People might be surprised by what’s not included in the checkup that family-medicine physician Lynn Oliver, M.D., provides her healthy patients: no EKG, no stress test, no 3D CT scan. Instead, just a standard blood pressure check and simple blood work to determine cholesterol and, sometimes, blood sugar levels, too.

While those fancier tests can be lifesaving if you’re experiencing chest pains or are at high risk of heart disease, using them in people without symptoms is often looking for trouble, she explains.

Unnecessary testing is not just a waste of time and money but also can cause harm, says Roger Chou, M.D., a professor at the school of medicine at Oregon Health & Science University. That often comes from false alarms that can trigger needless anxiety and a cascade of costly, sometimes risky procedures.

These practices are discouraged by a number of the medical specialty societies participating in the Choosing Wisely campaign, which aims to identify what really works, and what doesn't, in medical care.



When to Be Tested

Here are heart tests sometimes recommended by doctors, and when taking them can make sense.

Electrocardiogram (EKG or ECG): Electrodes attached to the chest to provide information about your heartbeat. May be useful for people with symptoms of heart disease such as chest pain, and possibly for those at risk of heart disease who are starting to exercise. Read more about EKGs.

Exercise stress test: Measures the heart’s function while it’s stressed by exercise or medication. May be useful when combined with an EKG, or in people who have an abnormal EKG.

Abdominal aortic aneurysm test: An ultrasound to look for ballooning in the body’s main artery, which can be deadly if it bursts. May be useful for people with detectable lumps in the abdomen and men 65 to 75, especially those who ever smoked. Women 65 and older who ever smoked might consider it, though evidence for them is less certain.

Peripheral artery disease tests: A comparison of the blood pressure in your arms with the pressure in your legs. May be useful for people with cramping in their hips, thighs, or calves when walking or exercising. Read more about tests for peripheral artery disease.  

Carotid artery imaging: An ultrasound of the arteries on either side of your neck. Narrowing of those arteries increases stroke risk. May be useful for people who have had a stroke or mini stroke (transient ischemic attack). Read more about carotid artery imaging.

CT angiography: A CT scan that produces a 3D image of the coronary arteries. May be useful for people with chest pain and unclear results on an EKG and stress test.

Editor's Note: This article also appeared in the May 2017 issue of Consumer Reports magazine.