The electrocardiogram, or EKG, is one of the most common tests performed during routine physicals. The doctor places electrodes on your chest and receives a ribbon of paper showing the electrical tracings of your heart. But a government panel recently made the controversial recommendation that the EKG, also known as ECG, should not be done as a routine screening test.
One of the nation’s top cardiologists, Chauncey Crandall, M.D., disagrees with the new guidelines. “This is a simple, cheap, important diagnostic tool that’s been time-tested over the past 100 years,” said Dr. Crandall, chief of the cardiac transplant program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach County, Fla.
The United States Preventive Task Force recommended that the EKG no longer be used as a screening test to identify individuals at low risk for heart attack or heart disease, saying there was no evidence that it helped doctors predict heart risks any better than traditional considerations such as smoking, blood pressure, and cholesterol.
However, Dr. Crandall says the EKG is valuable for other reasons besides predicting heart attack risk. It provides a wealth of information about the heart’s functioning. “An ECG can tell us if they have a regular heart rhythm, if they’ve had a previous heart attack, and also shows whether the heart can withstand stress,” he said. “I wouldn’t send anyone into battle or have them seated in the White House until I knew what their baseline ECG looked like.”
This is not the first time that the EKG’s value as a screening tool has been questioned. The American College of Cardiology and the American Heart Association currently recommend against EKG’s as a routine test for people at low risk of heart disease or without symptoms. Like the task force, these organizations contend that abnormal results can lead to more costly and potentially harmful follow-up testing.
Many studies, though, point to the value of the EKG, including one published in the Journal of the American Medical Association last April, which found that minor changes in the test results translated into a 35 percent increased risk of heart events, such as heart attacks, hospitalizations, or the need for heart surgery in people over 70.
According to Dr. Crandall, the call to abandon the EKG as part of a routine physical is another example of the government’s quest to save money regardless of sound medical practice. “This represents another example of government intrusion regarding what they think is right for your health, so you have to ask yourself, ‘Do you trust them?’”
