Stress testing combined with nuclear imaging is a cardiac procedure commonly performed both in the office and hospital settings. It allows the physician to actually visualize patterns of blood flow by looking at images of the heart, rather than just by looking at ECG tracings. The best patients for this test are those with an "intermediate" chance of having heart disease,that is the physician cannot be sure if the patient does or does not have coronary artery disease. If your symptoms are typical of cardiac disease and/or you have very strong risk factors for heart disease, your doctor will probably recommend going straight to coronary angiography using the cardiac catheterization technique. If your symptoms are not typical of heart disease and you have no risk factors, your physician may opt to perform "plain old" exercise testing without nuclear imaging or simply not ordering any noninvasive testing at all. All these options can be discussed with your physician.