Avoid echocardiograms for preoperative/perioperative assessment of patients with no history or symptoms of heart disease.
|Rationale and Comments:||Perioperative echocardiography is used to clarify signs or symptoms of cardiovascular disease, or to investigate abnormal heart tests. Resting left ventricular function is not a consistent predictor of perioperative ischemic events; even reduced left ventricular systolic function has poor predictive value for perioperative cardiac events.|
|References:||• Douglas PS, et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/ SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. J Am Soc Echocardiogr. 2011;24:229-67.
• Fleisher LA, et al. 2009 ACCF/AHA focused update on perioperative beta blockade incorporated into the ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. J Am Coll Cardiol. 2009;54:e13–118. http://content.onlinejacc.org/article.aspx?articleid =1140211.