Stress tests have been used for decades in the assessment of coronary artery obstruction or blockage. These tests are useful to sort out symptoms, especially when attempting to determine whether chest pain or shortness of breath is related to coronary artery atherosclerosis.
Stress tests, however, are not good at detecting early atherosclerosis that isn’t blocking blood flow. Plaque that is new and unstable may not block flow but could rupture and cause a clot to suddenly and completely block flow and result in a heart attack.
It is not rare for a person to pass a stress test and have a heart attack a short time later.
Despite these facts, stress tests continue to be used to reassure patients that they are “OK.” A negative stress test means you aren’t going to be helped by a stent or surgery to address blockage. It does not truly reassure that no atherosclerotic plaque is present. A false sense of reassurance can be bad.
Carotid Intima Media Thickness (CIMT) identifies the earliest stages of atherosclerosis. This is important because when you know you have a disease and are given the tools to prevent its progression, you can avoid the complications of late stage disease, including death and disability without warning. You can also avoid the costs and complications of expensive and invasive treatments.
To sort out symptoms that could be related to your coronary arteries, a stress test is helpful. But to determine if you should take measures to improve your arterial health to avoid heart attack or stroke and their complications and treatments, Carotid IMT is far more useful.
CIMT is also less expensive, less time consuming and does not require effort to be evaluated.