Wednesday, 13 April 2011


I have been sick for many years and I have found it sometimes very difficult to find out information about my conditions, in particular Pots syndrome. I have written this blog to try and help anyone who is suffering with POTS or Marfans Syndrome. By finding this blog hopefully you will find everything you need to know. I have tried to include everything that I have researched and also tried to give an account of my experience. I would emphasise that the most important thing is not to give up hope and to fight against this illness (in particular I refer to Pots). I really hope that this blog is of help to you!

Tips for Treating Pots

It is a real fight to get better so listed below are some of the key things that I think can help.



I take paediatric Atenalol oral solution 5ml of which I take 1 ml three times a day. The key problem with POTs patients is that we do not tolerate medications very well. Whilst in hospital I was given a higher dose (an adult dose) which slowed my heart rate down too much which was dangerous. It was my suggestion to try the paediatric dose. I had to push for this whilst in hospital so be forceful when you speak to your doctor. Sometimes I can lower the dose. I have my own heart monitor and if I feel that my heart rate is going too high I sometimes just take an extra dose at the time to relive the symptoms. Everyone is different so because this oral solution is a very low dose you can play around with it to find out exactly what suits you.


I take 10mg of Seroxat tablets, one per day. Seroxat is an antidepressant. My cardiologist told me it is sometimes used in the tilt table tests to raise blood pressure. In my case it helped to raise my blood pressure. The dose I take is a very low dose as I could not tolerate even 20mg. I think it also helped to ease the nervous state that I was in whilst I was very sick. As it is a very low dose it does not really work as an antidepressant and it is fine to stay on this dose long term. However I have now descovered that to stop taking seroxat this must be done slowly.

Alternative Medicine:

As soon as my blood pressure was high enough for me to go and see my osteopath I did so. I had seen him for many years to help with my Marfans syndrome. When he started to treat my Pots I saw him twice a week for about two months. There is a tiny bone in the neck at the front next to the main artery. He very gently worked on this bone as it helped to stabilise my blood pressure. His details are in my blog. I really do believe that this was one of the main things that started me onto the road to recovery. I now see him at six week intervals but he no longer needs to work on my neck. I really do think that it would be worth looking into this type of treatment if anyone has POTS but you must make sure you see a highly qualified osteopath like Stephen Sandler, who is renowned in his profession.

Mirena coil:

I had this fitted in April 2010. One thing that I noticed was that my symptoms were always worse during menstruation. I had a test to check my hormone levels and this showed I was entering into my menopause. The coil has helped so much. I have my own theory that POTs can be caused by hormones. Women that suffer from POTs seem to be teenagers, pregnant women or women who have recently had children or in their mid-forties. This is just my theory and I cannot explain why men and boys also get POTs but perhaps hormones play a big part for them too.


I think stress played a huge part in me becoming I'll. It was almost like a good old fashioned nervous breakdown. I now believe that I have always had POTs. As a young child I used to faint if I had to stand in the school play or as a teenager I used to faint if I had to stand in the pub but because I was so active and exercised all the time I think that my symptoms were kept at bay. I am sure that stress caused my body to almost give up in May 08. My Father had passed away and my Mother was taken into hospital with a heart block. I was manic at work and had a family and home to look after. I think finally all the stress got to me. After being in and out of hospital for a year and in a wheelchair my GP suggested that I see a Psychiatrist in 2009. He prescribed the Seroxat and said that he was sure it would help me to get better as it also raises blood pressure. He also recommended that I have some therapy to help me deal with the Pots. The seroxat really did help as did the treatment with a therapist which included EMDR (rapid eye movement therapy, usually used for trauma patients). My therapist also recommended that I try Mindfulness treatment.


