Don’t Take This Test to Heart

Echocardiography may not be a valuable tool for screening the general public for heart disease

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Screening for heart disease is a routine part of many physical exams. Some of these screening tests are simple tests, but others can be more sophisticated and expensive.

A new study suggests that screening the general public for heart disease using echocardiography, a type of ultrasound, may not reduce the risk of sudden death, heart disease-related deaths, heart attacks or strokes.

Echocardiography is an expensive procedure that is beneficial when a person has symptoms or a family history of heart problems.

"Ask your cardiologist about screening tests for heart disease."

This study was conducted by Haakon Lindekleiv, MD, PhD, of the University of Tromso, Norway, and colleagues.

The aim of this study was to find out if screening people for heart disease using echocardiography improved survival or reduced the risk of heart disease.

Echocardiography is an ultrasound scan of the heart. Doctors can use it to look at the size and shape of the heart and check to see if there is any damage to heart tissue.

Sometimes, echocardiography is recommended for people without any heart-related symptoms if any of their family members have hereditary heart disease or have died suddenly of heart disease. It is not clear whether screening using echocardiography, which basically means testing everyone including normal healthy individuals, is useful for people with no such history.

This study looked at 6,861 participants aged 25 years or older. Of these participants, 3,272 were randomly assigned to receive the echocardiography screening test and 3,589 were assigned to a comparison group that did not receive the echocardiography test.  

The participants followed up with the researchers for 15 years. During the study period, 880 people (26.9 percent) from the screening group and 989 people (27.6 percent) from the comparison group died.

According to the study authors, early diagnosis of certain heart valve problems in the study group did not translate into a lower risk of heart disease or death in that study group.

No significant differences were found in the rates of sudden death, heart disease-related deaths, heart attacks or strokes between the two groups. This finding means that any differences between the two groups could be due to random chance.

The researchers concluded that their findings support the current guidelines that echocardiography is not recommended to assess heart-related risks in adults without symptoms.

According to Baylor Heart Hospital Cardiologist and dailyRx Contributing expert, Sarah Samaan, MD, FACC, "Echocardiograms generally cost hundreds of dollars. They are performed by a trained sonographer and usually read by a cardiologist with special expertise in echocardiography.

"Typically we will order an echocardiogram if we suspect heart valve disease, a weak or scarred heart muscle, or an abnormally developed heart. However, a normal echocardiogram does not rule out blockages in the heart arteries and tells us very little about long-term prognosis in someone with no prior heart history.

“Although some people might believe that the more data we have, the better, this study reiterates that complex medical testing is not necessary, useful, or cost effective for the general population unless there is a clear reason for ordering the study,” said Dr. Samaan.

The results of this study were published July 22 in the JAMA Internal Medicine.

Funding information was not available, but no conflicts of interest were reported.

Reviewed by: 
Review Date: 
July 22, 2013
Last Updated:
July 26, 2013