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Why Is An ECG Done Before Surgery?

Dr Spurti Kattimani

8 Min Read

Fast Check Fact Checked

Electrocardiogram or ECG (or EKG) is a simple, non-invasive test to measure the heart’s electrical activity. It is often performed before surgery to assess a patient’s heart health and determine the risk of complications during and after the surgical procedure.

Most people don’t need an ECG for minor surgical procedures until advised by their Surgeon. Major surgery is different.

Table of contents:

Guidelines for Pre-op ECGs
- Who needs a pre-op ECG?
- When should a pre-op ECG be done?
- How is a pre-op ECG done?
- What do the results of a pre-op ECG mean?
Is an ECG necessary before surgery?
What is the purpose of an ECG before surgery?
How does a cardiologist clear a patient for surgery?
How do they check your heart before surgery?
Can anesthesia affect the heart?
Can a patient have surgery with an abnormal ECG?
Why is a chest x-ray done before surgery?
Can surgery cause a heart attack?
When is an ECG not helpful?
What are the risks of an ECG?
How should you prepare for surgery?
How do I book an ECG through the MFine app?
How will I get my report?
Get upto 50% off on X-rays, MRIs, and other scans
Guidelines for Pre-op ECGs

Here are some general guidelines for ECGs before major surgeries.

Who needs a pre-op ECG?

The need for an ECG is usually determined by the surgeon or anesthesiologist based on the patient’s age, medical history, and the type of surgery being performed. Patients who are at high risk for heart diseases, such as those with a history of heart attack or stroke, may be more likely to need an ECG. Not all patients require a pre-op ECG.

When should a pre-op ECG be done?

The timing of a pre-op ECG may vary depending on the patient’s individual circumstances and the surgical procedure being performed. In general, the ECG should be done close enough to the surgery that the results are still valid but not so close that there is not enough time to address any potential issues. A few days to a week before surgery is a common timeframe for a pre-op ECG.

How is a pre-op ECG done?

pre op ecg guidelines

A pre-op ECG is a simple and non-invasive test that typically takes only a few minutes to complete. The patient lies down, and electrodes are attached to the chest, arms, and legs. The electrodes are connected to a machine that records the electrical activity of the heart. The patient is asked to remain still and breathe normally during the test.

What do the results of a pre-op ECG mean?

The results of a pre-op ECG can help to identify any abnormalities or irregularities in the heart’s electrical activity. If the ECG shows any concerning findings, further testing or evaluation may be necessary before the patient can undergo surgery. The surgeon or anesthesiologist may also use the results of the ECG to determine the safest and most appropriate course of anaesthesia for the patient.

Is an ECG necessary before surgery?

Whether or not an ECG is necessary before surgery depends on the type of surgery and the patient’s individual health status.

An ECG may not be necessary for low-risk surgeries and patients without pre-existing heart conditions or risk factors.

However, an ECG may be recommended for patients with underlying heart disease, previous heart attacks, or other cardiovascular risk factors to assess the heart’s function and detect any abnormalities that may increase the risk of complications during or after surgery.

An ECG is a non-invasive, simple, and relatively low-cost test that can provide important information about the heart’s health and function, so it is often considered a useful tool for pre-surgical evaluation.

Ultimately, the decision to perform an ECG before surgery should be made by the patient’s healthcare team based on their individual health status and the specific requirements of the planned surgical procedure.

What is the purpose of an ECG before surgery?

The purpose of an ECG before surgery is to assess the patient’s heart function and detect any underlying heart conditions that may increase the risk of complications during or after surgery.

An ECG can identify abnormal heart rhythms, such as atrial fibrillation, and other heart conditions, such as coronary artery disease or heart failure. It can also help to determine the patient’s baseline heart function, which can aid in the post-operative care and recovery process.

How does a cardiologist approve a patient for surgery?

A cardiologist plays an important role in approving a patient for surgery, particularly for patients with pre-existing heart conditions or risk factors. The process of approving a patient for surgery typically involves a comprehensive evaluation of the patient’s medical history, a physical exam, and various tests to assess cardiovascular health and function.

The cardiologist may review the patient’s medical history and ask about any pre-existing heart conditions, such as coronary artery disease, heart failure, arrhythmias, or previous heart attacks. They may also inquire about any risk factors that may increase the risk of complications during or after surgery, such as smoking, high blood pressure, diabetes, or obesity.

The physical exam typically includes a thorough evaluation of the heart and circulatory system, including listening to the heart with a stethoscope, checking the pulse, and assessing blood pressure. Depending on the patient’s individual health status, the cardiologist may order additional tests, such as an electrocardiogram (ECG), stress test, echocardiogram, or cardiac catheterization, to assess the heart’s function and identify any abnormalities.

Based on the results of these evaluations, the cardiologist will determine whether the patient is at increased risk for complications during or after surgery and make recommendations for any necessary precautions or adjustments to the surgical plan. This may include adjusting medications, delaying the surgery to allow for further evaluation or treatment, or providing specialized monitoring during the procedure.

In some cases, the cardiologist may determine that the patient is not a good candidate for surgery or that the risks outweigh the benefits. However, in most cases, the goal of the evaluation is to help ensure a safe and successful surgical experience for the patient.

How do they check your heart before surgery?

In addition to an ECG, other tests may be used to check a patient’s heart before surgery, including

A physical exam
Blood tests, and
Imaging tests such as chest x-rays
Echocardiograms, and
Cardiac catheterization

The specific tests used will depend on the patient’s medical history and individual risk factors.

