If 1st cardiac stress test is negative, when the next one should be done ?
Most stress studies in this era involve a provocation – treadmill or pharmacologic, blood pressure monitoring, on-going 12 lead ECG monitoring and some form of imaging – echocardiogram, nuclear, MRI to monitor changes precipitated by the stress. These stress modalities have been shown to be 90-94% sensitive depending on which study you read. Each have their limitations, fortunately they do not overlap with each other. On-going serial cardiac stress tests are not the standard of care for anyone. Stress studies are most useful for risk stratifying people who are at moderate risk for coronary events or ischemia. They have never been shown to be helpful for a general screening study for anyone concerned about possible cardiac disease – but without risk factors. Stress tests are not helpful for people who are at low risk (one or fewer risk factors) for an event (no prior known CAD, no smoking, no diabetes, no high blood pressure, no high cholesterol, no strong family hx for heart disease) a
