The low impact of Screening electrocardiograms in healthy individuals: A prospective study and review of the literature

To determine how often screening electrocardiograms (EKGs), which are required by military regulation, change management or disclose cardiac disease in healthy people. A total of 1,718 consecutive EKG interpretations, whether or not the screening EKG led to further testing, disclosed serious or potentially serious cardiac disease, or changed management or disposition of the patient, were prospectively recorded. Thirty-four percent of the screening EKGs was abnormal. Seven (0.67%) of these abnormal EKGs altered management by leading to further consultation or testing. No screening EKG disclosed serious underlying cardiac disease. Two cases of potentially serious cardiac disease were discovered by the screening EKGs. At an average follow-up time of 34 months, neither of these two patients has developed serious cardiac disease. Our findings are similar to studies of other populations. Screening EKGs rarely caused a change in management. No adverse outcome would have occurred nor would serious cardiac disease have been missed if the routine screening EKG were not performed. The military should consider abandoning practice of performing screening EKGs in young, healthy individuals.