Choosing Wisely

Echocardiogram Before Surgery

When you need it—and when you don’t

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If you’re having surgery, you may wonder if you need an echocardiogram first. Some people
have this test to make sure it is safe for them to have surgery.

An echocardiogram uses sound waves (ultrasound) to make a moving picture of the heart. It shows if your heart has a problem pumping blood. And it can show if you are at risk for a heart attack or heart failure.

The test is a safe way to see how well your heart is working. If your doctor thinks you might have heart disease, the test can be a good idea. But often the test is not needed. Here’s why:

The test usually isn’t necessary if you don’t have symptoms.

People without symptoms rarely have pumping problems.

You usually don’t need the test if you haven’t had heart disease and you don’t have symptoms. An echocardiogram probably won’t find a problem that would affect your surgery.

Testing can be expensive.

A standard echocardiogram can cost $1,000 to $2,000. If your doctor orders a follow-up test called a TEE, it can cost another $2,000 or more, according to Even with insurance, you may have to pay up to half the cost.

An echocardiogram can lead to other tests.

A standard echocardiogram is very safe. It does not use radiation or have side effects. But the test can cause a false alarm. This can lead to anxiety, more tests, unnecessary medicines, or delayed surgery.

For example, if something looks wrong on the test, your doctor might order another test, called a transesophageal echocardiogram (TEE). In this test a tube is put down your throat and into your esophagus. This can cause a sore throat and in rare cases it can cause injury to the throat.

Some people get a stress echocardiogram, where images are taken before and after using a treadmill. In this case, a false alarm can lead to a coronary angiogram (cardiac catheterization). This is an invasive test with more risks. A tube called a catheter is put into your heart through an artery. Then dye is injected and X-rays are taken.

When should you have an echocardiogram before surgery?

You may need an echocardiogram before surgery if:

  • You have a serious heart condition, such as uncontrolled heart failure, irregular heartbeats (arrhythmias), or significant valve disease.
  • You have symptoms of heart disease, such as chest pain or shortness of breath.
  • Or you get tired or out of breath more easily than you did in the past.

In these cases, your doctor can use the echocardiogram to check your risks. The test can show if your doctor should change or postpone your surgery.


Advice from Consumer Reports

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2013 Consumer Reports. Developed in cooperation with the American Society of Echocardiography. To learn more about the sources used in this report and terms and conditions of use, visit