Bottom line: Lifecare Primary Medical in Richmond, TX performs in-office EKGs for preoperative clearance, evaluation of palpitations, dizziness and medication effects, and cardiac risk assessment, often during the same visit. The test takes only a few minutes and does not hurt. An EKG is not for emergencies: if you have chest pain or shortness of breath, call 911 immediately.
Chest pain or shortness of breath? Call 911. Do not drive to the clinic for an EKG if you have chest pressure or pain, trouble breathing, pain spreading to your jaw, neck, back, arms or shoulders, sudden dizziness or near-fainting, or nausea with these symptoms. The American Heart Association advises calling 911 right away for these warning signs of a heart attack.
Clinical guide
What an EKG shows, and what it cannot
An electrocardiogram (EKG or ECG) records the electrical signals that make your heart beat. Small adhesive patches on your chest, arms and legs pick up those signals, and the tracing shows your heart rate, whether the rhythm is regular, and patterns that can point to a past heart attack, strain on the heart muscle, enlarged heart chambers, electrolyte problems or effects of certain medicines. It is quick, painless and uses no radiation, which is why it is often the first heart test a provider orders.
A resting EKG is a snapshot of a few seconds. It cannot rule out every heart problem. Rhythm problems that come and go may not appear during the test, and blocked arteries often look normal at rest. If your symptoms or results call for more information, your provider may recommend a heart monitor you wear at home, a stress test, an echocardiogram or a cardiology referral.
When we recommend an in-office EKG
Having an EKG machine in our Richmond office means many patients can be tested during the same visit, without a separate appointment elsewhere. Common reasons include:
- Preoperative clearance before surgery or certain procedures, when your history or the planned procedure calls for one
- Palpitations, such as a racing, pounding, fluttering or skipping heartbeat
- Dizziness or fainting spells that are not happening right now
- Cardiac risk assessment in adults with high blood pressure, diabetes, high cholesterol, smoking history or a strong family history of heart disease
- Medication monitoring, since some medicines can affect heart rhythm
- Follow-up of a known heart condition or an abnormal earlier tracing
Preoperative clearance EKGs
Surgeons and anesthesiologists often ask your primary care provider to confirm you are medically ready for surgery. A preoperative evaluation reviews your heart and lung health, medications, blood thinners, diabetes control and any past problems with anesthesia. An EKG is ordered when your age, heart history, risk factors or the type of procedure make it useful, and lab work can be drawn in our office during the same visit. Bring the surgeon’s clearance form, your surgery date and a list of your medications. We send the completed evaluation to your surgical team. Schedule early, since abnormal findings sometimes need follow-up before surgery can proceed.
Evaluating palpitations
Palpitations are very common and are often harmless, triggered by caffeine, stress, dehydration, poor sleep, alcohol, nicotine, fever or some medicines and supplements. They can also come from an overactive thyroid, anemia or a heart rhythm disorder such as atrial fibrillation. Your visit includes a detailed history, an exam, an EKG and, when appropriate, blood tests such as electrolytes, thyroid function and a blood count. If the EKG is normal but symptoms continue, a wearable monitor can catch rhythms that happen only occasionally.
Palpitations with chest pain, fainting, severe shortness of breath or a very fast heartbeat that will not slow down need emergency care. Call 911.
It helps to keep a short symptom diary before your visit. Note when palpitations happen, how long they last, what you were doing, and whether you had coffee, energy drinks, alcohol or a new medicine that day. If you use a smartwatch that records heart rhythm, bring the readings so your provider can compare them with your EKG.
EKGs and cardiac risk assessment
An EKG is one piece of a heart risk evaluation, not a stand-alone screening test. The U.S. Preventive Services Task Force recommends against routine EKG screening in adults at low risk who have no symptoms, because it rarely changes care and can lead to unnecessary follow-up tests. For people with symptoms or higher risk, the EKG adds useful information to blood pressure, cholesterol, A1C, weight and smoking history. That combined picture guides treatment such as blood pressure control and cholesterol-lowering medicine. Learn more about heart disease care and hypertension treatment in Richmond.
What to expect during your EKG
- Get ready. Wear a top that is easy to remove or open. Avoid exercise and cold drinks right before the test, and tell us about every medicine you take.
- Patch placement. You lie down while our staff cleans small areas of skin and attaches electrode patches. Hair may be clipped so they stick.
- Recording. You lie still and breathe normally for a short recording. Staying warm and relaxed prevents shivering that can blur the tracing.
- Review. Your provider reviews the tracing with your symptoms and history and explains the next steps, including any referral.
