctor will consider the patient's history and other symptoms. For example, athletes often have a low resting heart rate that would be considered bradycardia in another person. A competitive athlete with a healthy history probably does not need treatment for bradycardia, while a person with normal or low activity levels and the same heart rate is a cause for concern.