Can anesthesia affect the heart?

Anesthesia can affect the heart, especially in patients with pre-existing heart conditions. Some anesthesia medications can cause changes in heart rate, blood pressure, and rhythm. Patients with heart disease may be more sensitive to these effects, and their heart function may need to be closely monitored during surgery. However, modern anesthesia techniques and monitoring equipment have greatly reduced the risk of anesthesia-related heart complications.

Can a patient have surgery with an abnormal ECG?

It is important to note that an abnormal ECG does not necessarily mean that a patient cannot have surgery. Depending on the severity of the condition, the type of surgery, and other factors, the surgery may still be possible with additional precautions and monitoring.

The decision to proceed with the surgery is typically made on a case-by-case basis, taking into account the patient’s overall health and the potential risks and benefits of the procedure.

Why is a chest x-ray done before surgery?

In addition to an ECG, a chest x-ray may also be done before surgery to assess the lungs and identify any potential issues such as pneumonia, lung cancer, or chronic obstructive pulmonary disease (COPD). A chest x-ray can also detect other conditions that may affect the heart, such as an enlarged heart or fluid around the heart.

This can help doctors determine the patient’s overall fitness for surgery and make any necessary adjustments to the procedure or anesthesia.

When is an ECG not helpful?

While an ECG is a useful tool for evaluating the heart’s function and detecting certain abnormalities, there are some situations where it may not be helpful or necessary.

For example, in low-risk surgeries for patients without pre-existing heart conditions or risk factors, an ECG may not provide any meaningful additional information beyond a routine physical exam. Similarly, in cases where the patient has a known history of heart disease or has already undergone extensive cardiac testing, an ECG may not be necessary or may provide limited additional value.

There are also certain types of heart conditions that may not be easily detected by an ECG alone. For example, certain types of arrhythmias, such as atrial fibrillation, may not always be evident on a resting ECG and may require additional testing, such as ambulatory ECG monitoring or electrophysiology studies.

In addition, an ECG may not be useful for assessing the heart’s response to stress, such as during exercise or other physical activity. In these cases, a stress test, echocardiogram, or other specialized testing may be more appropriate.

Ultimately, the decision to perform an ECG should be made by the patient’s healthcare team based on their individual health status and the specific requirements of the planned surgical procedure or other medical evaluation. In some cases, additional testing or monitoring may be necessary to fully evaluate the heart’s function and ensure the patient’s safety during and after the procedure.

What are the risks of an ECG?

indication of ecg before surgery anaesthesia

An ECG is a safe and non-invasive test, and the risks are generally minimal. Some patients may experience mild discomfort or skin irritation from the adhesive electrodes used to attach the ECG leads to the skin. In rare cases, some patients may have an allergic reaction to the adhesive or the gel used to conduct the electrical signals. But this is very unlikely.

How should you prepare for surgery?

Preparing for surgery can help to reduce the risk of complications and ensure a smoother recovery. Before surgery, patients should follow their doctor’s instructions carefully, which may include the following:

Fasting for a certain period of time before surgery to reduce the risk of aspiration
Stopping certain medications or supplements as instructed by the doctor
Quitting smoking, if applicable, to reduce the risk of lung and heart complications
Staying hydrated and getting plenty of rest in the days leading up to surgery
Making arrangements for transportation and aftercare, as necessary.

Patients should also inform their doctor of any medical conditions or medications they are taking and ask any questions they may have about the procedure. Following these guidelines can help to ensure a safe and successful surgical experience.

How do I book an ECG through the MFine app?

You can now book an ECG test from the comfort of your home. To book, follow these simple steps:

Download the MFine app
Register using your phone number
On the top right-hand corner, click on the “X-rays, MRIs & scans” icon
Now, on the search bar, type “ECG” to get started

How will I get my report?

You will find your report on the MFine app. To download your report,

Click on the burger menu on the top left-hand side of the screen
Click on “Health Files” under the records section
Next, click on the “Attachments and Reports” icon to download your reports

You will get your results in the next 30 minutes! On the app itself, this may take a bit longer.

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Conclusion

In conclusion, an ECG before surgery is a common and important practice to assess a patient’s cardiovascular health and identify any potential issues that may impact the safety and success of the procedure. By working closely with a cardiologist and following any necessary pre-surgical guidelines, patients can help ensure a safe and successful surgical experience.

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Written by

Dr Spurti Kattimani

Dr Spurti is a Consultant Physician with 6+years of experience. She has previously worked at Bangalore Medical College and ESIC College and hospital. She also worked as a Pathology professor and Dermatology resident in previous hospitals. Currently, she is working as a Program Manager and Consultant at MFine.

Why Is An ECG Done Before Surgery?

Who needs a pre-op ECG?

When should a pre-op ECG be done?

How is a pre-op ECG done?

What do the results of a pre-op ECG mean?

Is an ECG necessary before surgery?

What is the purpose of an ECG before surgery?

How does a cardiologist approve a patient for surgery?

How do they check your heart before surgery?

Can anesthesia affect the heart?

Can a patient have surgery with an abnormal ECG?

Why is a chest x-ray done before surgery?

When is an ECG not helpful?

What are the risks of an ECG?

How should you prepare for surgery?

How do I book an ECG through the MFine app?

How will I get my report?

Get upto 50% off on X-rays, MRIs, and other scans

Conclusion

Request a Call Back

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