Chest X-rays before surgery: When you need them—and when you don’t


Released December 21, 2015

Many people have a chest X-ray before they have surgery. This is called a “pre-op” chest X-ray. “Pre-op” stands for preoperative, which means that it is before an operation, or surgery.

If you have a heart or lung disease, you may want to get a pre-op chest X-ray. It can show medical problems, like an enlarged heart, congestive heart failure, or fluid around the lungs. These could mean that your surgery should be delayed or cancelled. However, if you don’t have signs or symptoms of a heart or lung disease, you should think twice about having a chest X-ray before surgery. Here’s why:

 

A chest X-ray usually doesn’t help.

Many people are given a chest X-ray to “clear” them before surgery. Some hospitals require a chest X-ray for almost every patient.
But, if you do not have symptoms of a heart or lung disease, and your risk is low, an X-ray probably will not help. It is not likely to show a serious problem that would change your treatment plan.
And a chest X-ray does not help the surgeon or the anesthesiologist manage your care. Most of the time, a careful medical history and physical exam are all you need.

 

A chest X-ray can have risks.

A chest X-ray uses radiation. Risks from radiation exposure may add up, so it is best to avoid it when you can. Also, a chest X-ray can show something that looks to be abnormal. This is often a false alarm. But you will need follow-up tests to rule out a serious problem. This can cause anxiety, and expose you to risks from the other tests.

 

When should you have a chest X-ray?

It is a good idea to have a chest X-ray before you have surgery or before you go into the hospital if:

  • You have signs or symptoms of a heart or lung condition. These include chest pain, coughing, shortness of breath, swelling in the ankles, fever, a recent heart attack, or a cold or other lung infection that does not go away.
  • You have a heart or lung disease, whether or not you have symptoms, and you have not had a chest X-ray within the last six months.
  • You are older than 70 and you have not had a chest X-ray within the last six months.
  • You are having surgery on the heart, lungs, or any other part of the chest, and you have not had a chest X-ray within the last six months.

 


 

How should you prepare for surgery?

Meet with your doctor or the hospital team before your surgery. Your doctor will examine you and review your medical history. Or the hospital may have a special team to do this, called a “pre-op” team. Bring a list of all the drugs, vitamins, and herbal supplements you take. Include the instructions and dose for each medicine. If you are told to get X-rays or any other tests, ask why they are necessary. You can say you do not want unneeded tests.

Quit smoking, at least for the surgery. The sooner you quit, the less likely you are to have complications from your surgery. It is very important not to smoke on the day of your surgery. If you need help stopping, ask your doctor.

Consider banking some of your own blood. You can have some of your own blood drawn and stored before surgery. That way, if you need a blood transfusion, you will get your own blood. This reduces the risk of infection or a bad reaction.

Ask if you should stop taking pain medicine before surgery. Also ask your doctor if you should stop taking aspirin or any other blood thinners. If you need to take a pain reliever before surgery, use Tylenol (generic acetaminophen). Avoid drugs that can cause extra bleeding during surgery, including Advil and Motrin (generic ibuprofen) and Aleve (generic naproxen sodium).

Ask for help. Ask someone to drive you to and from the hospital. You may also want someone to stay overnight in the hospital with you. And ask what kind of care you will need after surgery. Will you need nursing care? Will you need physical therapy or other rehabilitative care? Where will you get this care?

Pack a bag for your hospital stay. Bring:

  • Provincial health and hospital card.
  • Storage containers for dentures, contact lenses, and glasses.
  • A few items for your comfort, such as a music player and headphones, photos, and a favorite robe or pillow.
  • Do not bring money, jewelry, or other valuables.