Stress Test Necessary After Diagnosis?

Dr. Krumholz answers the question: 'Stress Test Necessary After Diagnosis?'

— -- Question: If I already know I have heart disease, why get a stress test?

Answer: The reason to get a stress test is for one of usually two reasons. The first reason is to diagnose someone with coronary artery disease. That is, someone comes in with some symptoms, they're not sure what they are, they could be a range of different things, and we use the test for diagnosis. To help us determine whether or not it actually is the heart, or should we be looking somewhere else?

Now, the question is, if I know I have coronary disease, do I need a stress test? Well, it's for the second reason that the stress test might be recommended and done. This is, in our world, we would call it risk stratification. It's about understanding how high is your risk. Are there things that we ought to recommend to you that can reduce your risk, that we wouldn't otherwise if your risk were lower, and what kind of decision-making should we make about things that we can do to help you live better or longer?

Now, this part of it is about looking at how long can you exercise, monitoring the electrocardiogram that you're hooked up to, to see if there's any evidence that -- with a little bit of exertion -- that your heart is starting to have problems. We'll check your blood pressure. We'll see how fast your heart rate goes and how well it recovers once you stop.

In some cases they may use some advanced techniques to actually look at the heart during the stress test, but all of these things -- once we know that you have heart disease -- may be helping us to understand your risk, and then helping us together, patient and doctor, work to make decisions about what kind of strategies are going to be best for you as an individual, and you don't always need this best, but when it's recommended for you in this case, that's likely the reason.

Next: What If I Cannot Exercise? How Can A Stress Test Be Done Without Exercising?

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