ACSM CEP Exam, Top Questions &
Answers, 100% Accurate. Verified.
Absolute Contraindications to Exercise Testing - ✔✔-• A recent significant change in the resting ECG
suggesting significant ischemia, recent MI (within 2 d), or other acute cardiac event
• Unstable angina
• Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
• Symptomatic severe aortic stenosis
• Uncontrolled symptomatic heart failure
• Acute pulmonary embolus or pulmonary infarction
• Acute myocarditis or pericarditis
• Suspected or known dissecting aneurysm
• Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands
Relative Contraindications to Exercise Testing - ✔✔-• Left main coronary stenosis
• Moderate stenotic valvular heart disease
• Electrolyte abnormalities (hypokalemia or hypomagnesemia)
• Severe arterial hypertension (SBP>200 mmHg and/or DBP >110 mmHg) at rest
• Tachydysrhythmia or bradydysrhythmia
• Hypertrophic cardiomyopathy and other forms of outflow tract obstruction
• Neuromotor, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise
• High-degree AV block
• Ventricular aneurysm
• Uncontrolled metabolic disease (diabetes, thyrotoxicosis, or myxedema)
• Chronic infectious disease (e.g. HIV)
• Mental or physical impairment leading to inability to exercise adequately
General Indications for Stopping an Exercise Test - ✔✔-• Onset of angina or angina-like symptoms
, • Drop in SBP of ≥10 mmHg with an increase in work rate or if SBP decreases below the value obtained
in the same position prior to testing
• Excessive rise in BP: SBP>250 mmHg and/or DBP>115 mmHg
• Shortness of breath, wheezing, leg cramps, or claudication
• Signs of poor perfusion: light-headedness, confusion, ataxia (loss of full control of bodily movements),
(pallor) unhealthy pale appearance, cyanosis (bluish skin color), nausea, or cold and clammy skin
• Failure of HR to increase with increased exercise intensity
• Noticeable change in heart rhythm by palpation or auscultation
• Subject requests to stop
• Physical or verbal manifestations of severe fatigue
• Failure of the testing equipment
Absolute Indications for stopping an exercise test - ✔✔-• Drop in SBP ≥10 mmHg with an increase in
work rate, or if SBP decreases below the value obtained in the same position prior to testing when
accompanied by other evidence of ischemia
• Moderately severe angina (defined as 3 on standard scale)
• Increasing nervous system symptoms (e.g. ataxia, dizziness, or near syncope)
• Signs of poor perfusion (cyanosis or pallor)
• Technical difficulties monitoring the ECG or SBP
• Subject's desire to stop
• Sustained ventricular tachycardia
• ST elevation (+1.0 mm) in leads without diagnostic Q waves (other than V1 or aVR)
Relative Indications for stopping an exercise test - ✔✔-• Drop in SBP ≥10 mmHg with an increase in
work rate, or if SBP below the value obtained in the same position prior to testing
• ST or QRS changes such as excessive ST depression (>2 mm horizontal or down sloping ST-segment
depression) or marked axis shift
• Arrhythmias other than sustained V Tach, including multifocal PVCs, triplets of PVCs, SVT, heart block,
or bradyarrhythmias
• Fatigue, shortness of breath, wheezing, leg cramps, or claudication
• Development of bundle-branch block or intraventricular conduction delay that cannot be distinguished
from V Tach
• Increasing chest pain
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