There are several categories of people who can benefit from a stress test:
- People with chest pain: Because chest pain can be caused by many things, a stress test can help a doctor decide whether the pain is due to heart disease or something else. For example, if someone is able to exercise for up to 12 minutes on a treadmill without getting any chest pain and with no irregularities appearing on the ECG, then the chances are very low that there is any heart disease.
- People with heart disease or angina (chest pain due to reduced blood flow in the heart): In people with these conditions, a stress test can help determine whether an additional test, such as an angiogram, is needed to evaluate the heart more thoroughly. If a person with heart disease or angina is able to exercise for up to 10 to 12 minutes, then an angiogram may not be needed.
- People who have had a heart attack: Sometimes a very easy stress test is done even within the first week following a heart attack. Many people will show a good result, indicating that they are ready to begin treatment with medication. However, if someone has pain or shows irregularities on the ECG during the stress test, then further assessment of the heart is needed using an angiogram.
- People with disease of the heart valves: A stress test can confirm a person's capacity to do exercise. However, if this capacity is very low, further assessment using an angiogram may be needed, and valve surgery may be considered.
- People who are suspected of having an irregular heartbeat (an arrhythmia): In some people, a stress test can help diagnose the presence of an arrhythmia.
- People with heart disease who have had surgery, or who are taking other treatment such as drugs, vitamins or minerals, or who are participating in a cardiac rehabilitation or exercise program: A stress test can be used to measure the effectiveness of the surgery or other treatment by monitoring exercise capacity. A stress test may also measure improvement from a cardiac rehabilitation exercise program.
- People who are at high risk of getting heart disease: This includes people with diabetes, high blood pressure, or high cholesterol levels, or those with family members who have had heart disease before the age of 50. Even if a person in one of these high-risk categories has no symptoms, a stress test is still recommended before the age of 50 to detect any early signs of heart disease so that it can be treated.
- People whose occupations involve a lot of physical exertion, e.g., firefighters: Even if these people do not have a family history of heart disease, a stress test is advisable over the age of 40.
- Sedentary adults who want to begin an exercise program: It is recommended that men over 35 years of age and women over 40 who want to start exercising should take an exercise test to assess their current exercise capacity and to rule out the presence of early heart disease.