Editing Electrocardiography (section)

==Medical uses==
[[File:Normal 12 lead EKG.jpg|thumb|Normal 12-lead ECG]]
[[File:12 lead ECG of a 26 year old male.jpg|thumb|325px|A 12-lead ECG of a 26-year-old male with an incomplete [[right bundle branch block]] (RBBB)]]

The overall goal of performing an ECG is to obtain information about the electrical functioning of the heart. Medical uses for this information are varied and often need to be combined with knowledge of the structure of the heart and physical examination signs to be interpreted. Some [[Indication (medicine)|indications]] for performing an ECG include the following:
* Chest pain or suspected [[myocardial infarction]] (heart attack), such as ST elevated myocardial infarction (STEMI)<ref>{{Cite news |url=https://www.ecgmedicaltraining.com/what-is-a-stemi/ |title=What is a STEMI? - ECG Medical Training |date=2015-06-24 |work=ECG Medical Training |access-date=2018-06-24 |language=en-US}}</ref> or non-ST elevated myocardial infarction (NSTEMI)<ref>{{Cite news |url=https://myheart.net/articles/nstemi/ |title=What is NSTEMI? What You NEED to Know |date=2015-04-30 |work=MyHeart |access-date=2018-06-24 |language=en-US}}</ref>
* Symptoms such as [[shortness of breath]], [[cardiac murmur|murmurs]],<ref name="masters">{{Cite book|last1=Masters|first1=Jo |last2=Bowden|first2=Carole |last3=Martin|first3=Carole|last4=Chandler|first4=Sharon |title=Textbook of veterinary medical nursing|date=2003|page=244|publisher=Butterworth-Heinemann|isbn=978-0-7506-5171-4|location=New York|language=Spanish|oclc=53094318}}</ref> [[Syncope (medicine)|fainting]], [[seizure]]s, funny turns, or [[cardiac dysrhythmia|arrhythmia]]s including new onset [[palpitations]] or monitoring of known cardiac arrhythmias
* Medication monitoring (e.g., [[drug-induced QT prolongation]], [[digoxin toxicity]]) and management of overdose (e.g., [[Tricyclic antidepressant overdose|tricyclic overdose]])
* [[Electrolyte imbalance|Electrolyte abnormalities]], such as [[hyperkalemia]]
* [[Perioperative]] monitoring in which any form of [[anesthesia]] is involved (e.g., [[Intraoperative neurophysiological monitoring|monitored anesthesia care]], [[general anesthesia]]). This includes [[Preoperative care|preoperative assessment]] and intraoperative and postoperative monitoring.
* [[Cardiac stress test]]ing
* [[Computed tomography angiography]] (CTA) and [[magnetic resonance angiography]] (MRA) of the heart (ECG is used to "gate" the scanning so that the anatomical position of the heart is steady)
* [[Clinical cardiac electrophysiology]], in which a [[catheter]] is inserted through the [[femoral vein]] and can have several electrodes along its length to record the direction of electrical activity from within the heart.

ECGs can be recorded as short intermittent tracings or ''continuous'' ECG monitoring. Continuous monitoring is used for critically ill patients, patients undergoing general anesthesia,<ref>{{Cite journal|last1=Drew|first1=B. J.|last2=Califf|first2=R. M.|last3=Funk|first3=M.|last4=Kaufman|first4=E. S.|last5=Krucoff|first5=M. W.|last6=Laks|first6=M. M.|last7=Macfarlane|first7=P. W.|last8=Sommargren|first8=C.|last9=Swiryn|first9=S.|last10=Van Hare|first10=G. F.|date=26 October 2004|title=Practice Standards for Electrocardiographic Monitoring in Hospital Settings|journal=Circulation|volume=110|issue=17|pages=2721–2746|doi=10.1161/01.CIR.0000145144.56673.59|pmid=15505110|s2cid=220573469|doi-access=free}}</ref><ref name=masters/> and patients who have an infrequently occurring cardiac arrhythmia that would unlikely be seen on a conventional ten-second ECG. Continuous monitoring can be conducted by using [[Holter monitor]]s, internal and external [[defibrillator]]s and [[pacemaker]]s, and/or [[biotelemetry]].<ref>{{cite journal |last1=Galli |first1=Alessio |last2=Ambrosini |first2=Francesco |last3=Lombardi |first3=Federico |title=Holter Monitoring and Loop Recorders: From Research to Clinical Practice |journal=Arrhythmia & Electrophysiology Review |date=2016 |volume=5 |issue=2 |pages=136–143 |doi=10.15420/AER.2016.17.2 |pmc=5013174 |pmid=27617093 }}</ref>

