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Different Types of ECG Tests and Their Uses
When a doctor needs to check how your heart is working, they might recommend an ECG test. But did you know there are different types of ECG tests, each designed for a specific purpose? Some are done while you’re resting, others while you’re moving, and some even monitor your heart for days to detect hidden issues. If someone experiences chest pain, dizziness, shortness of breath, or an irregular heartbeat, an ECG can help find out what’s happening.
Different ECG tests help doctors, nurses, phlebotomists, or anyone involved in healthcare get a clearer picture of heart health in different situations. Let’s go through the types of ECG tests, how they work, and why they are used.
Table of Content
What is an ECG Test?
If you’re having symptoms of a heart problem, like chest pain, palpitations (when you can feel your heart thumping), shortness of breath, or dizziness, your doctor may suggest an ECG/ Electrocardiogram test. You might also need an ECG if you have other health conditions, have had an accident, or need a check-up before surgery.
As of 2025, cardiovascular diseases (CVDs) remain a significant health concern in the UK. The British Heart Foundation reports that over 7.6 million people are living with heart and circulatory diseases. With so many people in the UK affected by heart disease, this ECG test helps doctors catch issues early and prevent serious health risks.
During the test, a health professional will place sticky sensors on your chest, arms, and legs. These sensors collect electrical signals from your heart and send them to an ECG machine, which prints out the results.
Heart Issues Detected by ECG Test
An ECG can help detect different heart issues, like:
- A heart attack or damage from a past heart attack
- An enlarged heart under strain
- Fast, slow, or irregular heartbeats (arrhythmias)
- Heart valve problems
Since there are different varieties of ECG tests, let’s find out how each one serves its own unique purpose.
We’ll go through them one by one.
Different Types of ECG Tests: What They Do for Your Heart
As per NHS, the ECG type you need will depend on your symptoms and what heart problem your doctor thinks you might have. Primarily, there are 3 types of ECG tests:
1. Resting ECG
A resting ECG is done while you’re lying down and completely relaxed. It’s a quick test that only takes a few minutes. The doctor uses it to check for things like —
- irregular heartbeats,
- past heart attacks,
- or an enlarged heart.
This test is usually performed using a 12-lead ECG, which provides a detailed view of your heart’s electrical activity from different angles. It’s basically a simple, no-fuss test that can give valuable information about how your heart is doing when you’re at rest.
You can check out this insightful blog to get a detailed overview of 12-lead ECG.
2. Stress or Exercise ECG (Treadmill Test)
This test is done while you’re walking on a treadmill or cycling on a stationary bike. The goal is to see how your heart behaves when it’s under stress or exertion.
It’s particularly useful for checking for coronary artery disease, which is when your heart’s arteries become blocked. The stress ECG helps doctors understand how your heart performs when you’re active.
3. Ambulatory ECG (24-hour Holter Monitor)
The ambulatory ECG, often called the Holter monitor, is worn for a full 24 hours (or even longer) while you go about your normal daily routine. The small ECG recorder continuously tracks your heart activity throughout the day.
This 24-hour ambulatory ECG test is perfect for catching heart rhythm problems that might not show up during a brief ECG in the doctor’s office, especially if the symptoms come and go.
Besides the above, there are other ECG types that serve different purposes.
4. Monitoring Patch
A monitoring patch is a small, sticky patch placed on your chest. Unlike traditional ECGs that use wires, this one doesn’t require any. The patch records your heart’s activity for up to two weeks.
It’s useful for detecting heart issues, especially irregular heartbeats, that happen randomly and may not occur during a standard test.
5. Cardiac Event Recorder
The cardiac event recorder is a portable device you wear or carry with you. It only records your heart activity when you feel symptoms like dizziness or heart palpitations. This makes it great for catching problems that happen intermittently.
Some event recorders are implantable (called ILR or Implantable Loop Recorders), meaning they’re placed under your skin to track your heart activity for up to three years.
This type of recorder is especially helpful for long-term heart health check-ups.
Resting ECG
The Resting ECG is a simple and quick test that helps doctors understand how your heart is working while you’re at rest.
How It’s Done
For a Resting ECG, you’ll be asked to lie down on a bed, feeling relaxed. The doctor or nurse will place small sticky pads, called electrodes, on your chest, arms, and legs.
These sticky pads are connected to an ECG machine that basically records the electrical signals from your heart. It’s important to stay still and relaxed for a few minutes while the machine does its job. The process is simple and doesn’t hurt at all.
Preparation
Before the test, make sure your skin is clean and free from oils or lotions, as these could make the pads not stick properly. Also, wear clothes that are easy to remove, especially your shirt, because they’ll need access to your chest.
