Indications for terminating the treadmill stress test


Absolute Indications

  • Drop in systolic BP by > 10mm/Hg during exercise, despite an increase in workload accompanied by evidence of ischemia

  • Increase of diastolic BP to 110 mm/Hg more **may fall under relative indications, consult with physician if noted.

  • Increasing anginal discomfort

  • CNS symptoms such as dizziness, presyncope, or ataxia (lack of voluntary coordination)

  • Signs of poor perfusion such as cyanosis or pallor

  • ST segment elevation greater than 1 millimeter in leads without preexisting Q waves because of prior MI (myocardiac infarction) (other than aVR, aVL, or V1)

  • Moderate to severe angina grade 3 to 4

  • Sustained ventricular tachycardia or other arrhythmia, including second or third degree atroventricular block, that interferes with normal maintenance of cardiac output during exercise

  • Technical difficulties monitoring the ECG or systolic BP

  • Te subject's request to stop

Relative Indications

  • Marked ST displacement (horizontal or downsloping of > 2mm, measured 60 to 80 ms after the J point in a patient with suspected ischemia)

  • Drop in systolic BP >10 mm Hg (persistently below baseline) despite an increase in workload, in the absence of other evidence of ischemia

  • Increasing chest pain

  • fatigue, shortness of breath, wheezing, leg cramps, or claudication

  • Arrhythmias other than sustained ventricular tachycardia, including multifocal ectopy, ventricular triplets, supraventricular tachycardia, and bradyarrhythmias that have the potential to become more complex or to interfere with hemodynamic stability

  • Exaggerated hypertensive response (systolic BP > 250 mm Hg or diastolic blood pressure > 115 mm Hg)

  • Development of bundle-branch block that cannot be distinguished from ventricular tachycardia

  • SpO2 (Percent saturation of arterial oxygen) <= 80%