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What Causes an Irregular EKG?

Mary McMahon
Updated Mar 03, 2024
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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.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon962811 — On Jul 25, 2014

I just got called back for an echo and I think that it's the same reason as the post above. I have a lot of anxiety too, and on that particular day I was actually in tears and fearful about something and it was the worst time to have had an EKG.

Then again, if it's true that the heart sometimes only misbehaves during times of stress, perhaps it's good luck that I was having that panic while I was there because otherwise if there is something wrong it would not have been detected.

I'm a carrier of Becker Muscular Dystrophy, too, so it's possible for me to have cardiac problems in my fourth or fifth decade.

By literally45 — On Jan 27, 2013

I have never had regular EKG test results because I experience a lot of anxiety when I go to the doctor's office. My blood pressure will also be abnormally high when I'm at the doctor's office. When I go back home and take my blood pressure, everything will be fine.

The first couple of times, my doctor thought that there was something wrong. But soon he realized that my results are getting skewed because of my anxiety.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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