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Indications for discontinuation of exercise testing

Indications for discontinuation of exercise testing
Absolute
Moderately severe angina (defined as 3 on a standard scale)
Drop in systolic blood pressure of >10 mmHg from baseline blood pressure*, despite an increase in workload, when accompanied by other evidence of ischemia
Sustained ventricular tachycardia
Signs of poor perfusion (eg, pallor or cyanosis)
ST elevation (+1.0 mm) in leads without diagnostic Q waves (other than V1 or aVR)
Increasing nervous system symptoms (eg, ataxia, dizziness, near syncope, or confusion)
Technical difficulties monitoring the ECG or systolic blood pressure
Subject's desire to stop
Relative
ST or QRS changes such as extensive ST depression (>2 mm of horizontal or downsloping ST-segment depression) or marked axis shift
Drop in systolic blood pressure of >10 mmHg from baseline blood pressure*, despite an increase in workload, in the absence of other evidence of ischemia
Arrhythmias other than sustained ventricular tachycardia, including multifocal PVCs, triplets of PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias
Development of bundle branch block or intraventricular conduction delay that cannot be distinguished from ventricular tachycardia
Chest pain that is increasing
Fatigue, shortness of breath, wheezing, leg cramps, or claudication
Hypertensive response (systolic BP >250 mmHg and/or diastolic BP >115 mmHg)
* Baseline refers to a measurement obtained immediately before the test and in the same posture as the test is being performed.
Modified from: Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002; 106:1883.
Graphic 79525 Version 10.0

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