What condition would contraindicate a stress test for an athlete with chest pain?

Unstable angina is a condition characterized by unexpected chest pain that occurs at rest or with minimal exertion, typically signaling a significant risk of adverse cardiac events such as myocardial infarction. Performing a stress test in the presence of unstable angina is contraindicated because the test involves exertion, which could exacerbate the condition and potentially lead to serious complications, including arrhythmias or a heart attack.

This response is appropriate because a stress test aims to assess cardiovascular function under controlled conditions, and in the case of unstable angina, the risks outweigh the potential benefits. In contrast, stable angina indicates that the patient experiences predictable chest pain with exertion but can usually engage in physical activity with appropriate precautions. Hypertension may require monitoring and management but is not an absolute contraindication in a controlled stress test setting. Atrial fibrillation, while it may complicate the interpretation of test results, does not automatically preclude the test unless it is associated with other significant cardiac instability.