Harvard Heart Letter

Heart Beat: Just-in-case electrocardiograms not recommended

Checking your heart's electrical activity with an electrocardiogram (ECG) or exercise stress test makes perfect sense if you or your doctor suspects cardiac trouble. What if you feel fine — no chest pain, shortness of breath or tiredness, or other symptoms of heart disease? Should you have an ECG or exercise stress test to "check under the hood" for undiscovered heart disease? No, says the U.S. Preventive Services Task Force, an independent panel of experts whose recommendations help define high-quality preventive health care for Americans (Annals of Internal Medicine, Sept. 20, 2011). The recommendation reaffirms the group's 2004 advice.

The task force found no evidence that a screening ECG or stress test — screening means checking apparently healthy people to see if they have an undiagnosed condition — will change your cardiovascular risk classification or the way you manage your heart health. And while an ECG is one of the safest tests around, it can lead to additional tests such as an angiogram or a cardiac CT scan. Those methods come with their own risks, such as the chance of bleeding or stroke with an angiogram, and radiation exposure with cardiac CT.

If you are worried that plaque may be lurking in your arteries, you don't need an ECG to tell you to exercise more, improve your diet, lose weight, stop smoking, de-stress yourself, or do any of the other things that will be good for your heart and arteries.

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