Is routine pre-operative electrocardiogram necessary?

Among 3,371 ECG (electrocardiograms) performed at Hat Yai Municipal hospital in 1981, at least 424 were done presumably for a routine preoperative investigation. Analysing the data file of each patient, it was found that 14 per cent had definitely abnormal ECGs of the type that generally implies ischemic heart disease. Another 9 per cent had ECGs that were possibly abnormal and needed, at least, a medical evaluation. However, only a fifth (22 out of 100) of those with abnormal ECGs were eventually examined and of these, less than half (9 out of 22) had their management altered. These results suggest that routine preoperative ECG lacks the potential usefulness given constraints present in several health centers in this country.