During a symptom-limited exercise test, if a patient experiences moderate-to-severe angina early in the protocol, what is the recommended action?

During a symptom-limited exercise test, if a patient experiences moderate-to-severe angina early in the protocol, what is the recommended action?

• A. Continue at a slower workload.
• B. Resume after brief rest to assess tolerance.
• C. Terminate the test.
• D. Ignore symptoms and complete the protocol.

Answer: (C)

When a symptom-limited exercise test shows moderate-to-severe angina early, the priority is safety. Angina during exercise signals myocardial ischemia, and continuing to push the workload increases the risk of more extensive ischemia or a cardiac event. Stopping the test at that point prevents further harm and allows immediate clinical management. After termination, the patient’s hemodynamics and symptoms should be reassessed, they should rest, and clinicians follow the protocol for post-test care (monitoring, vitals, and consider nitroglycerin or further evaluation as indicated). Continuing at a slower workload or resuming after a brief rest would risk provoking more ischemia, and ignoring symptoms is unsafe.

When a symptom-limited exercise test shows moderate-to-severe angina early, the priority is safety. Angina during exercise signals myocardial ischemia, and continuing to push the workload increases the risk of more extensive ischemia or a cardiac event. Stopping the test at that point prevents further harm and allows immediate clinical management.

After termination, the patient’s hemodynamics and symptoms should be reassessed, they should rest, and clinicians follow the protocol for post-test care (monitoring, vitals, and consider nitroglycerin or further evaluation as indicated). Continuing at a slower workload or resuming after a brief rest would risk provoking more ischemia, and ignoring symptoms is unsafe.