Exercise is the main key to getting better. I know it sounds silly when you can't even get out of bed but it is so important to build up the legs to help pump the blood round the body and stop it from pooling. Whilst I was in hospital I started to raise my legs and pedal in the air as if I were riding a bike. I could hardly do this at first but you have to keep trying as it is the key to getting better. When I came out of hospital I got a recling exercise bike and gradually built up every day. I also got a wheelchair. Getting house bound is the worst things that can happen. You get scared to go out in the end. At least if you have the wheelchair you can go to the shops (standing in line was impossible, and still is a problem for me even now) or be taken for a walk and get out now and then and try to walk yourself. With the wheelchair my mother took me out every day and I would try and walk pushing the chair. When I got too tired I would get in the chair and she would push me again. I would gradually build up every day. I make sure I walk for half an hour every day now and I speed walk (so there is hope I promise). I also swim. You must build up your leg muscles to help pump the blood round the body and stop blood pooling. I also used to put on music and dance around to build up my stamina. It nearly killed me at first but you have to be strong and don’t give up. Even now, first thing in the morning, my heart races. I take my medications and keep moving around. I climb the stairs a few times to get the circulation going and make sure I keep moving around. It is sometimes hard not to go back to bed but I make sure I avoid this at all costs.

Low GI Index Foods:

I have mentioned these in my blog. I stick as much as I can to this diet and I eat little and often. I can eat big meals now but my heart does race when I do this. Avoid garlic at all costs as this lowers the blood pressure.

High salt intake:

I eat boiled eggs now in the morning as I can add a lot of salt. I eat soup at lunch time and add salt. Then add lots of salt to my evening meal. I could not take sodium tablet as I could not swallow them. I do not measure what salt I take but I just add plenty to my food. I think sometimes it makes things worse to over analyse what we are doing as this adds to the stress and makes the Pots worse.

Drinking lots of fluids:

As well as drinking water I drink organic tea. I did stop caffeine when I first became ill but I have found tea does not make me urinate so much. I therefore retain the salt I need to increase the blood volume. This may work for you. I found coffee gave me an irregular heartbeat. Caffeine does raise the blood pressure so experiment.

Blood pressure machine:

I do not use this very much now. However, when I was really sick I found it was helpful to take my blood pressure. This would stop the panic attacks because I could see exactly what my blood pressure was. It stopped my imagination running wild.


Now this is controversial. I do not recommend this to anyone. I have smoked since I was 15. I mentioned earlier that I believe that I have had Pots since childhood and maybe because I smoked at such an early age this helped to keep my Pots symptoms at bay. I was forced to stop smoking as I was in hospital for my POTs in May 08 and started again in April 09 when my husband left me. As soon as I started to smoke my symptoms improved. My cardiologist is aware of this. He said that smoking does raise the blood pressure. I know all of the reasons why I should quit but it got me out of the wheelchair so it, for me, is a case of quality of life. I am going to try and quit again but must admit am scared to. Watch this space.

Change in life style:

My husband left because he could not cope with the POTs in April 09. I know realise he was a cause of much stress to me and maybe living with him made my symptoms worse. Another big cause of stress to me was work. I was pensioned off for ill health in July 09 as I could no longer work. I was very lucky that my company kept my job open all the time I was in hospital and I worked from home when I was able to but finally it was agreed that it was going to be impossible for me to return. I am very fortunate that I worked for 26 years so I have a pension to fall back on. I do not know what would have happened to me if I did not have this.

Get Your Kidneys Checked:

A doctor mentioned to me that there is a theory that damage to the kidneys by antibiotics in childhood could be a cause of POTs. My kidneys are slightly damaged and I only recently found this out.

Raise Your Bed Under Your Head:

My Professor told me to do this with either bricks or pillows which I did. It helps to stop your heart racing at night. I used to sometimes wake up at night trying to catch my breath. It was awful, like I had stopped breathing or had died. This did help. Also taking the Seroxat really did help as my panic attacks started to stop. I used to have very vivid dreams and I think I used to panic in my sleep.

