Which of the following is a contraindication to exercise in heart failure?

• A. Acute decompensation.
• B. Regular aerobic training.
• C. Adequate hydration.
• D. Stable resting heart rate.

Answer: (A)

When heart failure is not stable, exercise is not safe. Acute decompensation means the heart can’t meet the body’s demands and there’s fluid overload, poor perfusion, and a high risk of pulmonary edema, arrhythmias, or shock. Pushing exercise in this state can worsen congestion and lead to rapid deterioration, so stabilization with medical therapy comes before any exercise program.

In contrast, regular aerobic training is actually encouraged once stability is achieved, and adequate hydration supports preload and kidney perfusion. A stable resting heart rate suggests the patient isn’t in crisis and can usually participate in a supervised, appropriately progressed program.