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Evidence to Improve Care

Preoperative Cardiac Stress Tests for Noncardiac Surgery


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee does not recommend the routine use of noninvasive cardiac stress tests for preoperative screening purposes prior to noncardiac, intermediate-risk, elective surgery.

  • The Ontario Health Technology Advisory Committee recommends that the selective use of these tests be guided based on patients' clinical risk factors for perioperative cardiac complications, as well as whether information from the test would inform clinical decision-making.

Read the full OHTAC Recommendation report



Preoperative cardiac assessment (checking the heart) is meant to find patients who might have serious heart problems if they have surgery. In fiscal year 2011/12, the Institute for Clinical Evaluative Sciences found about 7,500 preoperative assessments of cardiac risk had been performed through cardiac stress tests in Ontario.


Health Quality Ontario Reviews Preoperative Cardiac Stress Tests for Noncardiac Surgery

Noninvasive (without putting tools into the body) cardiac stress tests (checking the heart for problems that might appear when the patient is not relaxed) are often used to find serious heart problems that might appear during surgery. Three types of tests are used: stress echocardiography, radionuclide myocardial perfusion imaging, and exercise/treadmill test. These tests are not invasive and can allow surgeons to postpone surgery for a better time or to prepare for any problems that might develop.


Preoperative Cardiac Stress Tests for Noncardiac Surgery: A Rapid Review (PDF)
March 2014


Related Resources

Preoperative Consultations: OHTAC Recommendation (PDF)
March 2014


Preoperative Resting Echocardiography for Noncardiac Surgery: OHTAC Recommendation (PDF)
March 2014


Preoperative Consultations: A Rapid Review (PDF)
March 2014


Preoperative Resting Echocardiography for Noncardiac Surgery: A Rapid Review (PDF)
March 2014


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: Relevant language in Schedule of Benefits for Physician Services has been updated.



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