Contraindications for Exercise Stress Testing1
• Acute myocardial infarction (within 2 days)
• High-risk unstable angina
• Uncontrolled cardiac arrhythmias causing symptoms or hemodynamic
• Symptomatic severe aortic stenosis
• Uncontrolled symptomatic heart failure
• Acute pulmonary embolus or pulmonary infarction
• Acute myocarditis or pericarditis
• Acute aortic dissection
• Left main coronary stenosis
• Moderate stenotic valvular heart disease
• Electrolyte abnormalities
• Severe arterial hypertension**
• Tachyarrhythmias or bradyarrhythmias
• Hypertrophic cardiomyopathy and other forms of outflow tract obstruction
• Mental or physical impairment leading to inability to exercise adequately
• High-degree atrioventricular block
*Relative contraindications can be superseded if the benefits of exercise outweigh the risks.
**In the absence of definitive evidence, the AHA/ACC suggests systolic blood pressure of > 200 mmHg and/or
diastolic blood pressure of > 110 mmHg. Modified from Fletcher et al.2
Last revised/reviewed: 04/2015 | Contact CCKM for revisions.
UW Health Non-ST-Elevation Acute Coronary Syndromes – Adult – Inpatient/Ambulatory CPG
1. 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). J Am Coll Cardiol. 2002;40(8):1531-1540.
2. Fletcher GF, Balady G, Froelicher VF, Hartley LH, Haskell WL, Pollock ML. Exercise standards. A statement for
healthcare professionals from the American Heart Association. Writing Group. Circulation. 1995;91(2):580-615.
Copyright © 2015 Univ ersity of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM @uwhealth.org Last Revised: 04/2015CCKM@uwhealth.org