Dobutamine stress echocardiography (DSE) continues to be widely and successfully applied to determine whether patients with and without known cardiac disease have ischemia. Dobutamine stress echocardiography (DSE) has bitfalls in intermediate patients for CAD which are poor echo windows with low specificity and sensitivity. Also, Exercise ECG has bitfalls including limitations of use and artifacts. So, we hypothesize that adding ECG recorded during dobutamine stress echo will improve specificity and sensitivity for diagnosis of stress induced ischemia in intermediate probability for CAD and will overcome bitfalls of exercise ECG (limitations and artifacts) and bitfalls of dobutamine stress echo (poor echo window).