John OsborneChief Medical Officer at ClearCardio LLC

A Normal EKG Doesn’t Mean Your Arteries Are Clear

22 Oct 2026 · 0 min

Watch on YouTube

0:28

In this segment, the speaker explains that an electrocardiogram (EKG) is not a reliable tool for assessing underlying coronary artery disease unless a heart attack is actively occurring. He highlights that EKGs can produce both false‑positive and false‑negative results: patients who have undergone stenting, angioplasty, or bypass surgery can have completely normal EKGs despite significant disease, while others may show abnormal, “funky” EKG patterns yet be perfectly healthy. Consequently, the speaker argues that EKGs are only truly useful when there is a clinical suspicion of an acute myocardial infarction at that moment, and that many referrals to cardiology based on abnormal EKGs turn out to be unnecessary.

Chest pain at that moment, unless you think you're having a heart attack at that moment, not terribly helpful, right? And we get both false positives and false negatives. You could— EKG could be completely normal and you could have significant heart disease. In fact, I've, I've had people with— who've had stents and balloons and surgery whose EKG is perfectly normal. And then of course we get referred in cardiology a lot of people whose EKG really looks weird and funky, and we check them out and they're fine. So EKGs, not terribly helpful unless, again, we suspect you might be having a heart attack at that moment.