Who Needs a Stress Test?
Although there are many reasons for your doctor to order a stress test, the most common reason is to evaluate the cause of chest pain. Because chest pain can come from areas other than the heart, such as the esophagus or the chest wall, a stress test can be helpful in determining the likelihood of whether or not you have heart disease. Sometimes a physician may ask you to have a stress test in the absence of chest pain if he or she suspects you are at increased risk of having coronary artery disease (also referred to as atherosclerosis or hardening of the arteries). You may be at increased risk if you smoke; have diabetes; high blood pressure or elevated levels of cholesterol; or if one of your parents or siblings had a heart attack at a young age. I have occasionally ordered stress tests for my patients who are asymptomatic, but who have important jobs that could put others at risk if they were to have a heart attack, such as airline pilots, police officers, and firefighters.
If you have coronary artery disease, chances are that you either have had, or will have, a stress test. Stress tests are commonly performed in patients who have already suffered heart attacks. The test allows doctors to assess the patient's risk of having another heart attack in the near future. They are also helpful in determining the effectiveness of medical therapy in preventing chest pain and limiting ischemia (a reduction in blood flow and oxygen to the heart muscle). Stress tests can also aid in the diagnosis and management of arrhythmias, which are abnormal and potentially harmful heart rhythms.
If you happen to be one of those individuals who is planning to begin an exercise routine, but haven't worked out for many years, your physician may advise you to have a stress test before you begin. That way, your doctor can gauge how much exercise you can safely do and provide you with a training program to help you get back in shape.
