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All seven Medical Spheres ›An electrocardiogram makes the heart’s electrical signals visible. Depending on the question, it takes a few minutes, accompanies you through daily life for one to two days or shows how the heart responds to exertion.
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Guide values based on the guideline and the clinics. Which type you need will be clarified in your consultation with the doctor.
The ECG
The heart is controlled electrically. Before every beat, an electrical impulse spreads across the atria and ventricles, starting from the sinus node, the natural pacemaker. The voltages produced are tiny but can be measured on the skin. The electrocardiogram, ECG for short, records them as a trace. It only measures and does not emit any current itself.
For a resting ECG, usually ten electrodes are attached to the chest, arms and legs. From these, the device calculates twelve leads – twelve viewing angles on the same heartbeat. The recording shows how fast and how regularly the heart beats and whether the impulse is conducted without disruption. Signs of a recent or previous heart attack, a thickened heart wall or changes in blood salts can also be found in it. However, anything that occurs only intermittently can easily be missed by this snapshot.
This is where the ambulatory ECG comes in. A small recorder, connected to the chest by a few adhesive electrodes, usually runs for 24 to 48 hours, including at night. In a diary, you note when symptoms occurred and what you were doing at the time. This helps to clarify whether skipped beats, a racing heart, dizziness or a brief faint are caused by the heart rhythm. After a stroke, the recording looks for undetected atrial fibrillation. If symptoms are rare, longer recordings may be considered, for example with an event recorder.
In an exercise ECG, known as ergometry, you pedal on a stationary bike against a resistance that increases in stages. ECG, pulse and blood pressure are monitored continuously, and a doctor is present. The test shows how much exertion you can manage and how your circulation and rhythm respond to it. Signs of reduced blood flow to the heart muscle under load point to narrowed coronary arteries. To confirm such a narrowing, the German National Disease Management Guideline on coronary heart disease now tends to recommend imaging methods. During treatment, however, the exercise ECG still provides important information.
The examination
The snapshot: heart rate, rhythm, electrical conduction and signs of a heart attack. For chest pain, it is one of the first tests in the emergency department.
One to two days of recording in your usual surroundings. This captures arrhythmias that occur only now and then and compares them with the symptoms you note down.
The heart under exertion: fitness, blood pressure response and rhythm as the load increases. If symptoms or abnormal traces appear, the exercise stops immediately.
The procedure
Which type of ECG makes sense depends on your symptoms and previous findings. You do not need to prepare much.
Symptoms, existing conditions and medication are discussed, and a physical examination follows. Previous ECG results make comparison easier.
Where necessary, the skin is cleaned and, if very hairy, shaved in places so that the electrodes stick well. Comfortable clothing is recommended for the exercise test.
The resting ECG is recorded lying down, the exercise test on a bike. You take the ambulatory recorder home with you and bring it back after the agreed time.
The traces are assessed by a doctor. For the ambulatory ECG, software helps by capturing every single heartbeat and flagging abnormalities.
You find out what the results mean and whether further tests or treatment will follow. The referring practice also receives a report.
Insurance
Statutory health insurance
If symptoms or a known heart condition make an ECG necessary, German statutory health insurance covers the test – in the emergency department, during a hospital stay and at scheduled appointments.
In Wertheim, care covered by statutory insurance is provided by the Bürgerspital, the hospital with a public healthcare mandate. Please bring your insurance card, referral, previous findings and medication list to your appointment.
Private insurance or self-pay
Private health insurance and the Beihilfe allowance for civil servants reimburse medically necessary tests according to their tariffs. The Main-Tauber-Klinik, the private clinic in the same building, offers cardiac diagnostics on an outpatient and inpatient basis.
An ECG without symptoms, for example as a check before taking up sport again, is not usually covered by statutory insurance and is paid for by the patient.
Specialists
In Wertheim, ECG tests are part of the Department of Internal Medicine. Listed here are the specialist in internal medicine who represents cardiology there and the specialist in internal and emergency medicine of the central emergency department, where a resting ECG is the first step for acute heart symptoms.
