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One has to bear in mind that having an ECG as part of a medical for a licence, whether that be for motor racing or flying, is in reality no different to an MOT, or whatever your national vehicle test may be called; it's a snapshot of what is happening at that precise moment in time.
Yes, it may detect those who already have an underlying coronary condition, but otherwise it is highly unlikely to predict that the patient is going to be subject to anything untoward such as a heart attack.
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