Pre-Operative ECGs

Note that the following advice relates to circumstances over and above those mentioned in the page outlining standard investigations.

Patient factors indicating an ECG

Other than standardised testing based on procedural severity, some amount of testing must be based on patient specifics.

Note that these recommendations only apply to major or major+/complex procedures.

An ECG is indicated if the patient is undergoing major or major+/complex surgery, has a documented history of the following comorbidities, and if the test has not been performed in the pre-op assessment clinic or if no ECG from the preceding 6 months is available:

  • Cardiovascular disease
    • ischaemic heart disease (inc. stents, previous MI, angina…)
    • heart failure
    • previous stroke/TIA
    • peripheral vascular disease
    • hypertension
  • Respiratory disease
    • COPD
    • pulmonary fibrosis
    • any other chronic and ongoing lung disease
  • Renal disease
    • chronic kidney disease stage 3 or greater (eGFR < 45 ml/min/1.72m2)
  • Other
    • diabetes mellitus (type 1 or 2)
    • the patient describes a deterioration in their health/exercise tolerance over the preceding 6 months