Are all abnormal ECGs indicative of heart disease

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No. Just as some individuals are very tall, some individuals without real cardiac pathology have electrocardiogram (ECG) findings that deviate enough from the population mean to raise the question of heart disease. Careful history and physical examination may help identify individuals who truly have cardiac pathology. Noninvasive techniques such as echocardiography and cardiac magnetic resonance imaging may aid in separating patients with true structural heart disease from those with unusual variations who are abnormal only in a statistical sense.

Other findings such as right bundle-branch block (RBBB), are present in patients with heart disease but also occur frequently in patients who have no evidence of heart disease by history, physical examination, or echocardiography.

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