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Most individuals who have a cardiac problem will
be identified with an ECG and an echocardiogram. You’re
probably aware that the ECG shows electrical problems of the
heart and an echocardiogram reveals structural problems of the
heart and gives us an idea of the heart size. In some
situations, the echocardiogram is not as good as the MRI scan of
the heart to show various parts of the heart. For example, the
right heart or the right ventricular chamber is much better
assessed with an MRI scan. Secondly, the arteries of the heart
or the origins of the coronary arteries are much better assessed
with an MRI scan than they are with an echocardiogram.
There are some people who have abnormalities
that will only be picked up when the heart is under stress. For
example, if someone has a blocked artery then the heart will
only complain when it is being challenged. So someone with a
blocked artery will have a normal ECG when they’re lying down
resting but when they exercise, the ECG may become abnormal. So
if we suspect blocked arteries in someone, that is someone who
is complaining of chest pain when they rush about, then we would
perform an exercise stress test.
A 24 hour ECG is very useful at identifying
individuals who have intermittent palpitation. A resting ECG at
the time that the individual doesn’t have any symptoms will be
normal but a 24 hour ECG may pick up individuals who have
intermittent palpitations and identify the rhythm disturbance in
that individual.
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