Srinagar, July 16: While an electrocardiogram (ECG) is a key diagnostic tool for detecting heart attacks, it’s not always conclusive. There are several reasons for this, and understanding them can help people better manage their heart health.
1. Timing Matters
An ECG may not show the typical signs of a heart attack if it is done too early—before substantial damage has occurred. In some cases, even during a heart attack, the ECG may appear normal, particularly if the damage is minor or the heart’s electrical activity hasn’t been significantly disrupted at that moment.
2. Type of Heart Attack
Not all heart attacks show up clearly on an ECG. Silent heart attacks, which may occur with few or no symptoms, often go unnoticed on ECGs if they don’t cause obvious electrical changes. That’s why doctors often keep patients under observation for 12 to 24 hours and conduct multiple ECGs to detect evolving abnormalities.
3. Additional Confirmatory Tests
Troponin tests are commonly used alongside ECGs. Troponin is a protein released when the heart muscle is damaged. However, troponin levels take time to rise after a heart attack. This makes it essential to repeat the test—typically after 90 minutes—especially if initial results are inconclusive.
Other diagnostic options include:
• Ultrasound (Echocardiogram): Helps assess heart function and detect damage.
• Coronary Angiography: A more invasive test that gives a detailed view of coronary artery blockages.
4. Preventive Screenings to Reduce Risk
Prevention is critical. People should monitor risk factors like high blood pressure, cholesterol, and obesity from as early as age 25. Specific tests and steps include:
• Check for familial hypercholesterolemia (FH): A genetic condition that causes high LDL cholesterol despite a healthy lifestyle.
• Measure Lipoprotein(a): Even normal cholesterol levels can be deceptive if lipoprotein(a) is elevated, as it accelerates plaque buildup.
• Keep LDL under 50 mg/dL (or below 30 mg/dL with family history), and triglycerides low.
5. Calcium Score Test
This non-invasive CT scan measures calcified plaque in the arteries. A high score indicates higher risk for heart attack or stroke, allowing for early intervention with medication and lifestyle changes. While it doesn’t predict an immediate event, it helps identify individuals who may benefit from proactive care.
In summary, while an ECG is a valuable tool, it should be part of a broader diagnostic and preventive approach that includes repeated testing, biochemical markers, imaging, and long-term health monitoring
