Table 10. – Abnormalities observed on cardiopulmonary exercise test or treadmill exercise test that should limit exercise intensity in patients with valvular heart disease.

Exercise-induced changes	Description
Signs and symptoms	Onset of angina, angina equivalent, or other signs and symptoms indicative of exercise intolerance
Blood pressure	Plateau response or decline in SBP; or, SBP >220 mmHg; or, DBP >115 mmHg
ST segment	Onset of ST segment depression (horizontal or descending) >1 mm
Ventricular function	Evidence of decreased ventricular function on exertion or onset of moderate to major left ventricular wall motion abnormalities
Pulse O 2 (CPET only)	Evidence of early plateau or decline on effort despite increased load
Arrhythmia	Grade 2 or 3 AV block, atrial fibrillation, supraventricular tachycardia, complex ventricular arrhythmias

CPET: cardiopulmonary exercise test; SBP: systolic blood pressure; DBP: diastolic blood pressure, AV: atrioventricular.