A:
If you do not have any known heart disease, and do not have symptoms of heart disease, you probably do not need a stress test at all.
I do not send my patients (at any age) for stress tests unless they have heart disease, chest pain, chest pressure when they exert themselves or other symptoms that might suggest their heart is not getting enough blood.
Some doctors send patients for stress tests if the patients are about to start a vigorous exercise program. This is especially true if the patient has known risk factors for heart disease.
But for people who feel well, the evidence of any value in having a stress test is soft at best. These tests also have false positive rates of about 15%. This means we might create alarm in someone who is perfectly fine.
Thomas H. Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance. 
