I did delay such tests for long, what decided me is very weak pulse in the morning, even after a normal night of sleep, and completely at rest horizontally. I had trouble keep my arms above my chest (felt like they were weighting a ton, same sensation if you try to hold your arms up for a few minutes). Also the fact that I couldn't use my indoor bike for 10 minutes without feeling numbness in many places and tingling that also reminded me of bad blood flow. I had to submit to cardiologists conclusion saying "nothing I can see here". My main problem with this is that, maybe a big panic/anxiety can trigger weak heart, bad blood flow, fat accumulation and small stroke. Which then weaken your heart for longer period, hence the whole fatigue, weak pulse, effort intolerance. Etc. Standard cardiac/blood pressure tests don't look there, and the only way would be high end cardiac or very invasive artery monitoring (angiography, coronarography) ...