===Screening===
[[File:ECGfemaleathlete.jpg|thumb|A patient undergoing an ECG]]
For adults, evidence does not support the use of ECGs among those without symptoms or at low risk of [[cardiovascular disease]] as an effort for prevention.<ref>{{Cite journal |last1=US Preventive Services Task |first1=Force. |last2=Curry |first2=SJ |last3=Krist |first3=AH |last4=Owens |first4=DK |last5=Barry |first5=MJ |last6=Caughey |first6=AB |last7=Davidson |first7=KW |last8=Doubeni |first8=CA |last9=Epling JW |first9=Jr |last10=Kemper |first10=AR |last11=Kubik |first11=M |date=12 June 2018 |title=Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement |journal=JAMA |volume=319 |issue=22 |pages=2308–2314 |doi=10.1001/jama.2018.6848 |pmid=29896632 |last12=Landefeld |first12=CS |last13=Mangione |first13=CM |last14=Silverstein |first14=M |last15=Simon |first15=MA |last16=Tseng |first16=CW |last17=Wong |first17=JB|doi-access=free }}</ref><ref name="Annals2012">{{Cite journal |last=Moyer VA |date=2 October 2012 |title=Screening for coronary heart disease with electrocardiography: U.S. Preventive Services Task Force recommendation statement |journal=Annals of Internal Medicine |volume=157 |issue=7 |pages=512–518 |doi=10.7326/0003-4819-157-7-201210020-00514 |pmid=22847227|doi-access=free }}</ref><ref name="whenyouneedEKGs">{{Citation |last1=Consumer Reports |title=EKGs and exercise stress tests: When you need them for heart disease – and when you don't |date=April 2012 |url=https://consumerhealthchoices.org/wp-content/uploads/2012/04/ChoosingWiselyEKGAAFP2.pdf |work=Choosing Wisely |publisher=[[Consumer Reports]] |access-date=14 August 2012 |last2=American Academy of Family Physicians |last3=ABIM Foundation |author-link=Consumer Reports |author-link2=American Academy of Family Physicians |author-link3=ABIM Foundation |archive-date=20 December 2013 |archive-url=https://web.archive.org/web/20131220223008/http://consumerhealthchoices.org/wp-content/uploads/2012/04/ChoosingWiselyEKGAAFP2.pdf |url-status=dead }}</ref> This is because an ECG may falsely indicate the existence of a problem, leading to [[misdiagnosis]], the recommendation of invasive procedures, and [[overtreatment]]. However, persons employed in certain critical occupations, such as aircraft pilots,<ref name="FAA Medical Standards 2006">{{Cite web |url=https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/media/synopsis.pdf |title=Summary of Medical Standards |year=2006 |publisher=U.S. Federal Aviation Administration |access-date=27 December 2013}}</ref> may be required to have an ECG as part of their routine health evaluations. [[Hypertrophic cardiomyopathy]] screening may also be considered in adolescents as part of a [[Preparticipation physical evaluation|sports physical]] out of concern for [[sudden cardiac death]].<ref>{{Cite journal |last1=Corrado |first1=D. |last2=Basso |first2=C. |last3=Schiavon |first3=M. |last4=Thiene |first4=G. |date=1998-08-06 |title=Screening for hypertrophic cardiomyopathy in young athletes |journal=The New England Journal of Medicine |volume=339 |issue=6 |pages=364–369 |doi=10.1056/NEJM199808063390602 |pmid=9691102 |doi-access=free }}</ref>