Why not a Stress Test in an Asymptomatic Person? “The World Is Drowning…….”

While growing up, I remember someone telling me a poignant story: “Once a teenager was drowning in a river, he started to yell, “Help me; help me, the world is drowning...........” Well, I will come back to this story at the end of this article... The really so very pertinent question in Medicine is: Should we do any test when someone is asymptomatic? In Cardiology, the very simple question to be asked is: “Do we need to do a stress test when a person is asymptomatic?” Whether that person is truly asymptomatic or not is altogether a different kind of question, however most of the guidelines (US, European and others) state not to do a stress test when a person is asymptomatic (Class III Indication)