Living with Pots is not easy. In the most part I live a normal life now. I still sometimes have bad days but I find that I just must not give into my symptoms. It is all trial and error but never give up hope. You can get better. Please read through my blog and I really do hope that you find the information in it of use to you. I mostly wrote this when I was very sick and I pray that all my hard work and efforts at the time of being so sick will help others. Pots is an awful condition but you can beat it. Good luck.

Tuesday, 14 October 2008

Marfans Syndrome

Marfan syndrome is a genetic condition which affects the body's connective tissues. The connective tissues help to provide support and structure to other tissue and organs. Marfan syndrome can affect the connective tissues in many different areas of your body, such as your blood vessels, skeleton, and eyes.

Symptoms of Marfans Syndrome

The symptoms of Marfan syndrome vary from person to person. Some people are only mildly affected, while others develop more serious symptoms. Marfan syndrome is hereditary, which means that it is passed on to you from your parents. If you have Marfan syndrome, your child has a 50% chance of developing the condition.

Marfan syndrome is a relatively rare condition. Approximately 1 in 5,000 people have the syndrome. Men and women are equally affected. Although rare, Marfan syndrome is the most common connective tissue disorder.

As Marfan syndrome can affect your heart and blood vessels, it is a potentially serious condition. Although there is currently no cure for Marfan syndrome, treatments are available which can help to effectively manage your symptoms, greatly improving your prognosis and life expectancy.

Features Of Marfans Syndrome

Outwardly, sufferers are usually tall and thin with disproportionately long limbs. Indeed, their arms are often 10% longer than they should be. They may be scoliolitic (have a sideways twist of the spine) or kyphotic (hump-backed) and have a pigeon or stove chest. Their joint hypermobility could be such that sufferers can bend their thumbs back to touch their forearms, and their fingers back at 90 degrees, without discomfort.

Sufferers are often very myopic (short-sighted) and some have dislocation of the lens and detachment of the retina. Marfan patients may also suffer from overcrowded teeth and a high, arched palate.

The major problems affecting a person with Marfan's Syndrome are linked to the heart and major blood vessels. The aorta - the large artery carrying blood away from the heart, may become dilated. Usually the ascending aorta - the section directly after it leaves the heart - is at risk, but it can also occur further down the vessel where it leads to the abdomen and lower body. The danger with this is that a swollen area, known as an aneurysm, could eventually burst. The aorta itself is made up of two layers of tissue. These can be torn apart - a disastrous and life-threatening event, known as a dissection. Indeed, aortic dissection is the most common cause of death in Marfan patients today. This can often be prevented if it is known to be a risk factor by reinforcement with an artificial structure made from titanium.

The aortic and mitral valves of the heart can also be affected. Situated on the left side of the heart, these may become 'incompetent' and let blood through when they are closed. This means that the heart can't pump as much blood as is needed and eventually a mechanical valve may be necessary.

Diagnosis Of Marfans Syndrome

Generally, Marfan Syndrome is diagnosed after a careful physical examination focussing particularly on the the eyes, skeletal and cardiovascular systems.

Suspected Marfanoid patients can also be monitored by Echocardiogram (a sound-wave picture of the heart) for early signs of aneurysm or mitral valve prolapse (the valves can become floppy).

The affected gene, FBN1, was discovered in 1990 and the protein it codes for (fibrillin) was discovered the following year. This knowledge should help develop a more accurate diagnostic test which could be applied at a much earlier stage. Mutations in the FBN1 gene can be detected in 80% of patients, thus enabling family members to be screened. Diagnosis can then be confirmed by genetic linkage studies.

Effects on Lifestyle

Stretchy connective tissue means that the aorta is not as strong as it should be, and is thus prone to tearing. Consequently a Marfan's person needs to avoid strenuous exercise and stress, or anything that would put the heart under excessive load. Nevertheless, a person with Marfan Syndrome still needs to be physically fit in order to maintain muscle tone, as well as ensuring the effective functioning of the heart and blood vessels. Hence golf, fishing, walking and non-competitive cycling would be ideal activities. Contact sports such as basketball and rugby are probably best avoided.

