Which of the following is a contraindication for stress testing
Stress testing is done in the diagnosis of ischemic heart disease. Coronary arteries supply blood to the heart in the presence of stenosis of coronary arteries myocardium supplied by a stenosed vessel suffers from ischemia. At times supply by stenosed vessel may be adequate at rest but on exaggeration, the requirement goes up and territory supplied by stenosed vessel manifest ischemia. This ischemia may be tracked by ECG, myocardial perfusion scan and stress echocardiography.
Contraindications for stress testing
|Absolute Contraindication||Relative Contraindications|
|Active endocarditis||Acquired complete heart block (left bundle branch block)|
|Acute aortic dissection||Hypertrophic obstructive cardiomyopathy with severe resting gradient|
|Acute myocarditis/pericarditis||Known left main coronary artery disease|
|Decompensated heart failure||Recent stroke or transient ischemic attack|
|Inability to exercise||Resting systolic blood pressure > 200 mm Hg or diastolic blood pressure > 110 mm Hg|
|Myocardial infarction in the previous two days||Tachyarrhythmia with an uncontrolled ventricular rate|
|Ongoing unstable angina|
|Symptomatic severe aortic stenosis|
Aortic stenosis being planned for valve replacement means it is a case of severe aortic stenosis. Severe symptomatic aortic stenosis is a contraindication of stress testing.
Tachycardia is not an absolute contraindication for stress testing
Effort angina is not a contraindication but rest angina is a contraindication for stress testing
Known case or old case of myocardial infarction is not a contraindication for stress testing, however, recent Myocardial infarction is a contraindication for stress testing