If my husband had a stress test in september 2019 and then started getting chest pains in march 2021, would that stress test still be valid? he got echo, multiple ekgs, chest x-ray and blood work done but were debating on another stress test?

Two year period is more than enough for disease progression. If he has typical angina and he is at high risk, he should have coronary angiogram done if no contraindication. If he doesn't want angio, he should choose a different stress test. There are 3 common tests: treadmill, echocardiogram and nuclear stress test. I do not know what test he had in 2019. If test (+), angiogram needs to be done.

You have not stated how old your husband is, if he is also in his 30's, chest pain due to heart disease would be uncommon. However, it is never wise to ignore it.It is useful to remember that in high- risk individuals symptoms of coronary disease may appear despite a negative test. Since it is important to clearly confirm or rule out coronary disease. Coronary angiography would provide the answer