Are Healthy Adults getting Unnecessary Heart Screenings?

There are many screening tests adults must see the doctor for. Some include cholesterol screening, mammograms and blood pressure screening. But do some patients get more heart screening tests than they really need? The answer is a resounding “yes”! A recent report indicated that up to forty four percent of healthy adults with no prior history of heart disease get an unnecessary heart

disease test. This is in the face of having a normal cholesterol level and a normal blood pressure test.

Why is this the wrong thing to do? Because, while most of these tests are not dangerous, they can often lead to false positive testing and further tests that are dangerous or risky to do. Such tests include the resting ECG, which really doesn’t show much in the way of heart disease unless a person has active stress on the heart or has had a heart attack in the past. This just isn’t the case in young, healthy people in most situations. A stress ECG is a better test for heart disease but has a high risk of false positives. It is a test in which you run or bike on a bicycle while your heart rhythm is evaluated. If the ST segment shifts too low or goes high, it could be an indication of heart disease. Unfortunately, with the high rate of false positives, some people go ahead and have an angiogram, which is more dangerous than your average stress ECG.

Another relatively unnecessary test is an echocardiogram which can be at rest or can be a stress echocardiogram. It evaluates the valves of the heart and looks at the way the heart muscle moves. It is really a better test to be done in someone who has a known heart condition or to follow a condition to see if it worsens.

These unnecessary screening tests add to the cost of health care and the burden of these extra costs are on the person who has to pay for the test or on the employer or insurance company. Ultimately, the cost is borne by everyone who must pay for higher premiums because so many unnecessary tests are being done. Some tests, of course, are worthwhile and are inexpensive, but some are very expensive and should only be used by those considered high risk for heart disease. The blood pressure evaluations and the cholesterol screens are good tests to be done periodically for everyone but beyond that, the other tests should be done for symptoms or for those with very high cholesterol ratings or chronically high blood pressure. Tests like screening for an abdominal aortic aneurysm, for example, is expensive and has a very low yield. It can instead be done as part of a thorough physical examination and the ultrasound part of the scan can be kept out of the picture.