I am a heart surgeon: I tell my patients that a normal ECG is not a clean chit
Editor’s Note: In this fortnightly column, top doctors share how they deal with their own health challenges, offering readers expert insight grounded in experience. Read
Editor’s Note: In this fortnightly column, top doctors share how they deal with their own health challenges, offering readers expert insight grounded in experience. Read more such stories here. Every week, someone walks into my clinic, sits across from me, and says, "Doctor, my ECG is normal. My cholesterol report is fine. So why should I worry about my heart?" It is a question I hear far too often, and every single time, I pause before answering because it reflects one of the biggest misconceptions people have about heart health. Many people genuinely believe that if a routine test looks normal, there is nothing more to worry about. Read Full Story As a heart lung transplant surgeon, I have seen firsthand how misleading that assumption can be. I have seen hearts that looked perfectly normal on paper fail catastrophically in real life. I have operated on patients who were fit, active, and seemingly healthy. Some had even gone for a morning jog just hours before suffering a massive heart attack. Their reports did not always tell the full story. Their lifestyle appeared healthy, yet within minutes, everything changed. The problem is not that people do not care about their hearts. Most people do. The real problem is that many have been taught to focus only on a few routine reports and believe those reports tell the complete story. Heart disease is much more complex than a normal ECG or a healthy cholesterol level. AN ECG ONLY TELLS YOU WHAT YOUR HEART IS DOING AT THAT MOMENT One of the first things I explain to my patients is what an ECG actually does.
An ECG records the electrical activity of your heart at that particular moment. It tells me how your heart is functioning while the test is being performed. It is an important investigation, but it has its limitations. What an ECG cannot tell me is whether your arteries have a blockage that has not yet affected your heart rhythm. It cannot reveal a narrowing of sixty per cent if it has not started causing electrical changes. It also does not know that your father suffered a heart attack at the age of 52, that you have been living with chronic stress for several years, or that you survive on five hours of sleep every night and consider it normal. A normal ECG simply means that your heart's electrical system appears normal at that moment. It is not a guarantee of future heart health, nor is it a certificate that says you are free from heart disease. THE WARNING SIGNS THAT MANY PEOPLE IGNORE Over the years, I have noticed a pattern among many of the patients who come to me too late. Almost all of them remember experiencing subtle symptoms months or even years before a major cardiac event, but they dismissed those signs because they did not seem serious. Some noticed slight breathlessness while climbing stairs and assumed they were simply out of shape. Others experienced pain in the jaw or shoulder after a heavy meal and blamed acidity. Some felt their heart racing for a few seconds while resting and thought it was only stress. Many complained of unusual tiredness that did not improve even after proper sleep and believed it was simply a part of getting older.
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