Dietary Considerations

Although no special diet is required, it would be prudent for the Marfan patient to choose their food wisely to ensure a balanced diet, rich in vitamins and minerals, particularly copper, which encourage the production of connective tissue.

For sources of copper see Copper


It used to be the case that Marfan's people died early of heart failure, but with modern drugs (ie, beta-blockers) and surgical intervention, longevity is now possible. Beta-blockers have been shown to slow the dilation of the aortic root.

Physiotherapy, attendance at pain clinics and bracing to stabilise curvature of the spine may be helpful with the skeletal effects. Lace-up shoes with ankle support, together with shoe inserts, may be helpful for weak ankles.

Spectacles or contact lenses may be prescribed to try and improve or correct visual defects; and surgery can replace ocular lenses and re-attach retinas.

Approximately 10% of Marfan patients suffer spontaneous pneumothorax (collapse of the lungs) and this requires hospital treatment.

My Profile

I am now forty three years old. I was diagnosed with Marfans Syndrome when I was a year and a half old. The main symptom that I suffer with is that I am partially sighted. I also am very tall and my joints are very flexible. I have had echocardiogram’s every two years but have not experienced any problems with my heart. I have experience some problems with my back and this has been greatly helped by my osteopath StSephen Sandler is a world expert.

I suggest that if you are very tall and that your arms are very long (usually Marfans patients arm span is longer than their height) I would suggest that you have a word with your GP as you may have Marfans.

Postural Orthostatic Tachycardia Syndrome

POT's syndrome is where the blood pools in the legs and as a result of this the heart rate increases upon standing by over 30 beats per minute (usually within ten minutes). Patients very often go into tachycardia and quite often pass out.

My Profile

n May 2008 I was sitting on the train travelling into London to work. The train was very crowded and suddenly I felt my heart rate going very fast and I had to get off the train. I had been experiencing a lot of stress at both home and work and I just thought that it was a bit of a panic attack. I went straight home but had to immediately call an ambulance as my pulse was racing. Apparently it was 200 beats per minute. I was admitted into hospital. I was lying on the stretcher for about an hour and by the time the nurse did the ECG my pulse had gone back to normal. I was dismissed from the hospital and given a beta blocker. This made my symptoms much worse and the following week I was admitted by ambulance again into hospital.

As I already had Marfans Syndrome the focus was on this condition. I had a CAT scan and various blood tests the results of which were all normal. I was hooked up to a heart monitor and I began to notice that if I stood up from either a lying or sitting position that my pulse would rise to 150 beats per minute. I informed my consultant of this and he carried out a standing ECG which showed the symptoms of tachycardia. I was released from hospital but needed further investigations. These included a tilt table test, various urine collection tests, numerious blood tests, tests on the adrenal gland, MRI scan, heart and blood pressure monitor tests and autonomic function test. All tests came back normal apart from the tilt table test and the heart monitor tests. I had to be admitted another two times into hospital as I was very unwell.

I have been more or less bed bound now since May as the doctors are finding it hard to give me suitable medications. I have researched POTS now and have found that a lot of patients are intolerant of certain medications. I am taking paediatric atenolol. I take 5ml syrup a day but have to split this three times a day as I can not take the full 5ml in one go. This does bring down the pulse but I can not seem to take enough of the medicine to enable me to exercise (or even walk up the stairs without becoming exhausted). I also take a steroid called fludrocortisone (0.5mcg per day). The purpose of this drug is to help the body retain salt and thus increase blood volumes.

I am due to be admitted into hospital again to trial a new drug with the atenolol. This drug is Midrodine. I hope that this drug will work because if it does not I may have to have a pace maker fitted and I do not relish the thought of this. I will let you know what happens, well that’s if I am here to tell the tale.

