ECG and blood pressure measurement

What an ECG shows

The recording may give information about rhythm, rate and electrical conduction. It may identify some arrhythmias or changes that need investigation. Some findings are harmless variants, while others matter only when linked to symptoms or known diseases.

An ECG at rest is a short recording. If palpitations occur only from time to time, they may not happen during the recording and the doctor may recommend longer monitoring. A normal ECG does not always exclude coronary disease and is not enough to judge every cause of chest pain.

How it is done and when it is recommended

Electrodes are placed on the skin of the chest and limbs. Stay still during the recording. The examination is quick and does not send electrical current into the body. Report symptoms, medicines and implanted devices, and bring old ECGs for comparison.

An ECG may be recommended for palpitations, fainting, chest pain, known heart disease or other reasons. Performing it as screening in every person without symptoms and at low risk has no proven benefit. Age or the wish for a general check do not alone determine the need for it.

Why measurement technique matters

Blood pressure varies during the day and may be affected by activity, stress, pain and the way it is measured. Measurement is done after quiet sitting, with the back and arm supported, feet on the floor and a suitable cuff. You should not talk during measurement.

In the initial assessment both arms may be measured. If the pulse is irregular, an adapted or manual measurement may be needed. An unvalidated device or an unsuitable cuff may lead to a wrong assessment and to unnecessary or insufficient treatment.

When arterial hypertension is suspected

According to European guidelines, repeated office values of at least 140/90 mmHg (tension 14 me 9) raise the question of hypertension. Confirmation usually requires further measurements, often at home or with 24-hour monitoring, depending on the situation.

High pressure only in the office is called the white-coat effect, while pressure that is normal in the office but high outside it may be masked hypertension. Interpretation limits vary with the method of measurement. A single value is not a basis for starting or stopping treatment on your own.

What happens after the results

If high pressure is confirmed, other risk factors and possible organ damage are assessed. The plan may include lifestyle changes, medicines and monitoring. The treatment target is adapted to the patient, tolerance and accompanying diseases.

For an ECG, the next step depends on the finding. No further investigation may be needed, or a Holter, echocardiography or a further consultation may be recommended. The automatic statement of the machine does not replace the doctor’s interpretation.

Frequently asked questions

Does a normal ECG exclude heart disease? Not entirely. An ECG is a short recording at rest. It may be normal even when there is coronary disease that appears only during exertion or an arrhythmia that occurs from time to time. The doctor decides whether a Holter, echocardiography or another examination is needed.

How do I measure blood pressure correctly at home? Sit quietly for 5 minutes, with your back supported, feet on the floor and the arm at heart level. Do not talk during measurement and avoid coffee or smoking 30 minutes before. Measure twice in the morning and twice in the evening for several days, and record the results.

What is the white-coat effect? It is pressure that is high in the consultation but normal outside it, because of anxiety in the medical setting. It is distinguished by home measurements or 24-hour blood pressure Holter. It is not always harmless and should be followed.

When is a blood pressure Holter needed? When measurements in the consultation and at home do not agree, when masked hypertension or the white-coat effect is suspected, or to assess the effect of treatment throughout the day and night. The device measures pressure automatically for 24 hours.

Should I have an ECG every year? Not if you have no symptoms and no particular risk. Routine ECG screening in adults without symptoms and at low risk has no proven benefit. An ECG is done when there is a clinical reason, or when the doctor sees it as reasonable for follow-up.

Are home wrist blood pressure monitors accurate? Many validated upper-arm cuff devices are reliable. Wrist devices and unvalidated ones are less dependable. Bring your device to the visit so that the doctor can compare it with their own measurement.

When emergency care is needed

Care at Tirana Polyclinic: We perform ECG and blood pressure measurement, as well as Holter ECG, 24-hour pressure Holter and echocardiography when indicated. The results are interpreted in the consultation and linked to the follow-up plan.