Whoa, whoa, whoa!

We don't do things like stress tests in asymptomatic people because we don't know what to do about positive results. Everything we know about how to interpret and act on the results of these tests assumes that those results come from people in whom there is a good reason to suspect cardiac ischemia. The same findings coming from a healthy person are much more likely to be false positives and the problem is no one knows how much more likely because the tests were developed and validated in patients. Medical data are full of borderline values, ambiguous squiggles, and funky images that come and go depending on the mindset of the examiner. These things are bad enough when the clinical situation is unambiguous. They are downright dangerous when it isn't.

As an example of what happens when you start messing around with stress tests, I had a crazy training partner when we were both in our 40s, an elite triathlete, who was a raving hypochondriac. He just freakin' had to tell someone he had chest pain one day, so he gets a stress thallium, they see "something," and he ends up on his back in the cath lab, at risk for a huge list of complications. Of course, he has a completely clean cath and has been fine ever since.