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Why I love the Electrocardiogram – the EKG

EKG Line

You put the leads on, push a button, and all of a sudden you see an electrical signal from the human heart – remarkable!  I’ve always been fascinated by that, even in my early days as a medical student. But when I learned about how to use those squiggling lines to find out how people’s hearts were doing, that was even more interesting.


Almost every time you come to see a cardiologist, a technician (rarely the doctor anymore) will place those sticky pads on your chest and arms, and record your electrocardiogram.  Then usually the doctor, if you’ve been to that office before, will compare that EKG to the previous ones the cardiologist has available to look at. So what is the cardiologist looking for?  Who invented this amazing device, and how long ago?


It was in the 1890’s, about 130 years ago, that a young Dutch doctor, just finishing his education, was attending a conference in London.  Wilhelm Einthoven was more interested in orthopedics and ophthalmology, but on this day he was awe-struck. A doctor named A. J. Waller was demonstrating on the stage how by hooking up electrodes to three legs of his bulldog Jimmy, and placing the fourth leg into a bucket of salt water, that somehow he could record the signals of the heart beating.  


Scientists had known for almost one hundred years prior that animal and human cells, those of the brain, heart, and the nerves, conducted electricity, but no one had been able to accurately record those signals from the human heart.  Einthoven was inspired that he could do that.


Working diligently in his lab for over 15 years, failing and failing until finally succeeding, Einthoven’s machine, which he first called the “electrocardiogram,” was reliable and ready to be used on patients.  For the first time in medical history, doctors could study the rhythm of the heart, how long it was taking the heart impulses to create the heart beats, and what patients were taking about when they complained that their heart was beating funny – they were having palpitations.  This device created the specialty of Cardiology, separating those could devine those signals from the doctors who could only take the pulse or listen to the heart with a stethoscope. Dr. Einthoven won the Nobel Prize in Medicine in 1921.


Today in my office, I use basically the very same type of machine that Einthoven invented.  Now, I can look at much more than the basic rhythm of the heart. I can see if someone has had a heart attack, and many heart attacks are silent.  I can see if the heart is getting enough blood, at least at rest. I can see if high blood pressure, hypertension, is thickening the heart muscle. I can see if medications are making the heart rate too slow, or causing the heart’s electrical system to possibly malfunction.  I can see if a pacemaker is working properly. And often times I can detect the cause of those intermittent palpitations (although not always!).


Even in the current days of so much more sophisticated heart imaging, such as echocardiograms, cardiac catheterizations, nuclear medicine scans, CT scans, and MRI scans, the electrocardiogram continues to be the basic tool of the Cardiologist.  Dr. Einthoven’s machine has stood the test of time, and will likely always be an important test for all patients with real or potential heart problems. So don’t object to having the EKG done, just about each and every time you see a cardiologist, even if sometimes pulling off those electrode pads is painful for a second or two!

Dr. Arnold Meshkov

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