What It Detects
So, what does a Resting ECG show? A Resting ECG shows several things about your heart:
- Irregular heartbeats (arrhythmia): This shows if your heart is beating too fast, too slow, or unevenly.
- Heart attack signs: It can pick up signs of a past or current heart attack by looking at the electrical patterns in your heart.
- Enlarged heart: If your heart is enlarged, which can happen due to things like high blood pressure, this test can spot it early.
Stress or Exercise ECG
Let’s find out what this ECG type involves and how it works.
How It’s Done
For a Stress or Exercise ECG, small electrodes are attached to your chest and shoulders. You’ll then start walking slowly on a treadmill or cycling on a stationary bike.
As you go, the treadmill or bike will gradually increase in speed and difficulty to make your heart work harder. During the test, the ECG machine will record how your heart reacts to the exercise.
If you start feeling chest pain, dizziness, or shortness of breath, the test will stop right away, and the doctor will check you over.
Preparation
Before the test, it’s best to wear comfortable clothes and sneakers because you’ll be walking or cycling. Avoid heavy meals and caffeine a few hours before the test to help your body stay calm and focused.
Also, your doctor may ask you to stop taking certain medications for a while before the test, so be sure to follow their instructions.
What It Detects
A Stress or Exercise ECG helps doctors check for several things:
- Blocked arteries (coronary artery disease): This can show if your arteries are narrowed or blocked.
- Heart rhythm problems triggered by activity: It can also spot any unusual heart rhythms that happen when your heart is under stress or activity.
- Heart function after a heart attack: After a heart attack, this test helps doctors see how well your heart is working when it’s pushed to do more.
In rare cases, the test can also help doctors identify stress-induced cardiomyopathy through changes in heart rhythm during exercise, which is a condition triggered by intense stress.
24-Hour ECG (Holter Monitor)
Let’s take a look at how the 24-hour ECG works and what it checks for.
How It’s Done
For a 24-hour ECG, small electrodes are taped to your chest. These are connected to a small, portable ECG recorder that you wear on a belt. You’ll wear it for 24 to 48 hours while going about your normal activities.
During this time, you might need to note down any symptoms like dizziness or palpitations to share with your doctor later.
Preparation
While wearing the monitor, avoid showering or bathing to keep it from getting wet. If you’re wearing it for several days, the doctor may show you how to disconnect and reconnect the device safely.
What It Detects
The 24-Hour ECG helps identify:
- Irregular heartbeats that come and go: It can catch heart rhythm issues that might not show up during a shorter test.
- Atrial fibrillation: A common irregular heartbeat that can cause problems like blood clots or stroke.
- Unexplained fainting or dizziness: If you’ve had episodes of fainting or dizziness without a clear cause, this test can help find the reason.
Wrapping Up
An ECG test is a quick, painless way to check your heart’s health. Your doctor will choose the right types of ECG based on your symptoms. If you have chest pain, palpitations, or dizziness, don’t ignore it—talk to your doctor.
On the other hand, if you’re a healthcare professional, getting accurate ECG recording and interpretation is super important. Even a small mistake can lead to missed heart problems or wrong diagnoses. That’s why proper ECG training is a must—it helps you understand heart rhythms, spot issues early, and give the best care to patients.
Want to learn ECG interpretation with hands-on practice? Our CPD Certified ECG Training covers everything from setup to spotting abnormal rhythms. Join our ECG Interpretation Course and gain the skills to perform ECGs with confidence.
Got questions about ECG tests? Contact us now!
FAQs
1) Are there any risks or side effects of ECG tests?
An ECG is completely safe and painless—it just records your heart’s activity. You might feel a little discomfort when the electrodes are removed, like peeling off a plaster. In a stress ECG, there’s a small risk of chest pain or irregular heartbeat, but doctors will monitor you closely and stop the test if needed.
2) How long will an ECG take?
An ECG can take different amounts of time depending on the type. A resting ECG takes about 5–10 minutes, while a stress ECG can last 15–30 minutes, depending on how long you exercise.
If you’re wearing a 24-hour (Holter) ECG, it records your heart for a full day or more, but setting it up only takes a few minutes.
3) What can an ECG show?
It checks your heart rate and rhythm, which helps doctors spot issues like heart attacks, but other tests may be needed for a full diagnosis.
4) Can stress affect ECG results?
Yes, stress can affect ECG results by increasing heart rate and changing heart rhythms. This can sometimes lead to temporary abnormalities, so it’s important to inform your doctor if you’re feeling stressed during the test.