Skip to main content

Evidence to Improve Care

Preoperative Resting Echocardiography for Noncardiac Surgery


Ontario Health Technology Advisory Committee Recommendation

  • On the basis of expert consensus, the Ontario Health Technology Advisory Committee does not recommend the use of resting echocardiography for routine preoperative screening purposes prior to noncardiac elective surgery with intermediate cardiac risk.

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. Sometimes doctors use special heart tests to check for these problems, and in Ontario they most often use a test called resting echocardiography. In fiscal year 2011/12, the Institute for Clinical Evaluative Sciences discovered about 10,000 preoperative assessments of cardiac risk were performed through resting echocardiograms in Ontario.


Health Quality Ontario Reviews Preoperative Resting Echocardiography 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.

Advantages to using stress echocardiography include easy availability and no need to inject substances into patients’ veins, no need to use radioactive substances, and no need to expose patients to radiation. Echocardiography provides information about problems in the part of the heart called the ventricle, abnormal valves, and abnormal motion in the walls of the heart.


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


Related Resources

Preoperative Consultations: OHTAC Recommendation (PDF)
March 2014


Preoperative Cardiac Stress Tests for Noncardiac Surgery: OHTAC Recommendation (PDF)
March 2014


Preoperative Consultations: A Rapid Review (PDF)
March 2014

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


Use of this site, and the interpretation of the information contained here, is subject to important terms and conditions. Use of this site and information except in accordance with these terms and conditions is expressly prohibited.


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 the Schedule of Benefits for Physician Services has been updated.



Let’s make our health system healthier

Join Our Patient, Family and Public Advisors Program

Patients, families and the public are central to improving health quality.


Man smiling

Sign up for our newsletter

Are you passionate about quality health care for all Ontarians? Stay in-the-know about our newest programs, reports and news.

Health Quality Connect - Health Quality Ontario's newsletter - on an iPad and a cell phone