CONTRAINDICATIONS TO INITIATE STRESS TESTING:
Absolute
1. Acute myocardial infarction (within 7 days) - if troponins are elevated prior to stress test in the last 7
days, please clear with physician before proceeding with stress testing
2. Active chest pain – avoid stress testing in patients with active chest pain, unless cleared by physician
3. Uncontrolled cardiac arrhythmias causing symptoms or hemodynamic compromise – vitals will need
to be checked prior to and periodically during stress testing
4. Symptomatic severe aortic stenosis – if ETT ordered for symptom assessment for aortic stenosis by
cardiology, recommend physician supervision
5. Uncontrolled symptomatic heart failure
6. Acute pulmonary embolus or pulmonary infarction within the last month
7. Acute myocarditis or pericarditis
8. Acute aortic dissection
9. Baseline Left bundle Branch block, paced rhythm, afib with rvr – contraindication for ETT only
10. Baseline High grade AV block – contraindication for Lexiscan only, unless hemodynamic compromise
exists for ETT
11. Uncontrolled hypertension – no stress on patients presenting with BP of > 200 systolic and 100
Diastolic
Relative
1. Left main coronary artery disease – if patient has had a recent coronary CTA or cardiac
catheterization, please confirm need for stress testing prior to proceeding
2. Moderate stenotic valvular heart disease
3. Electrolyte abnormalities
4. Severe arterial hypertension
5. Tachyarrhythmias or bradyarrhythmias
6. Hypertrophic cardiomyopathy and or other forms of outflow tract obstruction
7. Mental or physical impairment leading to inability to exercise adequately
8. High-degree atrioventricular block (for lexiscan imaging, this is a absolute contraindication)
