If you’re scheduled for non-cardiac surgery, a test that takes pictures of your heart can sometimes help to identify risky undiagnosed cardiac problems that may require a delay in your operation. But if your surgery isn’t related to the heart and you don’t have heart-related symptoms or risk factors, the test may not be helpful.

• Pre-surgical imaging tests are NOT always necessary. These tests aren’t useful for most people undergoing low risk procedures such as eye surgery or breast biopsy. In fact, even major surgery is safe for most healthy people who feel well and are moderately active without symptoms. All they usually need is a medical history and physical exam.
• The tests can pose risks! Preoperative imaging tests are usually very safe and can be done with little or no radiation. But if you’re unlikely to have a heart problem, they may produce false-positive results (indicating you have heart disease when you actually do NOT) that could prompt anxiety, additional risky testing, and a delay of your surgery.

When are the tests needed before surgery?

An imaging test may be ordered even for low-risk surgery if you have a severe heart condition or you’re experiencing symptoms that could be heart-related, such as chest pain, breathing difficulty, or a loss of stamina. They may also be considered prior to intermediate-risk surgery (such as knee or hip replacement) or high–risk surgery (such as a bypass operation for leg artery blockages) in people who have risk factors—including diabetes, kidney disease, or a history of coronary artery disease, heart failure or stroke, and who have poor exercise tolerance making it hard to assess heart-related symptoms or can’t walk a short distance or climb stairs without experiencing heart-related symptoms.

Conditions: Preoperative Assessment (Pre-Op), Low-Risk Non-Cardiac Sugery

Diagnostic Tests: Stress Cardiac Imaging (Stress Nuclear, Stress MIBI), Stress Echocardiography (Echo), CT Coronary Angiogram