ECG Test in Pokhara: What It Measures and When You Need One
An ECG (electrocardiogram) is one of the fastest, cheapest, and most informative cardiac tests available. At A&B International Hospital, Pokhara, a 12-lead ECG takes five minutes, is entirely painless, and produces results that are available immediately. This article explains exactly what an ECG records, how to interpret your report in plain language, and when you need one.
What Does an ECG Actually Record?
An ECG records the electrical impulses that travel through the heart muscle with each heartbeat. It does not measure blood flow, valve function, or heart structure — those require echocardiography. An ECG’s strength is detecting abnormal rhythms, conduction problems, and the electrical signature of myocardial injury.
Each heartbeat begins with an electrical signal from the sinoatrial node in the right atrium, spreads across both atria (producing the P wave), passes through the atrioventricular node into the ventricles (PR interval), and then depolarises the ventricular muscle (QRS complex), causing contraction. The ventricles then recover (T wave). Deviations from this normal sequence are diagnostic.
How Is a 12-Lead ECG Performed?
The 12-lead ECG at A&B is performed as follows: the patient lies flat on a couch; ten electrodes are placed — four on the limbs (wrists and ankles) and six across the chest (V1 to V6). The machine records twelve different views of the heart’s electrical activity simultaneously. The recording takes approximately five minutes from placement to printout. No needles, no discomfort, no preparation required.
The term “12-lead” refers to twelve electrical perspectives, not twelve separate wires. Ten electrodes produce twelve mathematical views.
What Conditions Can an ECG Detect?
ECG is an essential first-line test for a wide range of cardiac conditions. The following are the most clinically significant findings:
Myocardial Infarction (Heart Attack)
Acute MI produces ST-segment elevation in leads overlying the affected territory. An inferior MI (blocked right coronary artery) elevates ST in leads II, III, and aVF. An anterior MI (blocked left anterior descending artery) elevates leads V1–V4. Q waves develop hours to days after a completed infarction and represent dead myocardium. This is the ECG pattern that triggers immediate emergency intervention.
Arrhythmias
- Atrial fibrillation (AF): Absence of P waves, irregularly irregular rhythm. Very common in the Pokhara population aged over 60. Carries stroke risk.
- Supraventricular tachycardia (SVT): Sudden rapid regular rhythm, usually 150–220 bpm, with narrow QRS.
- Ventricular tachycardia (VT): Wide QRS tachycardia — potentially life-threatening.
- Ventricular fibrillation (VF): Chaotic rhythm — cardiac arrest pattern.
Heart Block
First-degree, second-degree (Mobitz I and II), and third-degree (complete) heart block are distinguished by the relationship between P waves and QRS complexes. Complete heart block requires urgent pacemaker assessment.
Left Ventricular Hypertrophy (LVH)
Long-standing hypertension causes the left ventricle to thicken. ECG shows tall R waves in V5/V6 and deep S waves in V1/V2 (Sokolow-Lyon criteria). LVH on ECG in a hypertensive patient confirms end-organ cardiac damage and should intensify blood pressure management.
Right Heart Strain (S1Q3T3 Pattern)
Deep S wave in lead I, Q wave in lead III, and T wave inversion in lead III may indicate acute pulmonary embolism (PE) — a medical emergency. This pattern in a breathless patient should prompt urgent further evaluation.
Pericarditis
Diffuse saddle-shaped ST elevation across multiple leads without a coronary territory distribution, combined with PR depression, is the ECG signature of pericardial inflammation. Unlike MI, pericarditis ST changes are concave upward and widespread.
How Do You Read Your ECG Report?
ECG reports from A&B include a machine interpretation and a doctor’s clinical review. Here is what the main parameters mean in plain language:
| Parameter | What It Means | Normal Value |
|---|---|---|
| Heart rate | Beats per minute | 60–100 bpm |
| Rhythm | Regular vs irregular | Regular sinus rhythm |
| PR interval | AV conduction time | 120–200 ms |
| QRS duration | Ventricular depolarisation | Less than 120 ms |
| QT/QTc interval | Ventricular recovery time | QTc less than 440 ms (men), 460 ms (women) |
| Axis | Mean electrical direction | -30° to +90° |
| ST segment | Myocardial injury marker | Isoelectric (flat) |
A prolonged QTc interval above 500 ms significantly raises the risk of a dangerous arrhythmia called torsades de pointes and should prompt medication review (many common drugs prolong QT).
What Is the Difference Between a Resting ECG and an Exercise ECG?
A resting ECG is performed with the patient lying still. It detects resting arrhythmias, completed infarctions, conduction abnormalities, and LVH. However, it can be entirely normal in a patient with significant coronary artery disease whose symptoms only appear during exertion.
An exercise (stress) ECG — also called a treadmill test — monitors the ECG while the patient walks on a treadmill at progressively higher speeds and inclines. Exercise-induced ST depression indicates myocardial ischaemia (inadequate blood supply during demand). This test is used to investigate exertional chest pain or to assess a patient’s cardiac fitness before surgery.
Exercise ECG is available at A&B. Patients must bring comfortable footwear and avoid eating for three hours before the test.
When Is an ECG Part of Pre-Operative Workup?
Any surgery requiring general or regional anaesthesia carries cardiac risk. A baseline ECG is routinely required before surgery in patients aged over 40 or those with known cardiovascular disease, hypertension, diabetes, or symptoms of arrhythmia. The anaesthetist reviews the ECG to identify rhythm problems, conduction abnormalities, or evidence of previous silent MI that could affect anaesthetic management.
Is ECG Covered Under ECHS at A&B?
Yes. ECG is covered under the ECHS treatment schedule for serving and retired armed forces personnel and their dependants. Present your ECHS card at registration. No prior referral is required for an ECG in an emergency setting.
How to Get an ECG Test in Pokhara
ECG at A&B is available as a walk-in service during OPD hours and 24/7 for emergency patients. No appointment is required. Results are available immediately after the recording is reviewed by the doctor on duty.
Get Your ECG Done at A&B International Hospital
A&B International Hospital
Pokhara-02, Bindhyaabasini Way to Sarangkot
Phone: +977 061-412512
12-lead ECG available 24/7. Immediate results. ECHS cashless service. Walk-in patients accepted. If you have chest pain, call first — do not delay.
