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New Guidelines Say No to Screening EKGs for Low-Risk Patients
Date:7/31/2012

By Carina Storrs
HealthDay Reporter

MONDAY, July 30 (HealthDay News) -- A top U.S. advisory panel has recommended against preventive electrocardiography (EKG) screening for people at low risk of heart disease.

The U.S. Preventive Services Task Force also determined there is not enough evidence to recommend for or against screening people without symptoms who are at moderate or high risk of heart disease.

The task force published its recommendations online July 31 in the Annals of Internal Medicine. They echo the task force's previous guidelines on EKG screening, which came out in 2004.

"The systematic review didn't come up with any science that would change the 2004 recommendation -- it is in fact the same as in 2004," task force co-vice chair Dr. Michael LeFevre said, explaining that the task force makes a general policy of updating all its recommendations about every five years.

"When you have an asymptomatic low-risk population, the chance that you're going to do harm instead of good [by screening] goes way up," LeFevre said.

In a low-risk population, abnormalities that show up in an EKG are probably not due to actual heart disease and are probably false positives instead, LeFevre explained. "Inevitably, that leads to further testing, including invasive testing such as heart catheterization" that carries the risk of rare complications like heart rhythm disturbances, he added.

Although the task force did not come to a conclusion about moderate- and high-risk groups of people based on the current evidence, "as a practicing family physician, it would be unusual for me to do an EKG in any asymptomatic person," LeFevre said.

The task force stated that evaluating traditional risk factors including bad cholesterol, high blood pressure and smoking were important, and that it was not clear that EKGs added any information to this assessment.

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