Cardiologist Dr Vijay D’Silva says ECG screening-heart disease connection is real missing early heart checks costs lives

The heart doesn’t often give up in a single night. Usually the trouble quietly accumulates for many years, hiding behind other illnesses, until suddenly it presents itself in a form we recognise as chest pain or a heart attack. In India, where the proportion of CVD among the younger generation is increasing year by year, early diagnosis has acquired equal importance as cardiac prevention.

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According to the World Health Organisation, the majority of early cardiovascular disease can be prevented by managing modifiable risks of elevated blood pressure, smoking, poor diet and lack of physical activity. “There are multiple prevention tools. Of all the tools available to clinicians, none is more straightforward or more widely available than the ECG” Dr Vijay D’Silva, Medical Director, White Lotus International Hospital, and Clinical Advisor & Mentor, Heartnet India tells Health Shots. Yet, it remains one of the most underutilised elements of preventative health care.

Why should you not wait for symptoms?

Heart disease develops silently. Rhythm problems, asymptomatic ischemia, and preclinical electrical disturbances may all exist long before the patient first begins to feel indisposed.

“Moreover, many patients recognise that they are completely in good health until they suddenly require hospital admission for an established cardiac disease. Often, compared with cases diagnosed earlier and treated accordingly, treatment becomes more complex, more costly, and far more emotionally stressful” says the doctor.

If this is to be avoided, the focus of healthcare must change from treating individuals when they suffer an attack to early screening for risk and intervening.

A simple test that can reveal more than people think

People often think an ECG is only used in an emergency; machines are brought out only when a patient presents to the Intensive Care Unit. This is not true. An ECG records the heart’s electrical activity and takes a few minutes to read.

“An electrocardiogram (ECG) can detect abnormal heart rhythms, evidence of prior silent damage to the heart muscle, and problems with electrical signal conduction in the heart” says the cardiologist.

Although an ECG alone cannot diagnose all heart conditions, it often serves as the first sign that leads to further investigation long before symptoms appear.

Who should consider earlier screening?

Age shouldn’t be the only indicator of who should have a heart checkup. Early detection is a more helpful indicator. “Those who have high blood pressure or diabetes, a family history of heart disease at a young age, smokers, the obese, or those with abnormal cholesterol or professionals who are under constant pressure and long hours at work, should be in the ‘risk’ category, as well as those with tiredness and breathlessness for no obvious reason” says the doctor. In all of these cases, an ECG should be administered for prevention, based on the person’s overall risk profile, not only when they reach a severe risk condition.

Taking ECG beyond hospital walls

Technology is gradually making this screening far more accessible. Portable ECG devices and digital tools that can interpret readings quickly mean that a heart check no longer has to happen inside a large hospital. “First-line screening often happens at primary care clinics and neighbourhood physicians, supported by digital tools that can transmit reports to a specialist for a faster opinion if needed” says the expert. This early referral is crucial, especially outside large urban areas where it can take days or weeks to reach a cardiologist. That delay can significantly affect how the condition develops.

Making early screening a habit, not an emergency response

The most beneficial change people can make is straightforward: have a heart check before signs or symptoms do. For those already at risk, an ECG as part of a regular health check is critically important, and should become as common as blood pressure, blood sugar and cholesterol checks and not only after something goes wrong. Those already burdened by the risk of cardiovascular disease receive good counselling and management through regular follow-up instead of isolated testing.

“Broader awareness can support building this into people’s routine. While an ECG takes only minutes, it can change the course of a person’s cardiac future” says the doctor.

In a society where heart disease is affecting more and more middle-aged adults, the consistent application of ECG screening as a standard practice rather than an exception could be a vital step towards recognising the risk earlier, initiating appropriate treatment sooner, and protecting individuals from potentially life-threatening cardiac mishaps that may be completely preventable.

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