ECG and heart check (Electrocardiogram (ECG) and cardiac assessment)

What is an ECG and heart check?

An electrocardiogram (ECG) is a quick, usually not painful test that records the electrical signals that make your heart beat. Sticky pads (electrodes) on your chest, arms and legs pick up these signals, which are drawn as a trace. A 'heart check' often combines an ECG with your blood pressure, pulse, history and sometimes blood tests.

An ECG is useful for looking at your heart rate and rhythm, and can show signs of some problems — such as an irregular rhythm like atrial fibrillation, a previous heart attack, a strained or thickened heart muscle, or certain electrical patterns. It is often used to investigate symptoms such as palpitations, or as part of assessing someone with high blood pressure.

Different versions exist: a resting ECG is a snapshot taken while you lie still; an exercise ECG records your heart while you walk on a treadmill or cycle; and longer monitors (worn for a day or several days) catch rhythms that come and go.

A single resting ECG only captures a few seconds of your heart's activity. A normal ECG is reassuring but does not rule out all heart disease — for example, narrowed arteries can be present with a normal resting trace, and an irregular rhythm may not show up if it is not happening at the time.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Resting ECG vs longer monitor

If your symptoms come and go, a single resting ECG may be normal even when there is a problem. Tell your clinician exactly when and how your symptoms happen so the right test is chosen.

Preparing for your test

• Wear or bring clothing that allows easy access to your chest; you may be asked to undress to the waist.
• For a resting ECG, no special preparation is usually needed — you can normally eat and drink as usual.
• For an exercise ECG, wear comfortable clothes and shoes you can walk or cycle in, and check whether to take or hold any medicines.
• Bring a list of your medicines and mention any heart condition, pacemaker or previous ECGs.
• Note exactly when your symptoms happen (rest, exertion, certain times) — this helps choose the right test.
• Tell staff if you have skin conditions or a lot of chest hair, as the area may need cleaning or shaving for the pads to stick.
• If you have chest pain now, do not wait for a routine check — call 999.

What happens

For a resting ECG, a healthcare professional cleans the skin and attaches several sticky electrodes to your chest, arms and legs. You lie still for a few minutes while the machine records the trace. It does not give any electric shock and you feel nothing. The whole thing usually takes 5–10 minutes.

For an exercise ECG, the same electrodes record your heart while you walk on a treadmill or cycle, with your blood pressure checked, until a target effort is reached or symptoms appear. Staff watch closely and can stop the test at any time.

The trace is interpreted by a doctor or, for more complex cases, a cardiologist. Some findings are explained on the day; a formal report may take longer. You should leave understanding what was found, what it does and does not show, and what happens next.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

A resting ECG is very low risk, but its main limitation is what it cannot show: a normal trace does not rule out narrowed arteries or a rhythm problem that is not happening at the time. An exercise ECG carries a small risk because the heart is stressed, so it is supervised and not suitable for everyone. Ask why this particular test is being done, what a normal or abnormal result would change, and whether your symptoms need a different test.

Published figures to discuss

An ECG's usefulness depends heavily on why it is done and when. A resting ECG only captures a short period, so it can be normal in someone with narrowed arteries or with a rhythm problem that is not occurring at the time (a false-negative for those conditions). It can also show borderline or 'abnormal' patterns that are harmless variants but trigger further tests (effectively a false alarm). Exercise testing carries a small, supervised risk because the heart is stressed. Robust single figures for false positives and false negatives depend on the population and the condition being looked for, so no fixed percentages are given here.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery after a resting ECG — you can return to normal activities straight away. 'Afterwards' mainly means understanding the trace and any report, and what happens next.

• Feeling completely well after a resting ECG
• Slight redness or stickiness where the electrodes were
• Tiredness after an exercise ECG, easing with rest
• A short wait for a formal report or for monitor results

Aftercare

• Make sure you understand what the ECG showed and what it does and does not rule out.
• Ask whether your symptoms still need a different or further test, even if the ECG was normal.
• Attend any follow-up tests, monitoring or referrals that are arranged.
• If you wore a monitor, keep any symptom diary and return the device as instructed.
• After an exercise ECG, follow any advice about activity and report ongoing symptoms.
• Keep a copy of your ECG or report, as it is useful for comparison in future.
• Share results with your own GP so your care stays joined up.
• Seek urgent help for new chest pain, severe breathlessness or collapse, separately from routine results.

