There are lots of different types of heart disease. An ECG can be useful for diagnosing some of them but you're overstating the relative value. For many patients, a CT coronary calcium score or CT angiogram may be more valuable in terms of detecting the type of arterial plaques that might require medical management or major lifestyle modifications in order to prevent a heart attack. These are also non-invasive, although they do involve some radiation exposure.
https://www.mayoclinic.org/tests-procedures/heart-scan/about...
https://www.mayoclinic.org/tests-procedures/ct-coronary-angi...
>For non-invasive heart disease risk prediction nothing beat ECG, period.
Emphasis on non-invasive diagnostic screening as invasive testing like angiogram need to be operated by specialist and can take months to be arranged, and only done after incidents e.g heart attack.
ECG is excellent for generic top level CVD anomaly conditions for examples arrhythmia and ischemia.
Having a CAC done is fairly cheap, ~$100 in the US. Insurance typically doesn’t cover it, but if anyone is concerned, it’s worth calling to set one up.
My dad’s doctor said he should get one, Medicare denied it, but he paid out of pocket to get one anyway. He found out he was 95% blocked pretty much everywhere and had a quadruple bypass. It likely added many years to his life and avoided a heart attack.
If you’re under a certain age (I want to say somewhere in your 50s), there isn’t any guidance for what normal is. If you’re in your 20s or 30s, I wouldn’t run out and get one. But if you’re in your 40s with a family history, or up into your 50s and beyond, it’s worth thinking about. I’ve also heard you’re only supposed to get them every 2-3 years, it’s not a yearly thing, due to the radiation.
(I am not a doctor)