EKG vs ECG—What’s the difference?

Heart Health
Doctor watching vital signs with tablet

Hearing that you need a heart test might make you a bit nervous. If your provider tells you that they want to do an EKG or ECG, just know that it's both quick and painless. In some cases, it can even be done in your doctor's office. 

So what's the difference? EKG and ECG are actually different spellings of the same diagnostic test that monitors your heart's electrical activity. EKG is the abbreviation from the German spelling of electrocardiogram (which is elektrokardiogramm in German). The EKG abbreviation came into use because of where the test was initially invented. While both terms are used, many providers refer to the test as an ECG today.

"The test is a way to record your heart's electrical activity to make sure it's healthy," says Elliot Jerud, MD, a cardiologist at Riddle Hospital, part of Main Line Health. "An ECG checks the strength of your heart and determines if you have a normal heartbeat. The test can also determine the size of your heart's four chambers, which blood flows through."

Let's take a look at what this test can do and why or when you might need one.

What can an ECG check for?

Sometimes your provider will recommend an ECG to check for heart conditions such as coronary artery disease or arrhythmia (irregular heartbeat). It can also be used to monitor your heart after a heart attack or check for signs of heart disease.

They'll also perform the test if you're showing symptoms like:

  • Dizziness
  • Chest pain
  • Fatigue
  • Shortness of breath

The procedure is painless and there is no electrical shock involved.

"Caring for our patients is more than just providing treatment, it's also working towards prevention," says Dr. Jerud. "Catching something early, like coronary artery disease, can actually save lives. We're now able to recommend heart-healthy lifestyle changes and prescribe medicine to prevent a heart attack."

What can you expect during an ECG?

An ECG only takes a few minutes and you don't have to do any special preparation. Your provider may conduct the test in their office, but it can also be done at an outpatient clinic or a hospital.

During the ECG:

  • You'll lie on a table with electrodes (sticky patches with metal conductors that transmit electrical current) attached to your chest, arms or legs.
  • The electrodes, which are also connected to a computer, will record your heart's electrical activity.
  • The activity results will print out on paper or be shown on a screen.

The test checks to see if your heart has a consistent heartbeat and rhythm and will let your provider know if you might have any heart conditions.

An ECG has no major risks, although in rare instances you may notice a slight rash where the electrodes were connected. And if you do feel any discomfort during the test it's usually after the health technician removes the electrodes from your skin.

What do ECG results mean?

Your provider will go over the results with you and explain anything that may be confusing. If the ECG results are abnormal, more tests may be needed.

Abnormal results might mean:

  • A heart attack
  • An irregular heartbeat (arrhythmia)
  • Your heart's walls are thickening
  • An aneurysm (your artery's wall weakens and bulges out)
  • You heart isn't getting enough blood supply

If you're diagnosed with any of these conditions, your provider will discuss treatments that are best for you, as well as lifestyle changes that can help.

Keeping your heart healthy

An ECG test is short, painless and it's common. In fact, the test is sometimes a part of a routine exam for middle-aged and older adults. So if you've been experiencing fatigue or chest pain or have a family history of heart disease, talk to your provider. They may recommend an ECG.

Next steps:

Make an appointment with Elliot Jerud, MD
Learn more about heart and vascular care at Main Line Health
Different types of heart murmurs — and what yours is telling you