Cardiac Stress Testing and Coronary Catheterization
The evaluating clinician must consider before recommending preoperative stress testing or cardiac catheterization, whether it would:
 
1.  change immediate management,

  OR

2.  change long-term management.

The change in management, boils down to this; "Does the patient in their day-to-day life have cardiac symptoms that would prompt you to recommend cardiac cath, PCI or even CABG if the stress test was positive?" If the answers to these questions is NO, then proceed with surgery OR if the perioperative risk is so high then a clear discussion with the patient of a risk-benefit analysis of the surgery should be performed.

“Rule of thumb – Noninvasive cardiac testing should be performed only if you would have performed the test without the surgery”