Who should have a stress test?

Any person who is suspected of having coronary disease should have a diagnostic workup including a stress test. In some instances, if the degree of suspicion for coronary disease is extremely high, your doctor may decide to forego stress testing and proceed directly to a coronary angiogram. Stress testing is also frequently done to detect occult coronary disease in someone about to undergo major surgery, before one is allowed to embark on an exercise program, or in people whose occupation potentially affects public safety, such as a commercial airline pilot. Lastly, stress testing is performed in people who have had prior angioplasty or coronary bypass surgery, as part of their follow-up care. Typical profiles of people referred for a stress test include the following: 1) A 50 year old male who complains of chest pain when he climbs up the stairs. 2) A 65 year old male who is without any symptoms but who is overweight, smokes, has a positive family history or coronary disease, and who leads a sedentary lifestyle (i.e., a "couch potato"). 3) A 73 year old female with history of hypertension and high cholesterol who is about to undergo repair of an abdominal aortic aneurysm (a major surgery that places great stress on the heart).