Symptoms of POTS

I have experienced the following symptoms:

Tachycardia, syncope (fainting), extreme fatigue, headaches, nausea and in particular morning sickness, extreme thirst, constant urination, restless legs at night, get very hot and can not tolerate heat, diarrhoea or constipation, difficulty swallowing, stomach pains, difficulty eating due to bloated feeling, weight loss, can not tolerate taking a bath or shower (the heat of the water exacerbates the symptoms).

Useful Tips

Drink plenty of water every day to increase the blood volume.

Wear support hosiery which provides compression of the veins. Tights would be preferable to stockings. These work in some patients. I have read that some patients use g-suits but I have not tried this myself yet.

When bathing do not have the water too hot.

Do not stand in the shower but sit on the floor.

Do not bend over, always bend with your knees.

Also when standing still try to cross your legs.

Do not drink alcohol as this makes symptoms much worse.

It is sometimes very difficult to eat large meals. I found that my tummy felt very bloated and that I often felt very sick. Also I had a very weird sensation in that I felt that my throat was closing up and that I could not chew my food properly. I also suffered with either diarrhoea or constipation. After researching POTS I found that food could play an important part in helping to improve symptoms. I now follow the GI diet (I do not actually diet but I mainly eat GI foods). I have also cut down on dairy products as I have read that they do not help POTS patients. I am mindful that my calcium intake is now lower and the only way that I can naturally address this is to eat nuts, oats and berries which I believe are high in calcium. I now also avoid garlic as this lowers the blood pressure as do nitrates (these can be found in greens and carrots and also I believe may be in tap water but I think this would depend on where you live). I also make sure I eat two bananas a day because the steroid depletes the body’s supply of potassium and magnesium (magnesium can also be found in nuts). Every morning I juice a lemon and add the juice and lemon to a cup of boiled water. I add a pinch of cinnamon, small pinch of ground cloves (only a pinch as this is a very strong spice and you should not use too much) and a pinch of ginger. These are all good for circulation. I also add half a teaspoon of honey as this is very good for the kidneys. I also drink one glass of Cranbury juice per day as this is also good for the kidneys (I am aware that this may increase my blood sugar levels). I have read that two strong cups of coffee in the morning can help to raise a low blood pressure but as I have eliminated all caffeine from my diet I have not tried this. This diet seems to be really working as for the first time in my life I have not suffered with the symptoms of irritable bowel syndrome in that I am regular now and have normal stools. The most important thing I think is to eat little and often. I eat at least every three hours so as to make sure my blood sugar levels do not drop. Some POTS patients recommend the sports drink Gatorade to help fight the fatigue symptoms. For myself I just found that it increased my heart rate so was of no use, it might be to you so it’s worth a try. I also find that high protein cereal bars are a handy and quick snack.

Exercise is very important although very difficult at times. In particular exercise the legs. An exercise bike is a good form of exercise for the legs and if you use one with a chair and so that you can lay flat this would be very helpful. Start off gradually to increase the muscles in the legs. If you can not get out of bed it is even more important to try and exercise the legs to keep the circulation going. Lie flat on your back and then you can raise your legs and pedal is if you were riding a bike. Or you can raise one leg at a time slightly then point your toe and then move the ankle so that the foot becomes straight again. You will feel this stretching the calf muscles at the back of your leg. With POTS even these simple exercises can be exhausting so do not be frustrated if you can not do these for long. Even if you can manage a minute several times a day it will help your circulation.

When you are in bed raise your head approximately 12 inches (use pillows but you could get an electric bed although this is an expensive option).

I would be really interested to hear if anyone has more useful tips?

Does anyone else suffer with both Marfans Syndrome and Pots Syndrome? I would be interested to hear!

Doctors Whom I Would Recommend

I have been extremely lucky in that I have had fantastic doctors to help with my diagnosis.

