Task Force Updates EKG Recommendations
Low-Risk People Without Symptoms Do Not Need EKG, Group Says
More About Risk Categories
Your doctor can estimate your risk by using your total cholesterol, HDL or "good" cholesterol, and blood pressure numbers along with information such as age, gender, and smoking history.
"You are at low risk if you have less than a 10% risk of heart attack or death from coronary heart disease in the next 10 years," Melnikow says.
Those with a 10% to 20% risk of heart disease in the next 10 years are at intermediate risk. A 10-year risk greater than 20% is high risk.
Scope of the EKG Recommendations
The task force considers evidence only. The recommendations provide doctors the best evidence for a test or service.
Doctors then use their clinical judgment when deciding which tests to do.
The panel doesn't consider cost. But for the record, costs vary. A resting EKG is about $50. In 2011, Medicare reimbursed $92 for a treadmill test.
New EKG Recommendations: Perspectives
The guidelines clarify that for a low-risk person without symptoms, getting an EKG doesn't add anything, says Ravi Dave, MD, attending cardiologist at UCLA Medical Center, Santa Monica.
He reviewed the updated guidelines for WebMD.
"For intermediate to high-risk, it leaves it up to doctors," he says.
"I think doctors [sometimes] do an EKG to avoid missing a major abnormality," Dave says. "What we can get from this study is, the evidence suggests there is no need to do a routine EKG on a low-risk person without symptoms."
Suzanne Steinbaum, DO, director of women and heart disease at Lenox Hill Hospital, New York, doesn't agree totally with the new EKG recommendations.
For those who are low risk and without symptoms of heart disease, she agrees that repeated EKGs done routinely over the years are not necessary.
However, she says, "I think everyone needs an EKG at some point in their life when they are healthy."
This EKG can then serve as a comparison later, if symptoms occur and an EKG is ordered, says Steinbaum.
Routine EKGs: Other Guidelines
The American Academy of Family Physicians does not recommend routine EKGs as part of a periodic health exam in adults without symptoms.