Does Anxiety Affect Results of Resting ECG During Heart Tests?

During a resting electrocardiogram (ECG) examination, the heart rate may increase due to anxiety?

Will being nervous and having a rapid heartbeat during a resting electrocardiogram (ECG) affect the results? Before my test, I might have been a bit anxious because I had just completed a pulmonary function test, which required me to take deep breaths and exhale forcefully several times.
After that, I was asked to undergo the ECG.
When I lay down, my heart was racing.
I tend to get nervous easily, and I'm unsure if the results of the test under these conditions are reliable.

Si Si, 40~49 year old female. Ask Date: 2019/01/26

Dr. Chen Jili reply Cardiology

During the follow-up appointment to review the report, the physician will provide an explanation and wish you good health.

Reply Date: 2019/01/26

More Info

Anxiety can significantly affect the results of a resting electrocardiogram (ECG), particularly during heart tests. When a patient is anxious, the body enters a state of heightened arousal, which can lead to physiological changes such as increased heart rate (tachycardia), elevated blood pressure, and altered heart rhythms. These changes can obscure the true underlying cardiac condition that the ECG is intended to assess.

In your case, the anxiety you experienced prior to the ECG, coupled with the physical exertion from the lung function tests, likely contributed to an elevated heart rate when you were lying down for the ECG. This rapid heart rate can lead to a phenomenon known as "rate-related changes" on the ECG, where the interpretation of the heart's electrical activity becomes more challenging. For instance, a fast heart rate can mask underlying arrhythmias or other abnormalities, making it difficult for the healthcare provider to accurately assess your heart's condition.

Moreover, anxiety can also lead to increased muscle tension, which can affect the placement of the ECG electrodes and result in artifacts on the ECG tracing. These artifacts can further complicate the interpretation of the results, potentially leading to false positives or negatives regarding cardiac issues.

It is essential to communicate any feelings of anxiety or discomfort to the healthcare provider conducting the test. They may take steps to help you relax before the ECG, such as providing a calming environment or allowing you to take a few moments to breathe deeply and settle down. In some cases, if anxiety is significantly impacting the results, the healthcare provider may recommend repeating the ECG at a later time when you are feeling more relaxed.

In summary, anxiety can indeed affect the results of a resting ECG by causing an increased heart rate and potentially leading to artifacts in the recording. If you are concerned about the impact of anxiety on your test results, it is advisable to discuss this with your healthcare provider. They can provide guidance on how to manage anxiety during tests and may suggest alternative approaches or additional evaluations if necessary. Remember, accurate diagnosis and treatment depend on clear and reliable test results, so addressing any factors that could interfere with those results is crucial for your health.

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