Contraindications to Stress Testing

Exercise stress testing is safe and associated with low morbidity and mortality when performed in appropriate clinical situations. This chapter summarizes the absolute and relative contraindications to exercise stress testing. After reviewing the indications and contraindications to exercise testing it is essential to review a patient's ancillary testing to identify conditions that are likely to yield false positive results or would benefit from the concurrent imaging. Acute myocardial infarction, within the first 48 hours, is an absolute contraindication to exercise ECG testing due to the risk of life-threating ventricular arrhythmias and worsening infarction. Pre-existing systemic hypertension will likely be exaggerated during exercise testing and therefore significant resting hypertension is a relative contraindication to exercise testing. Patient who are unable to cooperate with testing instructions are at risk of injury during exercise stress testing and therefore risks and benefits should carefully be considered.