Quick version
A long-term ECG can be a good method to use to get answers to whether symptoms such as palpitations, irregular pulse, dizziness, fainting, shortness of breath, chest pain, fatigue or disturbed night's sleep are due to a disturbance in the heart's rhythm.
Long-term ECG is a simple and safe method to map the heart's rhythm over a longer period of time - which increases the chance of catching difficult-to-detect symptoms.
7 important symptoms when a long-term ECG may be a good idea
Here we go through the most common – and most important – signs to pay attention to.
1. Heart palpitations – when the heart is racing or beating hard
A common reason why doctors order a long-term ECG for a patient is heart palpitations, or palpitations. This often feels like the heart:
- Beats fast or hard
- Suddenly races
- Beats with irregular beats
The problems can often come in attacks and occur both at rest and during stress. Since they sometimes disappear as quickly as they came, it can be difficult to catch them on a regular ECG. Here, long-term recording is much more accurate.
2. Irregular pulse – when the heart skips beats
Extra beats, so-called VES (ventricular extra beats) or SVES (supraventricular extra beats), are often harmless but may need to be investigated if they are numerous or disturbing. These are characterized by the heart beating strangely, just as if it is skipping a beat or beating out of sync. To determine whether the extra beats are harmless or if they are more serious arrhythmias, a long-term ECG is used.
3. Dizziness or a feeling of fainting – when the brain does not get enough blood
If you suddenly feel dizzy or feel faint for no apparent reason, it may indicate that your heart is beating too slowly or irregularly. This may include:
- Bradycardia (slow heart rate)
- AV block (blockages in the heart's electrical signals)
- Transient arrhythmias, such as atrial fibrillation
These can cause reduced blood flow to the brain and are important to detect – especially if you have also had episodes of impaired consciousness.
4. Shortness of breath – when the heart can't cope
Do you feel short of breath with light exertion – or even at rest – without having a lung disease or being untrained? This may be due to heart rhythm disorders such as atrial fibrillation or heart failure.
With these symptoms, a long-term ECG can help to see if the heart is in the wrong rhythm, which can explain your symptoms and lead to the right treatment.
5. Chest pain - when it presses on the chest but is not acute
A recurring feeling of pressure or pain in the chest can sometimes be due to arrhythmias or heart failure, especially if it occurs at rest. It is important to know that long-term ECG is not used in cases of suspected heart attack - this is an acute situation and should be investigated in the emergency room.
However, if the chest pain is recurrent and not acute, long-term ECG can provide important clues.
6. Fatigue and reduced energy – when energy is lacking
Long-term fatigue that cannot be explained by either lack of sleep or stress can sometimes be due to a heart rhythm disorder. In particular, atrial fibrillation can sneak up on you and cause diffuse symptoms such as lack of energy, fatigue, anxiety and stress.
A long-term ECG can then help a doctor make a diagnosis, especially if the fibrillation comes and goes.
7. Sleep disorders linked to the heart – when you wake up with a racing heart
Nocturnal arrhythmias are when you wake up with more palpitations or a feeling that your heart is “beating in the pit of your throat”. It is not uncommon for rhythm disorders to be activated during sleep, especially during stress or underlying heart problems.
To follow up on these problems, it may be useful to use a long-term ECG that includes nocturnal recording to reveal whether the heart is beating abnormally even while you are sleeping.