• List of current medicines
• A note of exactly when and how your symptoms happen
• Any previous ECGs or heart reports
• Comfortable clothing and shoes if an exercise ECG is planned
• Questions about what the result will and will not show
• A way to receive and store your result or report
• Your GP's details so results can be shared

⚠ Get urgent help if…

• Chest pain or tightness, especially spreading to the arm, jaw, neck or back, or with sweating or nausea — call 999; this may be a heart attack
• Sudden severe breathlessness or collapse — call 999
• Palpitations with chest pain, fainting or feeling you might pass out — seek urgent help
• Face drooping, arm weakness or slurred speech (signs of stroke) — call 999
• A racing, very slow or irregular heartbeat with dizziness or breathlessness — seek urgent assessment
• New blackouts or fainting, especially during exercise — seek prompt medical advice
• Any new symptom that worries you — a normal ECG is not a substitute for assessing symptoms

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your GP gives you.

Results & realistic expectations

A 'good' result is an accurate trace, correctly interpreted, alongside your symptoms and risk — not just the word 'normal'. A normal ECG means no problem was detected in the few seconds (or, for a monitor, the period) recorded. An abnormal ECG does not always mean something is wrong, and some patterns are harmless variants.

An ECG cannot prove your heart is healthy or guarantee you will not have a heart attack. A resting trace can be normal even when arteries are narrowed, and an intermittent rhythm problem may not appear unless it is happening at the time. The value lies in interpreting the ECG in context and using it to guide sensible next steps.

An ECG reflects your heart's activity at the time it is recorded. It does not stay 'valid' indefinitely — rhythms and the heart can change, so a new ECG may be needed if symptoms change or time passes. Keeping a copy is useful, because comparing an old and new trace can itself be informative.

Related tests, treatments or support

A heart check often combines an ECG with blood pressure, pulse, a cardiovascular risk score and sometimes blood tests. Depending on findings and symptoms, it may lead on to a heart ultrasound (echocardiogram), longer rhythm monitoring, an exercise test or specialist cardiology review.

Follow-up & long-term care

Follow-up depends on the findings and your symptoms. A clearly normal ECG in someone at low risk may need no further action. Abnormal or borderline findings, or ongoing symptoms, usually lead to further tests or referral, with a clear plan and a named person to follow it up. Results should be shared with your GP.

Repeat, follow-on and what comes next

• A normal resting ECG often needs a longer monitor if symptoms come and go.
• Borderline or abnormal traces are commonly repeated or followed by further tests to clarify.
• A new ECG may be needed if symptoms change or time passes, as the heart can change.
• Comparing an old and new ECG can change the interpretation, so keeping copies helps.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear explanation of what the ECG showed and, importantly, what it does not rule out.
• Advice on whether your symptoms still need a different or further test.
• Named follow-up for any abnormal finding, with timely cardiologist input where needed.
• A copy of your ECG or report for future comparison.
• Results shared with your GP so care is joined up, and clear advice on emergency symptoms.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether it is a resting ECG, an exercise ECG, or a 24-hour or multi-day monitor
• Whether a cardiologist reviews and reports the trace
• Whether the ECG is part of a wider heart check with blood pressure, bloods or a risk score
• Same-day reporting versus a standard turnaround
• Any follow-up consultation to discuss the result
• Whether further tests, such as a heart ultrasound, or specialist referral are needed afterwards

• Which type of ECG or monitor is included
• Who interprets and reports it, and whether a cardiologist is involved
• Whether a consultation to explain the result is included
• What happens, and what it costs, if the result is abnormal or inconclusive
• The cost of any further tests, such as a heart scan, that may be recommended
• How and when you receive your result or report
• Whether results are shared with your GP for continuity of care

On the NHS? ECGs are widely available on the NHS when clinically indicated; private ECGs and heart checks are used for speed, choice or as part of a check-up, and results should be shared with your GP.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the GP is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the GP who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good GP will welcome every one of these.

• Why is an ECG the right test for my symptoms or situation?
• What would a normal, abnormal or borderline result change in my care?
• Could my symptoms need a different test, such as a longer monitor or a heart scan?
• If something is found, what happens next, and who follows it up?
• Will a cardiologist review my ECG, and how soon will I get the report?
• Will you share my result with my GP, and can I have a copy to keep?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the GP who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified GP for ecg and heart check

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Electrocardiogram (ECG) British Heart Foundation — ECG British Heart Foundation — Exercise ECG NHS — Heart attack British Heart Foundation — Atrial fibrillation

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.