Is it fine to have a normal Holter and echo but an abnormal ECG?

Question

Hello doctor,

I got a 24-hour Holter test and echocardiogram done last year. The results were normal. However, when I got an electrocardiogram done eight months back, the results were abnormal, and they showed a possibility of left atrial enlargement and left ventricular hypertrophy. My cardiologist had suggested that I was fine as my 24-hour Holter test was good. I would appreciate a second opinion. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. An electrocardiogram (ECG) measures the heart's electrical activity, whereas echocardiography measures the mechanical parameters of the heart. Regarding the sizes of heart chambers, we get only a rough idea from ECG, which is not always correct. Therefore, chamber size, hypertrophy, etc., are best measured with echocardiography. As echocardiography findings are normal, it means that the findings were not correct. Although there is a two months difference between these two tests, the heart size cannot change in two months. Therefore, you can rely on echocardiography findings for mechanical factors of the heart. I hope this helps. Thank you.