Can A Routine EKG Predict A Future Heart Attack?

Can getting an EKG, where they attach electrodes to your chest to measure your heart activity, help predict whether you'll have a heart attack?

No, says updated federal guidelines announced Monday.

If you're otherwise healthy and at low risk for heart problems, you don't need a routine electrocardiogram, or EKG, says the U.S. Preventive Services Task Force.

And if you're at intermediate or high-risk for heart problems, but don't have symptoms -- like shortness of breath or chest pain -- there's no evidence one way or another that an EKG (sometimes called a ECG) will help predict a future attack, said Joy Melnikow, M.D., a member of the task force.

An EKG provides doctors with information on how fast your heart is beating, and whether it has a steady or irregular rhythm. An irregular EKG could indicate a heart problem.

The test is usually done while the patient is at rest, lying down, and then while exercising on a treadmill -- commonly called an exercise stress test.

Melnikow says healthy, low-risk people are not likely to develop heart disease, so an abnormal EKG in this group is more likely to be a false positive test result. False positives can lead to additional, more invasive tests that can cause more serious side effects or risks.

Guidelines about EKGs were first released by the panel in 2004. The new guidelines, published July 30 in the Annals of Internal Medicine, are based on recent research, but re-affirm the panel's earlier finding: A healthy, low-risk person without heart symptoms can skip a routine EKG.

As for those who have risk factors like smoking, high cholesterol or high blood pressure, the panel looked at whether an EKG could pinpoint those at highest risk of having a heart attack.

Unfortunately, there was "insufficient evidence" to help answer that question, Melnikow said. Doctors should consider giving the test on a case-by-case basis.

The usefulness of the EKG stress test has been questioned previously, reports the New York Times. In April, a group of nine medical specialty boards included it on its list of 45 common tests and procedures that doctors should perform less often.

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