Which of the following is a contraindication to post-MI exercise?

• A. Unstable angina
• B. Controlled arrhythmias
• C. Recovered from infection with no symptoms
• D. No history of MI

Answer: (A)

Ongoing ischemia, as seen with unstable angina, makes post-MI exercise unsafe. Exercise raises heart rate and oxygen demand, and if the heart isn’t getting enough blood—because the angina is unstable—pushing through it can worsen ischemia, trigger dangerous arrhythmias, or lead to heart failure. So until the angina is stabilized with medical therapy, exercise is not appropriate.

If arrhythmias are controlled and the patient remains hemodynamically stable, supervised exercise can often proceed with caution. Recovered from infection with no symptoms is generally compatible with exercise, and having no history of MI is not a contraindication to exercise in other contexts.