Heart Test and Therapy Don’ts

Cardiovascular treatments and exams identified by medical societies as unnecessary

(RxWiki News) When it comes to heart therapies and tests, some patients and doctors have a “more is better attitude.” A group of medical societies have called more than 130 treatments and exams into question.

Last year, nine medical societies, including the American College of Cardiology (ACC), put together a list of 45 “don’ts” that were intended to eliminate commonly ordered but often unnecessary tests and procedures. These tests and procedures can often be costly and sometimes do more harm than good.

Recently, 17 medical groups added 90 more recommendations to the list.

"Discuss all tests and procedures with your doctor."

Christine Cassel, MD, is president and CEO of the American Board of Internal Medicine (ABIM) Foundation, which organized an initiative called Choose Wisely. A goal of the group is to provide recommendations so physicians and patients can make more informed healthcare decisions.

Dr. Cassel has said that new guidelines seek to get rid of unneeded procedures that can waste money and sometimes harm a patient’s health. Potentially damaging approaches include excessive radiation exposure in the course of diagnostic imaging or surgery following a false-positive diagnosis, which can lead to complications.

Among the “don’ts” is a recommendation that patients experiencing a heart attack and undergoing a procedure called percutaneous coronary intervention (PCI) should not have stents placed in an artery or arteries beyond those responsible for the heart attack, according to the ACC. Stents are tubular structures that are inserted into arteries to prevent them from becoming blocked.

Some imaging tests are also among the diagnostic don’ts. For example, the ACC suggests that cardiac imaging tests should not be given if there are no symptoms of heart disease or if high risk factors such as diabetes or peripheral arterial disease (PAD) are not present.

This year, 12 of the guidelines cautioned physicians about treatment given to patients without any symptoms. One such warning came from the American Academy of Family Physicians, which said: “Don't screen for carotid artery stenosis  [a narrowing of the arteries that deliver blood to your brain] in asymptomatic adult patients [patients with no symptoms].”

Consumer Reports is working with other consumer-oriented groups such as AARP, the Leapfrog Group and the National Partnership for Women & Families to spread the Choosing Wisely guidelines to patients.

The Choosing Wisely campaign acknowledges that patients themselves often request unnecessary tests and treatments.

This public outreach seeks to educate Americans that not every test and procedure is appropriate for a particular condition, said ACC president, William Zoghbi, MD.

For more information on these guidelines, visit www.choosewisely.org.

The American Board of Internal Medicine Foundation announced the new list of common but often unnecessary tests and procedures on Thursday, February 21.

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Review Date: 
February 28, 2013