I first met Dr Rajiv Amersey MD MRCP who is a Consultant Cardiologist and Physician at Whipps Cross University Hospital, Holly House Hospital and Bart’s Hospital. He is a fantastic doctor and was very quick to spot the signs of POTS. He did not give me an immediate diagnosis as he wanted to eliminate all other conditions but I have never known a doctor to be so thorough and also kind.

After trials of various medications we decided that it might be time for me to see a specialist so I was referred to Professor Rodney Grahame CBE MD FRCP FACP who is a Consultant Rheumatologist/Honorary Professor at UCL in the Dept of Medicine. Professor Grahame is an expert in Marfans syndrome. Professor Grahame is semi retired now. He was a lovely man who spent a long time with me and finally concluded that I obtain an opinion from Professor Mathias who is an expert in POTS.

Professor Christopher J Mathias DPhil DSc FRCP FMedSci works at both the Imperial College London (St Mary’s Hospital) and the National Hospital for Neurology and Neurosurgery & Institute of Neurology, University College London. Professor Mathias is a charming man whom immediately puts one at ease. He carried out various autonomic function tests and I am to be admitted into hospital at the end of October for more tests.

If anyone has any of the symptoms of either Marfans or POTS I would recommend that you seek out the advice of any of the above doctors.


The following are some medications that I know about that are used to treat POTS.


For information on Midodrine see patient information leaflet:

Other Medications

Midodrine (Proamatine), is approved by the U.S. FDA to treat orthostatic hypotension, a condition related to POTS. It is a stimulant that causes vasoconstriction and thereby increases blood pressure and allows more blood to return to the upper parts of the body. Use of midodrine is often discontinued due to intolerable side-effects, and it is known to cause supine hypertension (high blood pressure when lying down


For informaiton on Fludrocortisone see patient information leaflet:

The first line of treatment for POTS is usually fludrocortisone, or Florinef, a corticosteroid used to increase sodium retention and thus increase blood volume and blood pressure. An increase in sodium and water intake must coincide with fludrocortisone therapy for effective treatment. Dietary increases in sodium and sodium supplements are often used. Gatorade is also effective in providing both sodium and fluid.

Beta Blockers

Beta blockers such as atenolol and propanolol are often prescribed to treat POTS. These medications work by blocking the effects of epinephrine and norepinephrine released by the autonomic nervous system. Beta blockers also reduce sympathetic activity by blocking sympathetic impulses.


Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Celexa, Lexapro, and Paxil, can be extremely effective in re-regulating the autonomic nervous system and raising blood pressure. Some studies indicate that serotonin-norepinephrine reuptake inhibitors (SNRIs) such as Effexor and Cymbalta are even more effective. Tricyclic antidepressants, tetracyclic antidepressants, and monoamine oxidase inhibitors are also occasionally, but rarely, prescribed. A combination of two antidepressants, usually an SSRI or SNRI with Wellbutrin or Remeron, is also shown to be very effective.


Medications used to treat ADD and ADHD such as Ritalin and Adderall are used to balance dopamine levels, increase vasoconstriction, and increase blood pressure.

AnxiolyticsAnti-anxiety medications, such as Xanax, Ativan, and Klonopin, can be used to combat imbalances of adrenaline usually seen with POTS patients.

Other medications

Angiotensin converting enzyme inhibitors, or ACE inhibitors, are used to increase vasoconstriction, cardiac output, and sodium and water retention.Clonidine can work in patients with reduced sympathetic activity.

Ironically an anti-hypertensive drug, Clonidine promotes production and release of epinephrine and norepinephrine.

Disopyramide, or Norpace, is an antiarrhythmic medication that inhibits the release of epinephrine and norepinephrine.

Erythropoietin, used to treat anemia via intravenous infusion, is very effective at increasing blood volume. It is seldom used, however, due to the dangers of increasing the hematocrit, the inconvenience of intravenous infusion, and its prohibitively expensive cost.

