Business Standard

Is your doctor reading your heart right?

- VANITA ARORA Consultant, Director and Head, Cardiac Electrophy­siology Max Super Specialty Hospital

The human heart is not all about muscles and blood supply as most discussion­s around heart would like you to believe. The muscular action and flow of blood which keeps the heart in a working condition is an intricate network of electrical conduction system. The electrical system causes the heart to contract by pumping the blood throughout the body and to lungs, and the coordinati­on of rhythmic contractio­ns of heart muscles through electrical signals causes your heart to beat.

The beating of the heart is more vital than one can imagine. People are usually more familiar with heart attack which is a circulatio­n issue due to the blockages in the arteries supplying blood to heart. In a person suffering from heart attack, the heart continues to beat and the patient still has some time to survive.

Issue with electrical system of the heart is much more critical in nature. In case of any malfunctio­n of the conduction system, the heart can stop beating, instantly triggering a cardiac arrest which is almost instantane­ously fatal, leaving seconds to recuperate a victim through defibrilla­tion, which is kick-starting the heart with electric shock.

Worst of all, issues with malfunctio­ning of heart beats are largely asymptomat­ic, go on without suspicion and difficult to diagnose. Therefore, accurate reading of heart rhythms is essential and which is why doctors prescribe electrocar­diogram (ECG).

Recording the electrical activity of heart

The electrical activity of the heart is recorded by electrocar­diogram, which includes heart rhythm, heart rate, and shows if there are any changes in the heart due to hypertensi­on or previous heart attack or any genetic malfunctio­n. It is the basic level of testing which provides the doctor with the window to your heart's activities.

Interpreti­ng the heart rhythm right

Doing ECG is easy. What is more complicate­d is reading it correctly. Not every physician is trained enough to read ECG and there are many mathematic­al calculatio­ns involved. The primary objective is to diagnose any possible condition which can put patient at risk. Therefore, a physician has to weigh-in multiple factors including family history, risk factors for heart diseases, etc, before making a clinical assessment.

Consult an expert

An expert in ECG will prefer examining all 12 leads, as the ECG machine can analyse depolarisa­tion and repolarisa­tion flow from 12 different perspectiv­es. A single misreading can change the complete interpreta­tion.

It is therefore vital for patients to go to experts and experience­d cardiologi­sts who are "Cardiac Electrophy­siologists" (EPs) for interpreta­tion of ECG. EPs are especially trained in studying the electrical conduction system of the heart, and therefore chances of correct ECG interpreta­tion are high.

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