Table 4 Absolute and relative contraindications for cardiopulmonary exercise testing
AbsoluteRelative
Acute myocardial infarction (3–5 days)Left main coronary stenosis or its equivalent
Unstable anginaModerate stenotic valvular heart disease
Uncontrolled arrhythmias causing symptoms or haemodynamic compromiseSevere untreated arterial hypertension at rest or haemodynamic compromise (>200 mm Hg systolic, >120 mm Hg diastolic)
SyncopeTachyarrhythmias or bradyarrhythmias
Active endocarditisHigh-degree atrioventricular block
Acute myocarditis or pericarditisHypertrophic cardiomyopathy
Symptomatic severe aortic stenosisSignificant pulmonary hypertension
Uncontrolled heart failureAdvanced or complicated pregnancy
Acute pulmonary embolus or pulmonary infarctionElectrolyte abnormalities
Thrombosis of lower extremitiesOrthopaedic impairment that compromises exercise performance
Suspected dissecting aneurysm
Uncontrolled asthma
Pulmonary oedema
Room air desaturation at rest ⩽85%*
Respiratory failure
Acute non-cardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (ie, infection, renal failure, thyrotoxicosis)
Mental impairment leading to inability to cooperate
  • Adapted from ATS/ACCP Statement on Cardiopulmonary Exercise Testing.1