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Electrocardiogram (EKG/ECG) Test for Children

The heart beats because of the flow of electricity within the heart. An electrocardiogram (EKG or ECG) is a simple test that measures and records the heart’s electrical activity. An EKG shows the details of your child’s heartbeat, including rhythm (steady or irregular) and rate (fast or slow). It also shows the timing of heartbeats as the chambers squeeze and relax with each heartbeat.

As a heart screening test, EKGs are one of the first tests we use to evaluate your child’s heart. The cardiologists at Pediatric Heart Specialists (PHS) perform EKGs in our offices during your child’s first appointment.

What is an electrocardiogram (EKG/ECG)?

An EKG is a painless, noninvasive (doesn’t enter the body) test that lasts just a few minutes. For a pediatric EKG, we place small, sticky patches (patch electrodes) on your child’s chest, arms and legs. Using wires, we connect the electrodes to the EKG machine, which records the heart’s electrical activity. We evaluate the EKG results to look for signs of heart diseases, such as unusual heart rates or rhythms.

What are the types of pediatric EKG/ECG?

We may use one or more types of pediatric EKG to evaluate your child’s heart, based on symptoms and how frequently they happen. The types of pediatric EKG include:

  • Standard (resting) EKG: This is the EKG we do in our office, and your child lies on an exam room table for the test. We use standard EKGs to screen for and help diagnose many heart conditions.
  • Stress test: Your child exercises while we monitor and record their heart’s electrical activity with an EKG. A stress test can show symptoms that may happen only when your child is physically active, which a resting EKG could miss.
  • Holter monitor: This small, portable device continuously records the heart’s electrical activity while your child wears it. A Holter monitor test lasts longer than a standard EKG (from 24 hours to 14 days), so it can record symptoms that come and go.
  • Cardiac event monitor: Slightly larger than a Holter monitor, a cardiac event monitor can record the heart’s electrical activity for up to 30 days. A cardiac event monitor can record heart symptoms that happen a few times a month, which a standard EKG or Holter monitor might miss.

What does an ECG show?

EKGs show the patterns of electrical activity in your child’s heart. Electrical impulses travel through the heart muscle to signal the heart to beat. If the activity on an EKG varies from a normal pattern, it may be a sign of heart disease.

At PHS, our pediatric cardiologists use pediatric EKG tests to help diagnose many heart diseases in children, including:

  • Heart rhythms that are too fast, too slow or irregular (arrhythmias)
  • Problems with the heart’s structure, such as its walls, valves or blood vessels, that are present at birth (congenital heart diseases)
  • Unusual patterns of electrical signals as they travel through the heart (conduction disorders)

Why might my child need an EKG/ECG?

When you come to PHS for your child’s heart care, our pediatric cardiologists usually do an EKG as part of our first evaluation. We use pediatric EKG to:

  • Screen for heart problems, whether or not your child is experiencing any symptoms
  • Get a baseline assessment of the heart’s electrical activity
  • Monitor your child’s progress with treatments, such as medication or a pacemaker
  • Evaluate the heart before or after cardiac catheterization or surgery

If your child is experiencing heart-related symptoms, a pediatric EKG test helps us find the cause. These symptoms may include:

  • Heart palpitations (a feeling of the heart racing, pounding or skipping beats)
  • Dizziness
  • Fainting
  • Chest pain

What happens during an EKG for a child?

A pediatric EKG is a quick, simple test that we do in our offices, so you won’t need to go elsewhere for the test procedure. Find out what to expect with the procedures for a Holter monitor and a cardiac event monitor.

Before a pediatric EKG/ECG

Before the appointment, you can explain the EKG to your child and tell them that you’ll be with them the entire time. The test won’t hurt even though it might look scary.

Preparing your child for an EKG test includes these simple steps:

  • Your child can eat and drink as usual at any time before the test.
  • Don’t use lotion, powder, cream or baby oil on your child’s chest on the day of the test.
  • Your child may bring a favorite toy, stuffed animal or blanket as a comfort item to hold during the test

During a pediatric EKG/ECG

An EKG lasts about five to 10 minutes, including the time to set up the equipment. The equipment includes patch electrodes, lead wires and the EKG machine that records the electrical activity.

For the EKG procedure:

  • Your child can hold their comfort item throughout the test.
  • We ask you to remove your child’s shirt and put a hospital gown on them, open to the front.
  • Your child lies on the exam room table, and we cover them with a sheet.
  • We attach about 12 patch electrodes to your child’s chest, arms and legs. We connect the electrodes to the EKG machine with wires.
  • During the actual EKG recording, your child should lie still and not talk so we can get the most accurate results.

After a pediatric EKG/ECG

When the EKG finishes recording, we remove the wires and electrodes, which feels like pulling off a small bandage. Our pediatric cardiologists examine the EKG results to check for any problems with your child’s heart.

During the same visit, we discuss the EKG findings with you. We talk about the next steps, which may be doing more tests or beginning their treatment.

What are the risks of an EKG/ECG for children?

As a safe, painless, noninvasive test, an EKG has almost no risk. Sometimes, the adhesive in the patch electrodes can cause skin irritation or an allergic reaction. We offer special electrodes designed for sensitive skin, if your child needs them.