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Evaluation

Gender of patient

Is there a recent and significant change in the resting ECG suggesting myocardial infarction or other acute cardiac event?

Has the patient had a recent complicated myocardial infarction?

Is the patient stable and pain free?

Does the patient have unstable angina?

Does the patient have an uncontrolled ventricular arrhythmia?

Does the patient have an uncontrolled atrial arrhythmia that compromises cardiac function?

Does the patient have third degee AV heart block without a pacemaker?

Does the patient have frequent or complex ventricular ectopy?

Does the patient have a fixed-rate pacemaker?

Is the patient in acute congestive heart failure?

Does the patient have a ventricular aneurysm?

Does the patient have severe aortic valve stenosis or other serious valvular disorder?

Does the patient have moderate valvular heart disease?

Does the patient have a suspected or known dissecting aneurysm?

Does the patient have active or suspected myocarditis?

Does the patient have active or suspected pericarditis?

Does the patient have hrombophlebitis or intracardiac thrombi?

Has the patient had a recent systemic or pulmonary embolus?

Resting diastolic blood pressure

mm Hg

Resting systolic blood pressure

mm Hg

Is the patient showing signs of significant emotional distress and/or psychosis?

Does the patient have an acute infection?

Does the patient have a chronic infectious disease?

Does the patient have an electrolyte abnormality?

Does the patient have an uncontolled metabolic disease, such as diabetes, thyrotoxicosis, or myxedema?

Does the patient have a neuromuscular, musculoskeletal or rheumatoid disorder that is exacerbated by exercise?

Is the patient at an advanced state of pregnancy?

Is the patient having a complicated pregnancy?

Results

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