Upcoming surgery? You may not need any heart tests beforehand

If you've ever had surgery, you may recall having a preoperative evaluation, sometimes referred to as "clearance" for surgery. These check-ups take place prior to a planned noncardiac surgery and typically include a physical exam and a detailed medical history. You may also get blood tests and x-rays. And you might have an electrocardiogram (ECG), a quick, painless test that records your heart's electrical activity. But what's the real purpose of a presurgical ECG — and when does getting this test actually make sense?

"For the vast majority of people, even those with known heart disease, an ECG isn't helpful before most surgeries," says Dr. Christian Ruff, director of general cardiology at Harvard-affiliated Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School. The purpose of a preoperative evaluation is to assess whether a person might be at elevated risk of a heart-related complication during or after surgery, he explains. However, an ECG (which lasts only about 30 seconds) isn't necessarily the best way to gauge a person's risk. And sometimes, the findings end up delaying a person's surgery for no good reason if they trigger unnecessary additional testing.