Version July 2025
| Absolute indications | |
| • Drop in systolic blood pressure >10 mmHg from baseline, despite an increase in workload when accompanied by any other evidence of ischemia | |
| • Moderate-to-severe angina, defined as level 2 angina, approaching level 3; the angina scale is described below | |
| • Increasing nervous system symptoms (eg, ataxia, dizziness, or near syncope) | |
| • Signs of poor perfusion (cyanosis or pallor) | |
| • Technical difficulties monitoring the ECG or systolic blood pressure | |
| • Patient's request to stop | |
| • Sustained ventricular tachycardia | |
| • ST segment elevation (>1.0 mm) in leads without diagnostic Q waves (other than V1 or aVR) | |
| Relative Indications | |
| • Drop in systolic blood pressure ≥10 mmHg from baseline, despite an increase in workload in the absence of other evidence of ischemia | |
| • ST or QRS changes such as excessive ST depression (>2 mm of horizontal or downsloping of ST segment depression) or marked axis shift | |
| • Arrhythmias other than sustained ventricular tachycardia, including multifocal ventricular premature beats, ventricular triplets, supraventricular tachycardia, heart block, or bradyarrhythmias | |
| • Fatigue, shortness of breath, wheezing, leg cramps, or claudication | |
| • Development of bundle branch block or intraventricular conduction delay that cannot be distinguished from ventricular tachycardia | |
| • Increasing chest pain | |
| • Hypertensive response (systolic blood pressure >250 mmHg and/or diastolic blood pressure >115 mmHg) | |
| Four-level angina scale for exercise tolerance testing | Level |
| Onset of angina, mild but recognized as the usual angina-of-effort pain or discomfort with which the patient is familiar | 1 |
| Same pain, moderately severe and definitely uncomfortable but still tolerable | 2 |
| Severe anginal pain at a level that the subject will wish to stop exercising | 3 |
| Unbearable chest pain; the most severe pain the patient has felt | 4 |
