The purpose of this research study is to determine if carotid artery ultrasound scanning can provide additional information for determining cardiovascular risk in patients.

Patients who agree to participate wil undergo non-invasive carotid intima-media thickness (CIMT) measurement and plaque assessment. Findings of CIMT will be compared to results of patient standard of care stress echocardiogram (SE) and of diastolic function.

We hypothesize tht 1) in patients undergoing SE for inappropriate or uncertain indications, CIMT and plaque assessment will provide useful risk stratification beyond use of traditional risk factors; 2) CIMT findings will correlate with results of SE in terms of exercise capacity and 3) Exercise capacity will correlate with diastolic function.

Inclusion Criteria:

• Asymptomatic
• No prior cardiac history (MI, PTCA, CABG, angina)
• No peripheral vascular disease
• No history of stroke or TIA
• Statins, antihypertensives, ASA treatment OK

Exclusion Criteria:

• History of CAD, CABG, PTCA, coronary or peripheral stenting
• History of stroke/TIA/peripheral vascular disease
• Inability to exercise on the treadmill
• Unwilling/unable to sign informed consent
• History of neck radiation or neck surgery or inability to obtain neck images
• End stage renal disease
• Preoperative evaluation
• History of chest pain

Eligible patients will be undergoing standard of care stress echocardiography