In this episode, Editor-in-Chief Marcelo F. Di Carli, MD, MASNC, is joined by Steven C. Scherping, III, MD, and ASNC President-elect Jamieson M. Bourque, MD, MHS, FASNC, from the University of Virginia to discuss their manuscript 'The prevalence and prognostic impact of additive abnormal stress exercise markers in patients with normal stress myocardial perfusion imaging.' Also joining the conversation is Diana M. López, MD from the Brigham & Women’s Hospital who wrote an accompanying editorial. Think a normal exercise SPECT MPI means you're in the clear? Think again. In this episode, we dive into new evidence showing that exercise-related clues can reveal risk that perfusion imaging alone might miss. This conversation unpacks what these markers mean—and why they matter. You’ll never look at a “negative” test the same way again.