Electrocardiograms in office practice

Electrocardiograms (EKGs) are a widely used diagnostic tool in primary care. The indications for EKGs are widespread. We reviewed all EKGs performed over a two year period at the two model practice units of the University of Mississippi's Department of Family Medicine. Four hundred and sixteen EKGs were reviewed and subdivided according to indication, outcome, and age. One hundred and sixty-six EKGs were read as abnormal. Overall, the percentage of abnormal findings increased in proportion to age. Seventy nine percent of the EKGs were obtained for 4 indications: (1) chest pain (28%), (2) health screening (24%), (3) abnormal rhythm (15%), and (4) hypertension (12%). The percentage of abnormal EKGs was found to increase with age for all four indications. Screening EKGs were essentially unremarkable prior to age 51. EKGs on the under 30 age group were by far more helpful when performed for abnormal rhythm. No abnormalities were found on patients under age 41 when performed for chest pain.