Care During Chemotherapy and Beyond


What Are ECG or EKG Changes?

An electrocardiogram (also called EKG, ECG) is a simple, and painless test that can indicate to your healthcare provider if you have any existing heart problems, or a history of any heart problems.

How It Works:

Electrical impulses travel through the heart, causing the heart to contract (squeeze). Through placing electrodes on the surface of your chest, upper abdomen, or back area, the electrical impulses can be recorded by the ECG machine. The specific pattern of the electrical impulses may show many things, including the electrical activity of the heart.
ECG changes may occur for many reasons. ECG monitoring is often done in your doctor or healthcare provider's office. It is helpful in managing your disease, by showing:

  • If you have any evidence of coronary artery disease.
  • Decreased blood flow to certain areas in the body
  • If there are chemical or electrolyte imbalances in the body (high or low blood potassium levels, for example)
  • If you have had heart damage in the past, or if you are currently experiencing heart damage
  • If your heart is enlarged
  • If your heart is beating regularly. Irregular rhythms may indicate an underlying problem or disorder.
  • If your ECG shows an irregular heartbeat or rhythm, this may be referred to as ECG changes.
  • There are some ECG changes that normal, healthy individuals experience throughout the day, and are unaware of them. Some types of ECG changes will tell your healthcare provider that you may have a certain problem that needs to be further investigated.


When you are having ECG changes, you may experience certain symptoms, or none at all. ECG tests are usually ordered before certain types of chemotherapy or treatment, or to monitor your heart during treatment, with or without any symptoms.

Some symptoms you may experience, that may be related to ECG changes can include:

  • You may be overly tired, or very weak. It may be hard for you to do any kind of your normal activities.
  • You may have coughing spells or a long-term (chronic) cough.
  • You may experience shortness of breath, either at rest or while performing any type of activity. This may include walking to the door, or climbing stairs.
  • You may have trouble lying flat in bed, and you may have to sleep on 2 or more pillows. Your shortness of breath may cause you to wake up in the middle of the night.
  • Your legs may be swollen, especially in your feet and ankles.
  • You may gain "water" weight easily, or feel bloated.
  • You may experience palpitations.
  • Some people may chest pain, which may range from excruciating, to a mild discomfort. The severity of pain does not indicate how severe the damage to the heart muscle may be.

Things You Can Do:

  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • If you have a family history of heart disease, stroke, high blood cholesterol, or high blood pressure, in a first or second-degree relative, you may be at risk for certain problems. Notify your healthcare provider if you have any of these diseases in your family.
  • If you smoke, be sure to quit.
  • You should try to exercise, as tolerated, to maintain your optimal level of functioning. Discuss with your healthcare provider how you can create a specific exercise program to suit your needs. Make sure to exercise only under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help you to feel better, and will promote the flow of oxygen in your lungs and blood.
  • Use relaxation techniques to decrease the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and try to concentrate on things that have relaxed you in the past.
  • If you are ordered a medication to treat this disorder, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.
  • If you miss a dose of your medication, discuss with your healthcare provider what you should do.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor:

There are many types of medications that may be used to treat your ECG changes. These may include:

  • ACE inhibitors - These drugs work by opening, or dilating, your arteries. They will lower your blood pressure, and improve blood flow to your kidneys, and throughout your body. Your healthcare provider may also prescribe these medications if you have diabetes or protein in your urine, to protect your kidneys. You may receive these medications if your ECG changes are due to a cardiovascular event, or heart failure. Some examples of this medication may include: enalapril maleate (Vasotec®), lisinopril (Zestril®), and fosinopril sodium (Monopril®)
  • Anti-anxiety medications: If your symptoms are due to anxiety, your healthcare provider may prescribe an anti-anxiety medication, called an anxiolytic. These medications will help you to relax. These may include lorazepam (Ativan®), or alprazolam (Xanax®). It is important to take these medications only when you are feeling anxious. Do not operate heavy machinery, or drive an automobile while taking these. If these medications do not control your symptoms, discuss this with your doctor.
  • Beta-blockers - These drugs can be used to slow down your heart rate, and improve blood flow through your body. You may take this drug if you have been diagnosed with irregular heartbeats on ECG, or high blood pressure. Some examples of this medication may include: metoprolol (Lopressor®), propranolol (Inderal®), and atenolol (Tenormin®).
  • Calcium Channel Blockers - These medications may be given to treat chest pain, high blood pressure, or irregular heartbeats. A few common drugs include verapamil HCL (Calan®), and diltiazem (Dilacor XR®).
  • Diuretics - These drugs may be known as "water pills" as they work to prevent heart failure by making you urinate out extra fluid. You may be given this medication if your ECG changes are due to fluid accumulation or heart failure. Some examples of this medication may include furosemide (Lasix®), and hydrochlorothiazide. You may receive this medication alone or in combination with other medications.
  • Digoxin - Also called digitalis, this medication works by slowing down the heart rate, and making it beat more effectively. This will pump blood through out the body better. You may receive this medication if you have certain types of irregular heartbeats or ECG changes. It is also called Lanoxin®.
  • Do not stop any of these medications abruptly, as serious side effects may occur

When to Contact Your Doctor or Health Care Provider:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection).
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat should be evaluated immediately
  • Feeling your heartbeat rapidly (palpitations)
  • Any new rashes on your skin, especially if you have recently changed medications
  • Any unusual swelling in your feet and legs
  • Weight gain of greater than 3 to 5 pounds in 1 week.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit