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Correspondence
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Volume 334:1064-1065 April 18, 1996 Number 16
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Preoperative Assessment of Patients with Coronary Disease

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 by Mangano, D. T.
To the Editor: Drs. Mangano and Goldman (Dec. 28 issue)1 recommend that all patients with known coronary disease undergo routine postoperative electrocardiography on day 1 and again before discharge from the hospital, to rule out myocardial infarction. Used this way, electrocardiography would be considered a screening test (i.e., a means of detecting a common, clinically important disorder in asymptomatic persons).

Unfortunately, neither the clinical circumstances nor the test meets the criteria for a good screening opportunity. Although it is true that a high proportion of patients with perioperative myocardial infarction do not have typical chest pain, the frequency of completely . . . [Full Text of this Article]

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