About Abnormal EKGs
The electrocardiogram (ECG or EKG) is a medical test that basically evaluates the electrical conduction system of the heart. It can help medical professionals discover a problem with the heart’s electrical impulses. It's typically the initial test that will indicate there’s an issue with coronary artery disease. An EKG can also help disclose the presence of arrhythmias, heart blockage, prior myocardial infractions (heart attacks), cardiomyopathy, left ventricular hypertrophy (LVH), and other issues.
The major components of the heart’s electrical cycle are the P-wave, QRS complex, and the T-wave. The P-wave represents the contraction of the atria (the top chambers of the heart) which pump blood to the ventricles (the bottom chambers of the heart). The QRS complex represents the contraction of the ventricles (the bottom chambers of the heart) which pump blood throughout the body. The T-wave shows repolarization, or the resetting of the ventricles to prepare them for the next heart beat.
T-wave changes are one of the most common abnormalities noted on an EKG. Changes in the T-wave may be a normal variant in some healthy individuals. It can also be related to age, body size/position, medications, or health issues like anemia, pericarditis and many others. T-wave abnormalities may also be caused by virtually any type of cardiovascular disorder such as coronary artery disease, valve impairments and hypertensive cardiovascular disease.
T-wave abnormalities are classified by their degree of abnormality. They are either considered to be minor or major changes, and ratings will depend on this classification, as well as the presence (or absence) of other risk factors. An EKG abnormality can be a red flag for a potential problem and the need for further investigation. When a case is rated or postponed for T-wave changes, favorable cardiac evaluation can often result in reconsideration.
Underwriting for Abnormal EKG
The primary questions to be asked to the proposed insured who presents an abnormal EKG history:
- When was the most recent EKG testing done?
- Was it considered to be normal, borderline or abnormal?
- Has the Dr determined the cause of the abnormal findings?
- Has there been any further cardiac work up or evaluation—like an echo?...results?
- Is there any other cardiac history, such as chest pains, heart attack, stents or bypass?
- Any history of high blood pressure or cholesterol?
- Is there any family history of heart disease?
The EKG is a simple and inexpensive test which is used in combination with other cardiovascular risk factors in the underwriting evaluation for significant coronary disease. Underwriting for an abnormal EKG can run anywhere from a Standard offer, to mild table ratings, and occasionally you’ll see underwriting request further evaluation if they see this is a new and undiagnosed concern with the insured’s doctor. A request for cardiac work up to include echocardiogram testing is not uncommon.
Please see the abnormal EKG questionnaire. This will help you gather the pertinent information that we’ll need to help evaluate your case.Download the Questionnaire
As always, we’re here to help answer your questions, and provide the best underwriting services possible to help you place your case.
Click here to contact our underwriter, Mike Woods, with specific underwriting questions about an abnormal EKG.