How is ECG performed on a woman?

Electrocardiogram, or ECG, is a non-invasive diagnostic tool to assess heart health. While doing an ECG on a woman, the female anatomy and physiology must be understood. ECGs are important to diagnose heart conditions unique to women, such as those related to pregnancy or menopause.

‍

ECG in women benefits them, ensuring timely diagnosis and treatment of heart conditions. The healthcare providers, follow the right steps to get accurate results and are able to instill a sense of confidence. Gauze in this blog guides you through important steps for performing an ECG on a woman.

‍

It is a win-win for both the patient and healthcare provider because it helps in early detection and improved outcomes. With accurate ECG readings, healthcare providers can offer better services to their patients.

Importance of ECG for Women

The electrical activities in the heart control the contraction and relaxation of heart muscles that pump blood. In ECG, electrodes are placed on the skin, capturing electrical signals to create a waveform recorded as a tracing. 

‍

Besides the heart issues that are the main cause of illness and death in women, many other factors, such as hormonal alterations, pregnancies, and PCOS, influence heart health in women, thereby making ECG a diagnostic tool to detect and manage issues at an early stage.

‍

Heart health challenges for women

Gender differences play a role, and women experience heart disease differently than men. Symptoms are more subtle and less recognized in women, leading to delays in diagnosis and treatment.

‍

Symptoms of cardiac problems

Women may experience atypical symptoms such as

‍

• Shortness of breath

• Fatigue

• Nausea

• Jaw, neck, or back pain.

‍

These symptoms can easily be mistaken for other conditions without an ECG.

‍

Risk factors for women

Risk factors prevalent in women are

‍

• Hormonal changes Menopause and pregnancy affect heart health.

• Autoimmune diseases Lupus and rheumatoid arthritis are more common in women and can increase heart disease risk.

• Mental health Stress and depression are more common in women and contribute to heart diseases.

‍

How ECG Machines Work on Women?

The mechanics of the ECG machine remain the same for both genders. However, hormonal changes and physiological factors affect the readings in women.

‍

• Hormonal fluctuations: Hormonal changes during the menstrual cycle influence the heart rate. A better understanding of these changes will help to interpret the results accurately.

• Breast tissue: The presence of fat and breast tissue requires extra care during the placement of electrodes for accurate reading.

• Pregnancy: Special care is necessary because of changes in the body that affect cardiovascular dynamics

‍

Preparing for an ECG for Women

Inform the doctor about medications you are taking, including birth control pills, medical conditions, and breast implants.

‍

• Stay relaxed and calm as anxiety and stress affect heart rate.

• Wear loose, comfortable clothing, and avoid wearing anything with metal fasteners.

‍

During the ECG procedure

During the ECG, you will be lying down on the table. Electrodes will be placed on your chest, arms, and legs to measure the electrical activity. ECG is a quick and non-invasive test where one may be asked to follow breathing instructions.

‍

• Position: You will be lying down on a table, and electrodes small sticky patches will be placed on your chest, arms, and legs.

• Recording: During the ECG, you will be asked to hold or take deep breaths.

• Duration: It takes only a few minutes to complete the ECG.

‍

After the ECG

After the ECG is taken, the electrodes will be removed from the skin. And cleaned off any remaining adhesive. Then, you can resume your usual activities immediately. 

‍

ECG lead placement

ECG lead placement in women follows the same guidelines as that in men. The electrodes are positioned on the chest and limbs to capture heart activity. Factors such as breast size, implants, or scars from previous surgeries necessitate adjustments.

‍

V3 to V6 leads may be placed underneath or slightly around the breast tissue to avoid interference in women with large-sized breasts. Maintaining skin contact and lead positioning is essential to ensure reliable results. Medical professionals should also be mindful of patient comfort and modesty during the procedure.

‍

Standard ECG lead placement.

The procedure requires a placement of limb leads and chest leads.‍

‍

Limb Leads

• LA:  Left arm.

• RA: Right arm.

• RL: Right leg.

• LL:  Left leg.

‍

 Chest leads.

• V1  4th Intercostal space, right of the sternum.

• V2  4th Intercostal space left of the sternum.

• V3  midway between V2 and V4.

• V4  5th intercostal space in mid clavicular line.

• V5  5th intercostal space. One intercostal space lateral to V4.

• V6  5th intercostal space in the anterior axillary line.

‍

Modifications while taking women's ECG

The modifications include using smaller electrodes for placing them to commodate breast tissue.

‍

•  For large breasts, one must ensure proper contact with the skin. It might involve moving the leads upwards or outwards to avoid any interference from the breast tissue.

•  Scar tissue present should also be avoided to cause any discomfort and ensure accurate readings.

‍

Step-by-step guide for ECG

An outline of steps for performing an ECG accurately and efficiently follows. Each step helps to minimize errors and obtain transparent, interpretable results essential for identifying heart conditions.

‍

Prepare the patient 

• The patient must be comfortable and relaxed.

• All metal objects, including jewelry and hair clips, should be removed.

• If necessary, the patient can be asked to change it to comfortable clothing.

‍

Prepare the machine

Attach the ECG leads to the machine and ensure they are securely connected.

‍

 Prepare the ECG Machine

• ECG machine is turned ON, and the appropriate recording mode is selected. 

•  ECG leads are attached to the machine, ensuring they are securely connected.

‍

Apply the Electrodes

The patient's skin is cleaned with a mild, alcohol-based pad to remove oils or lotions. The electrodes are then applied to the designated locations on the patient's chest, arms, and legs. The electrodes are carefully placed over the skin.

‍

Recording the ECG

While taking an ECG, the privacy and modesty of a woman are crucial. Doctors must perform the ECG in a private room using draping techniques and cover all areas that do not need monitoring. It enhances comfort and also allows women patients to cooperate.

‍

• Begin the recording and instruct the patient to breathe normally. 

• Avoid sudden movements.

‍

Monitor the recording

• Observe the tracing and adjust if the tracing is unclear or noisy.

‍

End the recording

• Stop the machine once the recording is complete and remove the electrodes from the patient skin.

Review and analyze the recording

• Examine the ECG tracing for any abnormalities.

Interpreting ECG results

In women, the ECG result changes due to unique female physiology.

‍

• QT interval of women is higher than men.

• ST segment changes If the doctor doesn't consider the gender and health history of the person. Then, this may cause ST segment changes.

‍

Considerations for Women in ECG

All female patients should inform their healthcare provider if they are pregnant or breastfeeding. These conditions impact ECG results. Hormonal changes during the menstrual cycle also influence readings. Breast implants or large breast requires specific adjustments to electrode placement. One must ensure proper communication with a technician.

‍

•  Pregnancy and ECG: Pregnancy doesn't generally affect ECG; however, a growing uterus requires adjustment while positioning the electrodes. Pregnant women are often tilted on the left side to avoid compressing major blood vessels.

•  Menstruation and ECG: Menstruation generally has no impact on the accuracy of ECG.

•  Breast implants and ECG: Implants obstruct lead placement and require lead position adjustment.

‍

ECG findings in women

Women display short QT intervals, a small R wave amplitude, and a longer PR interval than men.

‍

Normal ECG shows

• Regular rhythm. Heartbeats are evenly blessed.

• Average heart rate. Usually between 160 to 100 beats per minute.

• P waves. Are upright and smooth representing the electrical activity of atria.

• Normal QRS complex represents the electrical activity of ventricles is upright and narrow.

• T waves represent the repolarization of ventricles and are upright but sometimes can be inverted.

‍

Risks of ECG procedure

ECG is the safest method to diagnose heart health. However, women can have the following concerns.

‍

• Skin reactions: The adhesive of the electrodes may cause skin irritation and allergies.

• Pregnancy concerns: It is crucial to prevent pregnant women from stress.

‍

Advances in ECG Technology for Women

Women, because of the differences in symptoms and physiology, have their heart health often underdiagnosed and under-treated. New ECG devices and algorithms are being developed to address differences and improve diagnostic accuracy.

‍

AI and machine learning are advances in technology that help to analyze ECG data. Personalized ECG analysis for women improves health outcomes and reduces cardiovascular risk. In recent years, these advancements in electrocardiogram technology, offer women more convenience and options for heart health monitoring.

‍

These are-

• Wearable ECG devices: Smartwatches or Fitbits monitor heart rate and rhythm continuously. They are handy for women.

• Remote ECG monitoring: Remote ECG monitoring allows women to send ECG data to the health care providers from their homes.

• ‍Mobile ECG devices: They are small portable devices that can be carried anywhere by the woman to perform an ECG anytime at their convenience.

‍

Follow-up and additional tests for women

Often it may be necessary to do some other tests besides the ECG.

‍

• Echocardiogram. The ultrasound of the heart, a video of heart function and structure.

• Holter monitor. ECG devices are worn for a day or two to capture the rhythm of the heart during activities.

• Stress test. Determines performance of heart under stress activities.

‍

Interpreting women's ECG using AI

AI algorithms analyze ECG data more quickly and accurately than humans. It helps to identify potential heart problems, a useful feature for women who experience heart attacks presented differently than men and have symptoms that are often overlooked

‍

‍Conclusion 

Interpreting a woman's ECG requires understanding the physiological differences from men. While the procedure remains the same, factors like breast tissue can affect electrode placement.

‍

Hormonal changes also influence results, making interpretation more challenging. Gauze uses AI-powered techniques for precise ECG analysis, ensuring reliable and accurate results.