Clinical Exercise Physiology - Contraindications and Indications

Acute myocardial infarction within 2 d

Absolute Contraindications

Ongoing unstable angina

Absolute Contraindications

Uncontrolled cardiac arrhythmia with hemodynamic compromise

Absolute Contraindications

Active endocarditis

Absolute Contraindications

Symptomatic severe aortic stenosis

Absolute Contraindications

Decompensated heart failure

Absolute Contraindications

Acute pulmonary embolism, pulmonary infarction, or deep venous thrombosis

Absolute Contraindication

Acute myocarditis or pericarditis

Absolute Contraindication

Acute aortic dissection

Absolute Contraindication

Physical disability that precludes safe and adequate testing

Absolute Contraindication

Known obstructive left main coronary artery stenosis

Relative Contraindication

Moderate to severe aortic stenosis with uncertain relationship to symptoms

Relative Contraindication

Tachyarrhythmias with uncontrolled ventricular rates

Relative Contraindication

Acquired advanced or complete heart block

Relative Contraindication

Recent stroke or transient ischemia attack

Relative Contraindication

Mental impairment with limited ability to cooperate

Relative Contraindication

Resting hypertension with systolic greater than 200 mm Hg or diastolic greater than 110 mm Hg

Relative Contraindication

Uncorrected medical conditions, such as significant anemia, important electrolyte imbalance, and hyperthyroidism

Relative Contraindication

ST elevation (>1.0 mm) in leads without preexisting Q waves because of prior MI (other than aVR, aVL, or V1)

Absolute Indication

Drop in systolic blood pressure of greater than 10 mm Hg, despite an increase in workload, when accompanied by other evidence of ischemia

Absolute Indication

Moderate-to-severe angina

Absolute Indication

Central nervous system symptoms (e.g., ataxia, dizziness, or near syncope)

Absolute Indication

Signs of poor perfusion (cyanosis or pallor)

Absolute Indication

Sustained ventricular tachycardia or other arrhythmia, including second- or third-degree atrioventricular block, that interferes with normal maintenance of cardiac output during exercise

Absolute Indication

Technical difficulties monitoring the ECG or systolic blood pressure

Absolute Indication

The individual request to stop

Absolute Indication

Marked ST displacement (horizontal or downsloping of >2 mm, measured 60-80 ms after the J point in an individual with suspected ischemia)

Relative Contraindication

Drop in systolic blood pressure greater than 10 mm Hg (persistently below baseline) despite an increase in workload, in the absence of other evidence of ischemia

Relative Indication

Increasing chest pain

Relative Indication

Fatigue, shortness of breath, wheezing, leg cramps, or claudication

Relative Indication

Arrhythmias other than sustained ventricular tachycardia, including multifocal ectopy, ventricular triplets, supraventricular tachycardia, and bradyarrhythmias that have the potential to become more complex or to interfere with hemodynamic stability

Relative Indication

Exaggerated hypertensive response (systolic blood pressure >250 mm Hg or diastolic blood pressure >115 mm Hg)

Relative Indication

Development of bundle branch block that cannot be distinguished from ventricular tachycardia

Relative Indication

SpO2 </ 80%

Relative Indication