Stress Awareness Month: When Heart Symptoms Deserve a Closer Look

Clinicians explain what stress tests show and which patients may need one

By BC News Staff Writer

Stress is a normal part of daily life, but heart symptoms should never be brushed off as “just stress.” During Stress Awareness Month, clinicians are reminding residents that while most people do not need a cardiac stress test, certain symptoms and risk factors can prompt a referral.

A stress test measures how the heart performs when it has to work harder — typically through monitored exercise or medication that simulates exertion. Providers use the test to evaluate blood flow, heart rhythm, and how well the heart responds under physical demand.

Who may be referred for a stress test
Cardiologists often order a stress test when a patient reports symptoms that could signal heart disease. These include chest discomfort, shortness of breath, dizziness, unusual fatigue, or irregular heartbeat.
Patients with existing heart conditions may also undergo testing to monitor treatment progress or determine safe activity levels.
A referral is also common for individuals with multiple risk factors, such as diabetes, high blood pressure, high cholesterol, smoking history, or a strong family history of early heart disease. In some cases, a stress test is recommended before major surgery to ensure the heart can tolerate the procedure.

Understanding stress‑test results
Stress tests generally fall into three categories, each guiding a different next step in care.
Normal result
A normal test indicates that the heart is receiving adequate blood flow during exertion and that the short‑term risk of a heart attack is very low. When results look healthy, symptoms often point to a non‑cardiac cause. Patients are encouraged to continue healthy habits and follow up if symptoms persist.
Abnormal result
An abnormal test suggests the heart may not be getting enough blood during activity. Next steps vary based on the patient’s needs and the complexity of the findings. A cardiologist may adjust medications, address risk factors such as cholesterol or blood pressure, or recommend additional testing. In some cases, further evaluation with cardiac catheterization and imaging may be advised to check for blockages in the coronary arteries. These decisions are reviewed carefully with the patient and family.
Equivocal result
Occasionally, results fall into a gray area — not clearly normal or abnormal. When this happens, the physician reassesses symptoms and overall risk. If concern for underlying coronary disease remains high, the cardiologist may proceed with angiography to get a direct look at the heart’s blood vessels.
When to seek care
Clinicians emphasize that not everyone needs a stress test. But anyone experiencing chest discomfort, unexplained fatigue, dizziness, or shortness of breath should talk with a provider rather than assume stress is the cause.

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Disclaimer
This report is for general information only and is not a substitute for professional medical advice, diagnosis or treatment. Individuals experiencing chest pain, shortness of breath, dizziness, or other concerning symptoms should seek evaluation from a licensed health care provider.