A stress test may be necessary to diagnose heart disease or to estimate the patient’s risk of a future cardiac event, and in many cases some kind of imaging is necessary to fully evaluate the patient. As an office-based procedure, we perform stress testing both with nuclear imaging, in which a mildly radioactive tracer is injected in order to measure blood flow, and with stress echocardiography, in which the heart is watched with ultrasound during exertion.