Pregabalin, or Lyrica, an anticonvulsant drug, has been shown to be especially effective in treating neuropathic pain associated with POTS. In fact, Lyrica is currently the only prescription drug approved by the FDA to treat fibromyalgia. Some POTS patients also report improvement in concentration and energy while on Lyrica.

Pseudoephedrine and phenylephrine, over the counter decongestants, increase vasoconstriction by promoting the release of norepinephrine.Pyridostigmine, or Mestinon, inhibits the breakdown of acetylcholine, promoting autonomic nervous system activity. It is especially effective in patients who exhibit symptoms of excessive sympathetic activity.

Theophylline, a drug used to treat respiratory diseases such as COPD and asthma, is occasionally prescribed at low doses for POTS patients. Theophylline increases cardiac output, increases blood pressure, and stimulates epinephrine and norepinephrine production. Due to its very narrow therapeutic index, Theophylline is known to cause a wide variety of side-effects and even toxicity.

Women who report a worsening of symptoms during menstruation will often use combined (containing both estrogen and progestin) forms of hormonal contraception to prevent hormonal changes and an aggravation of their condition.

Drugs That Can Make Symptoms Worse

Drugs that can cause or worsen orthostatic intolerance are:

A-Receptor blockers
Angiotensin-converting-enzyme inhibitors
Calcium channel blockers
Ganglionic blocking agents
HydralazineMonoamine oxidase inhibitors
Sildenafil citrate (Viagra)
Tricyclic antidepressants

Useful NHS Medicin Guide


Statements and information regarding any products mentioned within this site have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure or prevent any disease or heath condition. Any information on this site should be considered as general information only and should not be used to diagnose or treat any health condition.

Please seek medical advice for a diagnosis and treatment of any medical concerns you may have, and before implementing any diet, supplement, exercise, or other lifestyle changes.

What Is An ECG

What is an electrocardiogram?

An electrocardiogram or 'ECG' records the electrical activity of the heart. The heart produces tiny electrical impulses which spread through the heart muscle to make the heart contract. These impulses can be detected by the ECG machine. You may have an ECG to help find the cause of symptoms such as palpitations or chest pain. Sometimes it is done as part of routine tests, for example, before you have an operation.

The ECG test is painless and harmless. (The ECG machine records electrical impulses coming from your body - it does not put any electricity into your body.)

How is it done?

Small metal electrodes are stuck onto your arms, legs and chest. Wires from the electrodes are connected to the ECG machine. The machine detects and amplifies the electrical impulses that occur each heartbeat and records them onto a paper or computer. A few heartbeats are recorded from different sets of electrodes. The test takes about five minutes to do.

What does an ECG show?

The electrodes on the different parts of the body detect electrical impulses coming from different directions within the heart. There are normal patterns for each electrode. Various heart disorders produce abnormal patterns. The heart disorders that can be detected include:

Abnormal heart rhythms.

If the heart rate is very fast, very slow, or irregular. There are various types of irregular heart rhythm with characteristic ECG patterns.

A heart attack, and if it was recent or some time ago.

A heart attack causes damage to heart muscle, and heals with scar tissue. These can be detected by abnormal ECG patterns.

An enlarged heart.

Basically this causes bigger impulses than normal.Limitations of the ECG

An ECG is a simple and valuable test. Sometimes it can definitely diagnose a heart problem. However, a normal ECG does not rule out serious heart disease. For example, you may have an irregular heart rhythm that 'comes and goes', and the recording can be normal between episodes. Also, not all heart attacks can be detected by ECG. Angina, a common heart disorder, cannot usually be detected by a routine ECG. Specialised ECG recordings sometimes help to overcome some limitations. For example:

Exercise ECG.

This is where the tracing is done when you exercise (on a treadmill or exercise bike). This helps to assess the severity of the narrowing of the coronary arteries which causes angina.

24 hour ECG monitor.

This is where you wear a small monitor for 24 hours which constantly records your heart rhythm. It aims to detect abnormal heart rhythms that may 'come and go'.