Q: Should I get an ECG as part of my annual wellness exam?
A: There’s no reason to routinely use electrocardiograms to screen people for signs of coronary heart disease, even if they have risk factors for the condition. That’s according to the latest recommendationsfrom the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts that advises the federal government.
The advice is no surprise—it reaffirms the group’s own past recommendations and those of other medical organizations. But the recommendations, published in JAMA in June 2018, are based on additional research conducted in the past several years. The conclusion remains: If you’re at low risk of coronary heart disease, you shouldn’t be screened for the condition with an electrocardiogram.
The USPSTF says there’s not enough evidence to recommend for or against routine screening for people at intermediate or high risk of coronary heart disease. Higher-risk individuals have at least a 10 percent risk of experiencing a heart attack in the next decade, based on factors such as older age, high blood pressure, diabetes, or smoking. (You can calculate your personal risk with the American Heart Association’s heart risk calculator.) Right now, there’s insufficient evidence that routine ECGs would offer these patients any additional benefit beyond the care they already receive.
An important point: The recommendations relate only to screening—that is, ECG for people with no symptoms of coronary heart disease. If you do have symptoms, you may indeed need an ECG or other tests to get a diagnosis. Many doctors still prefer to get a baseline ECG at least once a decade to havesomething to compare to a subsequent ECG if new symptoms develop.
This article first appeared in the November 2018 issue of UC Berkeley Health After 50.
Also see 13 Tips for Preventing Heart Disease.