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A physician can use EKGs in the diagnosis of a wide variety of abnormalities and diseases, such as:
- Coronary artery disease. A disease in which blood flow to the heart and body is restricted due to hardening of the arteries (atherosclerosis).
 Heart attack, either previous or current. The EKG is an essential investigation for diagnosis of heart attack. Initial findings may determine which patient requires emergency cardiac catheterization and angioplasty or administration of thrombolysis.
- Arrhythmias. Abnormally fast (tachycardias) or abnormally slow (bradycardias) heart rhythms. For example, the EKG may help the physician detect heart block – abnormally slow heart rhythms due to either the partial or complete loss of electrical communication between the upper chambers (atria) and lower chambers (ventricles) of the heart. A pacemaker may be required as part of treatment. If the arrhythmia only occurs occasionally, the patient may be asked to wear a portable ECG called an event monitor, or Holter monitor. This device allows physicians to gather information about the heart's function over a prolonged period.
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- Atrial fibrillation. A condition in which the upper chambers of the heart beat abnormally fast and may cause blood clots.
- Cardiac hypertrophy. An enlarged or thickened heart muscle. Recent studies have shown benefit in EKGs to help distinguish between benign, physiological heart enlargement (e.g., from sustained, intense exercise – “athlete’s heart”) and pathological enlargement (from significant heart disease).
- Cardiomyopathy. A disease in which the heart muscle functions improperly due to a variety of conditions.
- Pericarditis. Inflammation of the pericardium – a thin, fluid–filled sac surrounding the heart.
- Long QT syndrome. A disorder of the heart’s electrical system, which could lead to fainting (syncope) or sudden cardiac death.
- Myocarditis. Inflammation of the heart muscle due to viral or bacterial infection.
- Certain congenital heart defects. Heart defects that someone is born with, such as Wolff-Parkinson-White syndrome.
Many people with coronary artery disease, heart valve disease or heart muscle disease will eventually show abnormal EKG readings. However, many EKGs are performed when the patient is at rest, which means certain abnormalities that occur during periods of stress may not show up. Because it is very common to see this false-negative result (e.g., the EKG does not find the damage or abnormality that is really present), a normal EKG is not enough to rule out suspected heart disease.
In some instances, patients may be asked to exercise lightly in conjunction with the EKG. This is called a stress test. It is used to evaluate the function of the heart under more strenuous conditions. If the patient is unable to exercise, they may be given drugs that stimulate the heart to beat more rapidly. | 
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