Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The myth about screening for heart disease

Davis Liu, MD
Conditions
February 20, 2013
Share
Tweet
Share

8172034_cover
An excerpt from 
The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy.

In the spring of 2008, NBC’s Meet the Press moderator and Washington bureau chief, Tim Russert, died suddenly of a heart attack at the age of fifty-eight. Time magazine identified him as one of the one hundred most influential people in world in 2008. His ability to make complex topics clear for the public and to ask the hard questions will be missed.

Perhaps more shocking was that just a few weeks earlier, he had passed a cardiac stress test.

In other words, the stress test was normal.

This is one of the biggest myths that must be dispelled about screening for heart disease. In patients with no symptoms, screening for heart disease with heart stress tests such as treadmills or using EKGs has not been shown to save lives. These tests are far more beneficial in evaluating patients with symptoms of chest pain, shortness of breath, palpitations, or other symptoms that might be related to the heart. Yet this message is not being heard. A 2011 article from Consumer Reports found in a survey of over eight thousand subscribers between the ages of forty and sixty who had no history or symptoms of heart disease that about half had undergone an EKG and one out of five had taken a heart stress test.

In patients at little to low risk for heart disease, an EKG or stress testing can actually lead to harm. The heart stress test can be a false positive; that is, the test can detect an abnormality which then has to be further investigated with either a nuclear medicine scan or a CT angiogram, both of which require radiation exposure. In patients at little to low risk, the subsequent results are normal, as one would expect. The patient went through unnecessary worry and testing. There can be too much of a good thing.

In the case of Mr. Russert, who was at higher risk of heart disease due to his age, gender, and other risk factors, passing a cardiac stress test also shows the limitation of these tools. They do not work well in predicting the risk of heart attack in patients with no symptoms. Be aware of this limitation before someone recommends this type of testing, particularly when you feel well.

Consumer Reports has an excellent app that helps you determine which interventions are best in screening for heart disease.

The boring, unsexy task of controlling cholesterol and high blood pressure were rated the best and highest. The benefits far outweighed any of the risks. One of the worst interventions, where the risk outweighed the benefit? The heart stress test.

As you pay more out of pocket for health care, isn’t important to know what is and what isn’t worth your hard-earned money?

Davis Liu is a family physician who blogs at Saving Money and Surviving the Healthcare Crisis and is the author of The Thrifty Patient – Vital Insider Tips for Saving Money and Staying Healthy and Stay Healthy, Live Longer, Spend Wisely.

Prev

The young and healthy can die from influenza complications

February 20, 2013 Kevin 2
…
Next

Make patients more accountable for their own health

February 20, 2013 Kevin 68
…

Tagged as: Cardiology

Post navigation

< Previous Post
The young and healthy can die from influenza complications
Next Post >
Make patients more accountable for their own health

ADVERTISEMENT

More by Davis Liu, MD

  • The mission to make health care equitable and accessible for all

    Davis Liu, MD
  • How to close the leadership challenge and end this COVID chapter

    Davis Liu, MD
  • What’s wrong with health care, and do we have the will to change?

    Davis Liu, MD

More in Conditions

  • Addressing menstrual health inequities in adolescents

    Callia Georgoulis
  • Healing beyond the surface: Why proper chronic wound care matters

    Alvin May, MD
  • Why specialist pain clinics and addiction treatment services require strong primary care

    Olumuyiwa Bamgbade, MD
  • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

    William J. Bannon IV
  • Facing terminal cancer as a doctor and mother

    Kelly Curtin-Hallinan, DO
  • Why doctors must stop ignoring unintentional weight loss in patients with obesity

    Samantha Malley, FNP-C
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 8 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The myth about screening for heart disease
8 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...