In preoperative evaluation of an asymptomatic patient with mild comorbidity undergoing low-risk surgery, which test is not routinely indicated?

• A. Chest X-ray
• B. Routine stress testing
• C. Electrocardiogram
• D. Basic metabolic panel

Answer: (B)

In preoperative care for someone asymptomatic with only mild comorbidity undergoing a low-risk operation, the goal is to avoid tests that won’t change how you manage the patient. A stress test is meant to reveal myocardial ischemia under exertion, but in this specific scenario the chance that a stress test will alter the perioperative plan or improve outcomes is extremely small. The harms—false positives, unnecessary further testing, delays, and increased costs—outweigh any tiny potential benefit, so routine stress testing is not indicated.

Other tests like chest imaging, routine electrocardiography, or basic metabolic panels are not automatically required in this exact situation either, unless there are specific symptoms, known disease, or pulmonary or renal concerns that would reasonably prompt testing. The key idea is to tailor tests to whether they would change management, which routine stress testing in an asymptomatic, low-risk case does not.