EKGs in athletes are a bit more likley to result in false positives than the general population. Ie, they can be indicative of a problem when there is in fact none. If you decide to get one, make sure to see a specialist who deals with lots of athletes, or at least active people.

FWIW, an arrythmia should be relatively easy to determine.

Josef

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Josef
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Your MD should be able to give you guidelines on appropriate tests. It would be worth a call to him/her and explain your concerns.

If am not a doctor, but I doubt than an EKG by itself would be the right way to tell whether someone is ok to engage in an endurance sport. A cardiac stress test (which has an EKG component) is probably a better way to go. I believe that the Boulder Center for Sports Medicine requires the cardiac stress test for anyone above age 44 who wants a lactate threshold test, and probably a VO2 max test as well. So, age is obviously a factor.

As for your question about experiences, I would think that vast numbers of people have had a simple EKG. Some docs include them in a routine physical. They are relatively quick, cheap and they are not invasive. Biggest problem is that people with chest hair get shaved in a funny pattern. By contrast, I found the cardiac stress test to be ... stressful. Big surprise. They had me hit my max HR (or thereabouts) on a treadmill and then immediately lie down. One of the worst feelings of my life. Didn't last long.

Depends on what you want to achieve/detect from the EKG. I am told that EKG is simply a starting place - if you have a problem, it might detect your problem and it might not. I got an EKG 2 months ago because my doctor and I suspected I might have a heart problem - but if I do have it, it's a specific heart problem (variant angina) that is usually not detected by an EKG OR by a stress test.

Also, doctors can be in a BIG hurry. What I learned was to spend hours researching everything I could about my potential heart problem, how the EKG works, what other tests I might consider asking my doctor to order, etc. so that I could come to my doctor with a prepared list of questions.

P.S. My EKG came back normal, except for one thing - the EKG interpreter had marked my low pulse as an "arrythmia" - often a low pulse means you are dying - my doctor had a good laugh about this because clearly my low pulse was due to being in great cardiovascular condition. I think the people who administer EKGs are not used to dealing with athletes!

Good luck!
Oleander

I don't mean to hijack the thread, but Oleander reminded me of something worth sharing. A highly-trained endurance athlete will have an enlarged heart ... for good reasons. A sedentary, heart-diseased person will also have an enlarged heart ... for bad reasons. The EKG doesn't exactly make a distinction.

I've been rejected for life insurance policies twice because I was told my EKG indicated I have an enlarged heart. I've seen a cardiologist and been through a whole battery of stress tests, die injections, scans, etc. I'll be 50 in 3 weeks. She says I have the heart of a healthy 20-something. But I'm having trouble getting additional life insurance because some clown in an office somewhere is looking at an EKG out of context and concluding I'm a walking Big Mac.

Bob C.

An EKG is a relatively simple, but not necessarily diagnostic test. It basically takes a picture of the electrical activity of your heart. If you are worried about blocked arteries, you may see some abnormalities, but these usually don't show up on the EKG until the blockages are pretty serious. Also, at rest, the heart does not have to work very hard -- it does not need very much oxygen, and so even a blocked artery might deliver enough oxygen at rest. This is why you can hear about someone having a "normal EKG", and then going out and having a heart attack as they leave the doctor's office. A cardiac stress test, also known as an exercise stress test or exercise tolerance test, is a better predictor, because with exercise the heart has to work harder, needs more oxygen, and a blocked artery may not be able to deliver this increased demand. So, the resting EKG may be normal, but the exercise EKG may be abnormal.

For arrhythmias, the problem with a single EKG is that it only captures 10-15 seconds of heart activity. If you do not have the arrythmia when the EKG is recorded, your rhythm looks normal. Believe me, I tried to capture my arrhythmias by keeping an EKG machine in my office for a month (I work at a hospital)! Every time I hooked myself up and ran an EKG... nothing. As soon as I unhooked myself, there was my arrhythmia! There are much better tests to diagnose an arrhythmia, such as an event recorder, or a Holter monitor.

Definitely get a cardiologist who knows something about athletes. My cardiologist does hard-core back-country skiing 10 months out the year, so he is much more in tune with what my training looks like, and issues affecting an athlete's heart.

Good luck,

Sharon

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Festina Lente

Bob... You are correct. By coincidence, this was explained to me a few hours ago by a cardiologist.

Maybe some of you remember from a past post, that I was a little worried because my 12 year old was getting readings over 240 bpm on his HRM. I took him today to the cardiologist to test him. He ran an EGC exercise stress test on him. Before the test he asked me why I wanted to test him and I mentioned that I just wanted to see if there was something wrong with him as his HRM was going at times over 240 bpm during the run. He asked why he was using a HRM and I told him that he was a triathlete. He made a surprised face, raised an eyebrow and proceeded to give indications to her assistant to set my son up for the test.

My son finished the test arrogantly asking why they stopped the treadmill if he could go longer. The MDs looked at each other with a surprised look, told my son that the treadmill was set to stop after 21 minutes and then asked me to explain more precisely what type of athletic training was my son doing because it was very unusual to see someone lasting the whole test. I told them I was in first place interested in knowing if my son's heart was healthy. They looked again at each other and told me that his ECG results were not "normal". For a couple of seconds my own heart shrunk, but then they told me not to worry as my kid was very healthy. What I understood of their explaination was that if taken out of context his ECG results were clearly not normal and only because I told them that he was a dedicated triathlete they could say that there was really nothing wrong with my kid's heart.

The report says that my son reached 20 METs when the treadmill was stopped. Doing a Google search I found this calculator http://www.exrx.net/...ators/Treadmill.html for the test he ran. According to the calculator when the treadmill was stopped (under his will as he says :) ) at 21 minutes he was reaching 73.6 VO2 MAX.

Something else... The Timex BodyLink HRM he was using when he reached over 240 bpm (see actual graph below of one of his practice runs) was clearly being affected by some type of interference as the cardiologists confirmed that his MHR is with a good degree of precision close to 208 bpm. I am now sure of this now, because he was wearing the same HRM during the ECG stress test and it again showed at times readings of 240 bpm when my son was well below 190 bpm.

Sergio

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Note: English is not my first language. Please read this translated post considering that.