The Power Course

Which of the following is a contraindication for stress testing


1 ) Aortic stenosis being planned for valve replacement
2 ) Effort angina
3 ) Tachycardia
4 ) Known case of myocardial infarction


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




Aortic stenosis being planned for valve replacement

Last Modified : 25-Dec-2019

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