Don't order annual electrocardiograms (EKGs) or any other cardiac screening for low-risk patients without symptoms.
Sources: US Preventive Services Task Force (USPSTF)
Recent guidelines from the U.S. Preventive Services Task Force (USPSTF) (2011), the American Academy of Family Physicians (AAFP) (2011), the American College of Cardiology (ACC) Foundation (2010), and the American Heart Association (AHA) (2010) advise against exercise electrography in asymptomatic, low-risk individuals.
The AHA compiled data, including information from the Framingham Heart Study, to determine appropriate use of cardiac screening tests by looking at prognostic considerations. Those risk factors include gender and age (males over the age of 45 years) with one or more risk factors. The greater the number of risk factors a patient has, the more likely it is that the patient will benefit from screening. If a patient’s risk is less than 10 percent (calculated using a risk assessment tool(hp2010.nhlbihin.net)), screening is not recommended.
The USPSTF reviewed new evidence regarding the reduction of risk for coronary heart disease (CHD) events in asymptomatic adults by screening with electrocardiography (EKG) compared with not screening and issued the following recommendations: The USPSTF recommends against screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at low risk for CHD events (D recommendation). (1) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at intermediate or high risk for CHD events (I statement).
For Your Patients
From Other Organizations
Watch the video as Dr. LeFevre talks with a patient who requests a stress test to make sure nothing is wrong.
This recommendation is provided solely for informational purposes and is not intended as a substitute for consultation with a medical professional. Patients with any specific questions about this recommendation or their individual situation should consult their physician.
The Choosing Wisely®(www.choosingwisely.org) campaign was created as an initiative of the American Board of Internal Medicine (ABIM) Foundation(www.abimfoundation.org) to improve health care quality. More than 50 specialty societies have identified commonly used tests or procedures within their specialties that are possibly overused.
Learn more about the AAFP support of the Choosing Wisely® campaign.
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Annual EKGs for Low-risk Patients