What stress tests can and can’t predict

Answering two most frequently asked questions about stress tests

If you have chest pain or other symptoms of heart disease, you may be asked to complete a stress test stresstest.fwso your doctor can help determine the right treatment plan. Patients are often curious about how to interpret the results of a stress test or what the results may indicate. Let’s break down the two stress test related questions I most often receive:

“I had a normal stress test. This means I will never have a heart attack, right?”

False. Stress tests do not predict heart attacks, and passing a stress test does not indicate that you are not at risk of a heart attack in the future. The intent of a stress test is to help your physician find out if your symptoms are related to a lack of blood flow to your heart. There are other reasons to utilize stress tests, but the majority of stress tests are ordered because a patient has symptoms such as shortness of breath, chest pain/pressure and fatigue — all of which may be related to a heart blood flow problem.

If a patient comes in and is not having any symptoms and is currently physically active, it is unlikely that we will gain additional information from a stress test. However, there are always exceptions to the rule, and your physician may be looking at more advanced issues such as risk for an upcoming surgery or helping to define an abnormality seen on a separate test. Bottom line: Stress tests help physicians learn more about the patient’s symptoms and what they may indicate.

“Since my stress test was normal, my heart arteries are normal as well, correct?”

A stress test does not look at the coronary arteries; it looks at the heart blood flow. If the heart blood flow is normal, then there are no “critical” coronary artery blockages present that would induce cardiac symptoms, but a patient could have non-critical coronary artery blockages present and still have a normal stress test.

This is why it is so important for patients to define their overall cardiac risk profile (family history of cardiac disease, high blood pressure, high cholesterol or diabetes) and practice a heart-healthy lifestyle at any age (don’t smoke, lose excess weight, engage in regular exercise, avoid foods high in saturated fat, trans fats or cholesterol, limit sodium intake and manage stress).

Take the next step:

  • To make an appointment to discuss your need for diagnostic testing, call 888-287-1082 or email at CVCCallCtr@med.umich.edu. 


tobin_kenneth 150x150Dr. Kenneth Tobin is a clinical assistant professor for the Department of Internal Medicine and director in the Chest Pain Center at the University of Michigan. His specialty is cardiology, with clinical interests in the association of patent foramen ovale and stroke, patent foramen ovale and migraine, preventive cardiology and echocardiography.



Frankel-informal-vertical-sigThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at umcvc.org.