Severe coronary artery disease in the asymptomatic patient

Asymptomatic patients more than 40 years of age who have major risk factors for coronary atherosclerosis (i.e., strong familial history for coronary atherosclerosis, hypertension, hypercholesterolemia, or diabetes mellitus or history of heavy cigarette use) should be given an exercise tolerance test. Establishing the presence or absence of coronary artery disease will help in management whether this be medical, surgical, or preventative.