Sometimes, an abnormal EKG reading is a normal variation in a person’s heart rhythm. In other cases, it may be due to an underlying heart condition or a reaction to medication.
An electrocardiogram (EKG) measures the electrical activity of the heart. Some factors that can affect the result are an irregular heart rate, changes in the shape or structure of the heart, or an electrolyte imbalance.
An EKG reading is a helpful diagnostic tool. Once a doctor has identified the underlying condition, they can suggest appropriate treatment.

Each line on an EKG corresponds to an electrical signal sent from the heart. Doctors know how to read and interpret these lines, which gives them a sense of the heart’s overall state.
The administering doctor or healthcare professional will attach electrodes to a person’s skin, typically at 10 different points around their chest and on the limbs.
Each heartbeat sends out an electrical impulse. These electrodes pick up this impulse and record the activity in a waveform on a graph.
This happens extremely briefly, which is why an EKG is so important. An EKG can catch these tiny details and record them for a doctor to analyze.
Learn more about an EKG.
An abnormal EKG means that there is something unexpected in the EKG reading. This is not always a sign of an unhealthy heart.
With this in mind, an abnormal EKG reading could appear for many reasons, including:
Irregular heart rate
An EKG will pick up any irregularities in a person’s heart rate.
The human heart typically beats at around
Irregular heart rhythm
Although it may vary slightly between people, each heart keeps a steady rhythm. A person may physically feel changes in this rhythm, such as skipped heartbeats or feeling as though the heart is fluttering.
An EKG will help doctors see how and where the heart is beating out of rhythm, but it can only record the irregularity if it occurs during the test.
Since this is unlikely, doctors may recommend using a Holter monitor, which monitors the heart’s activity for 24 hours or longer. This gives doctors a better opportunity to catch the irregularity.
Abnormalities in the shape of the heart
An EKG gives doctors an idea of how hard the heart works in each area. An abnormal EKG result can indicate that one region or section of the heart is larger or thicker than the others.
A thickened heart could mean that the heart is working too hard to pump blood. This
Electrolyte imbalances
Electrolyte minerals are essential for overall health, but they also affect heart health and may even cause an abnormal EKG.
Electrolytes conduct electricity in the body and help keep the heart rate and rhythm consistent. An imbalance in electrolyte minerals such as potassium, sodium, calcium, or magnesium may cause an abnormal EKG reading.
Medication side effects
Some medications may cause an abnormal EKG reading. Anyone getting an EKG should discuss any medications they are taking with a doctor. It may also help to check the list of side effects provided on the packaging.
Some medications that help balance the heart rhythm may cause abnormal heart rhythms in some people. Such medications include certain beta-blockers and sodium channel blockers.
If a doctor thinks the type of medication a person is taking may be causing their symptoms, they may suggest alternatives and do a follow-up EKG to see how the person responds to the new medication.
High blood pressure
Other aspects of heart disease may lead to an abnormal EKG. For example, people with high blood pressure are likelier to have abnormal EKG readings.
Heart attack
Sometimes, an abnormal EKG result may be a sign of a serious issue, such as a heart attack.
When a person has a heart attack, the heart can lose its fresh supply of blood, which can cause tissue damage and even cell death.
Damaged tissue will not conduct electricity as well as healthy tissue, which could cause abnormal EKG readings.
Treatment for an abnormal EKG depends on the underlying issue. If the doctor suspects the abnormal EKG results from normal variances in the human heart, they may recommend no treatment.
They may recommend an alternative if a particular medication is causing the abnormal readings. If the doctor suspects a person has an electrolyte imbalance, they may suggest fluids or medications containing electrolytes.
Other issues may require more individualized treatments. An arrhythmia may or may not require treatment. Most arrhythmias pose little to no risk to the person, as they may not cause symptoms or interfere with the heart’s function.
On the other hand, some arrhythmias may interfere with the heart’s ability to pump blood. If a heart has trouble keeping a steady rhythm, a doctor may recommend medications or ask the person to wear a pacemaker to help restore the heart’s rhythm.
Anyone having a heart attack will need emergency medical treatment. The person may also need to undergo surgeries such as angioplasty to keep the blood flowing and reduce damage to the tissues.
Many people will get an EKG reading at some point in their lives because they experience common symptoms such as chronic chest pain, shortness of breath, or a rapid pulse.
Doctors may also regularly use EKGs to check on people with diagnosed heart disease.
Another reason to get an EKG is to check for heart palpitations or arrhythmia. A person may feel as though their heart skips a beat, flutters, or beats very strongly.
Doctors may recommend an EKG to check for any underlying issues and, depending on the results, order additional tests.
An abnormal EKG may be a concern since it can indicate underlying heart conditions, such as abnormalities in the shape, rate, and rhythm of the heart. A doctor can explain the results and next steps.
Yes, anxiety may cause the rate and rhythm of the heart to change, resulting in an abnormal EKG reading.
An EKG can diagnose irregularities such as:
- irregular heart rhythms or arrhythmias
- a current or previous heart attack
- irregularities in the shape of the heart
- blood flow issues
An EKG is a risk-free and noninvasive procedure. It does not send electricity into the body and will not cause any pain.
It is an essential tool for diagnosing conditions affecting the heart. Most people will undergo an EKG at some point.
Although having an abnormal EKG can seem scary, it is important to understand that it is just one part of a proper diagnosis. Many things can cause an abnormal EKG, and not all are dangerous.
A doctor can recommend further tests to diagnose the underlying cause of a person’s symptoms and EKG results.
