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About 6 million Americans are medically evaluated for an acute episode of chest pain each year. Making the proper diagnosis, especially in an emergency, can be challenging for physicians and emergency medical personnel. The best tool they have is a 12-lead electrocardiogram (EKG or ECG).

A 12-lead EKG is a procedure that records the electrical impulses that occur just before your heart beats. The EKG also yields information about the heart’s function and structure, and is vital in the identification of a heart attack.

Ten sensors, called electrodes, are placed on the skin in strategic locations: one on each arm and leg, and four on the chest. They convey their information via wires that are connected to a sophisticated monitor. The results are printed out on a ruled paper strip that is immediately reviewed by a physician or paramedic. Irregularities, such as heart attacks, are identified by their characteristic abnormal patterns.

The 12-lead EKG is considered the key to the pre-hospital evaluation of a heart attack, primarily because it lessens the time it takes to make the diagnosis. Timely diagnosis of heart attacks is crucial in determining whether clot-busting (thrombolytic) therapies can be administered, or if immediate interventional therapies in the cath lab would be necessary. This can make a life-or-death difference.

A University of Cincinnati study showed that paramedics who transmitted EKGs to the hospital by cellular telephone shortened the time it took to initiate thrombolytic treatment by 20 minutes—a big time savings, since this therapy works best when started within 70 minutes of diagnosis.

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