TABLE 455 Indications for Terminating Exercise Testing

Exercise stress testing may be contraindicated for various reasons (I§ble,45-6).25 If the patient has physical limitations preventing exercise but no other contraindications, a pharmacologic stress test using a chronotropic drug (i.e., dobutamine) may be appropriate. Exercise testing may not be safe for patients at high risk for acute ischemia or those with other uncontrolled cardiovascular or pulmonary pathology. Further, patients with an abnormal baseline ECG—such as those with left ventricular hypertrophy, bundle branch block, or digoxin effect—are less likely to benefit from standard exercise testing owing to difficulties in interpretation of exercise-induced ECG changes.

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