Can an electrocardiogram detect coronary heart disease and myocardial infarction?

Myocardial infarction usually refers to myocardial infarction (MI), and an electrocardiogram (ECG) can generally detect coronary heart disease and myocardial infarction.

The ECG is primarily a test that evaluates the electrical activity of the heart. It helps determine whether conditions such as cardiac enlargement, arrhythmia, myocardial infarction, or myocardial ischemia are present, and it can also serve as a monitoring tool for patients with heart disease. When coronary heart disease is present, it can typically be detected by ECG. For example, changes in the ST segment or T wave on the ECG may suggest coronary heart disease or insufficient blood supply to the myocardium. However, these findings only raise suspicion and cannot provide a definitive diagnosis; further tests such as coronary angiography or cardiac enzyme panel are required for confirmation.

During ECG examination, if a patient shows ST-segment elevation accompanied by tall, peaked T waves—where the ST segment is明显 elevated above the isoelectric line—and if the patient is already experiencing symptoms such as chest tightness or chest pain, early or acute-phase myocardial infarction should be strongly suspected. In such cases, prompt testing of cardiac enzyme levels is necessary to confirm whether myocardial cell damage or necrosis has occurred. Therefore, an ECG can generally detect myocardial infarction.