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Congenital heart disease (CHD) is a morphologic defect of the heart or great vessels which is present at birth. "Congenital" does not imply the defect was inherited, although many CHD are heritable. CHD may also be caused by de novo spontaneous mutations, which have the potential to be transmitted to progeny. Diagnosis of CHD is important for the health of the patient and also to eliminate affected individuals from the breeding pool.

The primary indication for obtaining an electrocardiogram (ECG) is to evaluate an arrhythmia. Patients with a history of syncope, episodic weakness, or collapse should be evaluated with an ECG. An ECG is an insensitive test for assessment of specific cardiac chamber enlargement, and interpretation of structural heart disease is best done using radiography and echocardiography.