Studies continue to show that stress testing can reveal coronary artery disease (CAD) before the onset of any symptoms, or in the absence of overt symptoms (e.g., silent cardiac ischemia). According to the American Heart Association, stress testing is not recommended for general screening of people who do not have symptoms of heart disease unless those people are considered at high risk. However, several recent research studies have indicated that stress testing can identify potential heart problems in apparently healthy people with no symptoms.

Ultrafast computed tomography (also called electron beam computed tomography or EBCT) may be an alternative to exercise stress testing in identifying clogged arteries. A feature of EBCT is that it can detect even low percentages of calcified plaque that has formed in coronary arteries. This can be useful in younger individuals who have early, but asymptomatic heart disease. However, EBCT has little application in the elderly, who typically have greater degrees of calcification. Moreover, because EBCT involves exposure to radiation, it is not recommended as a general screening tool by the American Heart Association.

Nuclear stress testing is also becoming more available. Currently, the most common form of nuclear stress test is the SPECT test, which relies on a thallium tracer that is relatively easy to produce and store. However, this test results in a higher rate of false positives than the more sensitive PET test. Until recently, though, PET testing was more limited because of the difficulty associated with obtaining the radionuclide tracers. In recent years, the availability of tracers and the cost has come down, so PET testing has become more common.

Nuclear stress testing is also becoming more available. Currently, the most common form of nuclear stress test is the SPECT test, which relies on a thallium tracer that is relatively easy to produce and store. However, this test results in a higher rate of false positives than the more sensitive PET test. Until recently, though, PET testing was more limited because of the difficulty associated with obtaining the radionuclide tracers. In recent years, the availability of tracers and the cost has come down, so PET testing has become more common.