EKG analysis is very complicated. Pulse rate is not really a factor, they check your pulse on every medical, not just the EKG ones.
The EKG is looking for potentially abnormal signals in the nerve mechanism that controls the heart...these could be caused by 1001 different things, many of which are benign and common. If you have a real serious problem on the EKG, they will catch it and ground you.
The thing that creates EKG issues for healthy people is certain types of heart rythm inconsistencies...these often feel like your heart skips a beat (I have had this problem). This is harmless in most cases and can occur once a day or once a minute. However if they occur many times each minute there can be a medical issue.
The problem is the EKG takes a very short snapshot, only a few seconds...if you happen to have one of those unusual rythms during the snapshot, they don't know if that is happening once a day, once an hour, or once every six seconds....
They will usually give you your medical, but after the FAA reviews it, they may require a follow up exam where you have to wear a heart rate monitor for 24 hours to record all irregularities during that period. This is an expensive nuisance. You can sometimes minimize the rythm irregularities for the EKG by doing these things...
1) Don't drink the day before
2) Don't exercise hard the day before
3) No caffiene the morning of
4) Low Potassium can cause these...eat bananas (this solves the problem for me)
Also if you are a serious endurance athlete, your heart may idle rough (kind of like a hot-rod) when resting. I learned in the military to do a few pushups before the EKG to get the heart rate up to a smoother rythm.
