Acquired advanced or complete heart block is classified as what in relation to symptom-limited exercise testing?

Acquired advanced or complete heart block is classified as what in relation to symptom-limited exercise testing?

• A. Absolute contraindication
• B. Relative contraindication
• C. No contraindication
• D. Optional contraindication

Answer: (B)

During symptom-limited exercise testing, safety depends on the heart’s ability to increase rate and maintain adequate output as workload rises. Acquired advanced or complete heart block disrupts AV conduction, so the ventricles may pace at a slow, fixed rate that cannot adapt to exercise demand. This can lead to reduced cardiac output and symptoms like dizziness or fainting during the test. The risk exists but can be managed with precautions—such as a functioning pacemaker, continuous ECG monitoring, and readiness to pace if needed—so it is considered a relative contraindication. It’s not an absolute contraindication, since safe testing is possible in some patients, and it isn’t categorized as no contraindication or an optional contraindication.

During symptom-limited exercise testing, safety depends on the heart’s ability to increase rate and maintain adequate output as workload rises. Acquired advanced or complete heart block disrupts AV conduction, so the ventricles may pace at a slow, fixed rate that cannot adapt to exercise demand. This can lead to reduced cardiac output and symptoms like dizziness or fainting during the test. The risk exists but can be managed with precautions—such as a functioning pacemaker, continuous ECG monitoring, and readiness to pace if needed—so it is considered a relative contraindication. It’s not an absolute contraindication, since safe testing is possible in some patients, and it isn’t categorized as no contraindication or an optional contraindication.