Reasons to stop the test

There are several reasons why an exercise ECG may be stopped prematurely:

• achievement of the diagnostic end point eg ST depression, arrhythmia etc

Safety factors:

• if there is excessive ST segment change eg depression or elevation of more than 4mm;
• if patient is in danger of falling or exhausted;
• the presence of arrhythmias (atrial fibrillation, sustained ventricular tachycardia, bradycardia or atrioventricular block);
• a drop in systolic blood pressure of more than 20mmHg;

Limitation of symptoms:

• the patient complains of chest pain as a result of the test. Note that if the test is being used as a diagnostic test for the cause of a patient's chest pain then one must continue to look for ECG changes - in this circumstance be very careful. One must balance the need to establish a diagnosis with the risk of myocardial infarction.