Table 7. Predetermined indications for terminating exercise (adapted from ACSM, 2000).

Absolute

Decrease in systolic blood pressure by at least 10 mmHg or unchanged in spite of increased loading together with other evidence of ischemia

Moderate or severe angina

Increasing nervous system symptoms (ataxia, dizziness, near syncope)

Signs of poor perfusion: pallor, cyanosis, nausea, or cold and clammy skin

Systolic blood pressure rise over 260 mmHg, diastolic over 1115 mmHg

Technical difficulties in monitoring the ECG or blood pressure

Subject refuses to continue the exercise

Sustained ventricular tachycardia

ST elevation (> 1.0 mm) in leads without diagnostic Q-waves (other than V1 or aVR)

Relative

Drop in systolic blood pressure of > 10 mmHg from baseline despite an increase in workload

ST or QRS changes such as horizontal or downsloping ST depression > 2mm or marked axis shift

Arrhythmias other than sustained ventricular tachycardia, including multifocal PVCs, triplets of PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias

Fatigue, shortness of breath, wheezing, leg cramps, or claudication

Bundle branch block or intraventricular conduction delay that cannot be distinguished from ventricular tachycardia

Increasing chest pain

Hypertensive response