Guidelines for EKG stress tests are being updated, mostly to integrate more and better data with new work structures. Diagnosis of coronary artery disease is still the principal indication for stress testing. Interpretation needs to be multivariate, providing the probability of the existence of lesions in light of the various risk factors, and age, sex, and symptoms. There are new indications for the test, and new contraindications too. These are defined according to population subgroups, like athletes, women, children, the elderly, asymptomatic patients, diabetics, hypertensive patients, PAD patients, or patients in the context of a non-cardiac surgery pre-op visit. The advice is to use complementary testing for all the various cardiac pathologies – congenital, ischemic, valvular, cardiomyopathies, congestive heart failure, rhythm and conduction disorders, pacemaker fine-tuning, or pulmonary hypertension. The usefulness of an EKG stress test, in other words, now extends to all cardiovascular disease.