Starting exercise in chronically ill patients:
Exercise cardiac stress testing referral:
Stress testing should be conducted in patients with suspected or known coronary artery disease, typical and atypical angina or have had prior heart attack. In healthy people, without symptoms, those with multiple heart risk factors (high cholesterol, high blood pressure, family history, obese, diabetes mellitus) or concurrent chronic diseases or those in a high-risk occupation for example pilots, firefighters, law enforcement officers, and transit operators should undergo exercise stress testing. Stress testing is also recommend for men over age 40 and women over age 50 who have been inactive but plan to start vigorous exercise. Evaluation of exercise capacity in patients with heart disease involving one or more of the valves of the heart, those with heart rhythm disorders, and those with pacemakers is also necessary. (27)