Which tests will I need before surgery?

It follows the framework NICE (the UK guideline body) uses in NG45: the tests recommended before surgery depend on how big the operation is and on your overall health (your ASA grade) plus specific conditions. You answer those questions and it shows the tests usually considered for that combination — and why. It's a guide to set expectations, not an order; your own pre-op team decides.

The principle is the same — fitter patients having smaller operations need fewer tests — but exact rules differ by country and hospital. This tool follows UK NICE NG45. In the US and elsewhere, ASA-based local protocols are used, which can vary. Always follow the tests your own team orders.

It's a simple measure anesthetists use for your overall health: ASA 1 is fit and healthy, ASA 2 is a mild well-controlled condition, ASA 3 is a condition that limits daily activity, and ASA 4 is a severe, life-threatening condition. Higher grades usually mean more pre-op tests.

Neither is routine. A chest X-ray is reserved for people with significant lung or heart disease, new breathing symptoms, or certain major (especially chest) operations. An echocardiogram (2D echo) is considered — usually after an ECG and on specialist advice — if you have a heart murmur, breathlessness, heart failure, or known significant heart disease, to check your valves and how the heart is pumping. Current cardiac guidance also weighs how active you can be (functional capacity) and sometimes a BNP blood test when deciding who needs an echo.

Not as routine pre-op tests. Scans are ordered for a specific reason — most often to diagnose, stage or plan the operation itself (CT and MRI), or to answer a particular question: an abdominal ultrasound before gallbladder surgery, a carotid Doppler before major vascular or heart surgery (or after a stroke/TIA), a leg-vein Doppler if a clot is suspected, or an echocardiogram (a heart ultrasound) for a murmur or breathlessness. If you need one, it's because it will change your care — not as a tick-box screen.

Often none. NICE does not recommend routine tests for fit, healthy people (ASA 1–2) having minor surgery. Tests are added when the operation is bigger or a health condition makes them useful.

Your team sees your full history, medicines and examination, and may add a test for a reason specific to you — or skip one this tool suggested. The tool gives the typical pattern; clinical judgement always wins.