Which condition is an absolute contraindication to symptom-limited exercise testing?

Which condition is an absolute contraindication to symptom-limited exercise testing?

• A. Decompensated heart failure
• B. Chronic stable angina
• C. Mild hypertension
• D. Uncomplicated diabetes mellitus

Answer: (A)

When evaluating someone with an exercise test, the test is only done if it’s safe for the heart to be put under increased work. Decompensated heart failure means the heart is not pumping effectively and fluid, congestion, and unstable hemodynamics are present. Pushing the heart harder with exercise can tip you into pulmonary edema, dangerously low blood pressure, or life-threatening rhythm problems. In this situation the risk of harm is too high, so the test is not performed. Chronic stable angina isn’t an absolute ban. With stable symptoms and proper supervision, the test can be done, and it’s stopped if chest pain or other warning signs develop. Mild hypertension or uncomplicated diabetes mellitus aren’t absolute contraindications; they’re conditions that require careful monitoring, but they don’t by themselves rule out a supervised, symptom-limited stress test.

When evaluating someone with an exercise test, the test is only done if it’s safe for the heart to be put under increased work. Decompensated heart failure means the heart is not pumping effectively and fluid, congestion, and unstable hemodynamics are present. Pushing the heart harder with exercise can tip you into pulmonary edema, dangerously low blood pressure, or life-threatening rhythm problems. In this situation the risk of harm is too high, so the test is not performed.

Chronic stable angina isn’t an absolute ban. With stable symptoms and proper supervision, the test can be done, and it’s stopped if chest pain or other warning signs develop. Mild hypertension or uncomplicated diabetes mellitus aren’t absolute contraindications; they’re conditions that require careful monitoring, but they don’t by themselves rule out a supervised, symptom-limited stress test.