Locations
Each clinic shows on its own website how the treatment works there.
Germany
The Bürgerspital, a hospital with a public healthcare mandate, records ECGs in its Department of Internal Medicine and in its central emergency department, which is open around the clock; the Main-Tauber-Klinik in the same building is open to privately insured and self-pay patients.
Frequently asked questions
Not from the measurement itself, as the device only picks up the voltages generated by the heart. At most, removing the adhesive electrodes can be unpleasant; sensitive skin sometimes stays red for a short while.
Go about your day as normally as possible – work, stairs, a walk – so that typical situations are captured. The device must not get wet, so do not shower or bathe. Note down in the diary any symptoms with the time they occurred, your sleeping times and your medication.
A light meal a few hours beforehand is usually fine, but not a large meal right before. Whether any heart medication should be paused for the test is decided by the doctor; please do not stop anything on your own.
With acute heart symptoms such as chest pain at rest, shortly after a heart attack, with acute inflammation of the heart muscle or pericardium, very high blood pressure or certain severe valve defects. Anyone who cannot cycle needs a different method. Acute chest pain belongs in the emergency department; if life is at risk, call 112.
Serious incidents are rare. However, because the heart is deliberately put under strain, arrhythmias, chest pain or a drop in blood pressure can occur. That is why you are monitored throughout and emergency equipment is on hand.
Not necessarily. A normal resting ECG does not rule out narrowed coronary arteries or an arrhythmia that occurs only intermittently. If the findings do not match the symptoms, further tests follow, such as an ambulatory ECG or a heart ultrasound.
Usually imaging follows that shows the blood supply to the heart muscle or the coronary arteries, and depending on the findings also a cardiac catheter examination. This takes place at a heart centre that specialises in it and that the clinics in Wertheim work with.
Consultation
Describe your request – the right clinic will get back to you.
Reviews
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Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanIch bin rundum begeistert von meiner Erfahrung in dieser Haartransplantationsklinik. Von der ersten Kontaktaufnahme bis zur Nachsorge war alles hervorragend organisiert und professionell. Das gesamte Team war unglaublich freundlich, hilfsbereit und zuvorkommend. Man hat sich jederzeit gut aufgehoben und ernst genommen gefühlt. Besonders positiv fand ich, dass sich alle Mitarbeiter ausreichend Zeit genommen haben, um meine Fragen zu beantworten und jeden Schritt verständlich zu erklären. Auch der Service war erstklassig. Die Organisation, die Betreuung vor und nach dem Eingriff sowie die Kommunikation waren wirklich hervorragend. Das gesamte Team hat einen sehr kompetenten und gleichzeitig menschlichen Eindruck gemacht. Die Klinik selbst ist modern, sauber und sehr gut ausgestattet. Während der Behandlung wurde äußerst sorgfältig und professionell gearbeitet, und ich hatte zu jedem Zeitpunkt das Gefühl, in guten Händen zu sein. Ein großes Dankeschön an das gesamte Team für die tolle Betreuung und den freundlichen Umgang! Ich kann die Klinik absolut weiterempfehlen und bin mit meiner bisherigen Erfahrung sehr zufrieden. Wer Wert auf Professionalität, Qualität und einen hervorragenden Service legt, ist hier meiner Meinung nach bestens aufgehoben.
Westfalenklinik Fachklinik für Plastische und Ästhetische Chirurgie · Original in GermanBisher war es nur ein Beratungsgespräch aber es war sehr gut.
Weight Doctors Group · Original in GermanIch fand, dass der Arzt gut und verständlich erklärt hat. Ich habe diese Woche noch einen Termin in einer anderen Klinik, da ich mich gründlich informieren möchte; auch der Preis wird dabei eine Rolle spielen – darüber bin ich ganz offen.
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Alster-Klinik Hamburg · Original in GermanÜber die ehrliche Einschätzung
Alster-Klinik Hamburg · Original in GermanIch habe mich sehr wohl geführt, das Gespräch war sehr gut, die Ärztin hat mir sehr ausführlich alles erklärt und bin mit einem sehr guten Gefühl nach Hause gegangen.
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