Heart tests before surgery: When are they necessary?

Most people don't need an electrocardiogram before a minor, low-risk procedure. Major surgery is different.

Published: May, 2020

If you've ever had surgery, you may recall having a preoperative evaluation, sometimes referred to as "clearance" for surgery. These check-ups often occur days or weeks prior to a planned, non-cardiac surgery and typically involve a physical exam. You also may get blood tests, x-rays, and an electrocardiogram (ECG) — a quick, painless test that records your heart's electrical activity.

"These evaluations are designed to assess your chances of experiencing a heart-related problem during the surgery," says Dr. Brendan Everett, director of the general cardiology inpatient service at Harvard-affiliated Brigham and Women's Hospital. The term "clearance" is misleading, as there is no way to guarantee you won't have complications. Still, knowing ahead of time about any heart-related risks you may have enables the surgeon to better prepare for possible complications and have a backup plan available, says Dr. Everett.

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