II. Risk Factors: Major Cardiovascular Risks - Unstable Coronary Syndromes
- Recent Myocardial Infarction (Within 30 days)
- Unstable Angina or severe Angina (Angina Class 3-4)
- Decompensated Congestive Heart Failure
- Severe valvular disease
- Severe Aortic Stenosis (mean gradient >40 mm Hg, area <1 cm)
- Symptomatic Mitral Stenosis
- Significant Arrhythmia
- High grade Atrioventricular Block
- Symptomatic ventricular Arrhythmia
- Uncontrolled rate in supraventricular Arrhythmia with Heart Rate >100
III. Risk Factors: Intermediate Cardiovascular Risks
- Mild Angina Pectoris (Angina Class 1-2)
- Prior Myocardial Infarction (by history or EKG)
- Prior documented Myocardial Infarction
- Prior positive stress test
- EKG with pathological Q Waves
- Compensated or prior Congestive Heart Failure
- Renal Insufficiency (Serum Creatinine >2 mg/dl)
- Diabetes Mellitus
IV. Risk Factors: Minor Cardiovascular Risks
- Advanced age
- Abnormal Electrocardiogram
- Left Ventricular Hypertrophy
- Left Bundle Branch Block
- ST Segment abnormalities
- T Wave abnormalities
- Heart rhythm other than sinus rhythm (e.g. Atrial Fib)
- Low functional capacity (<4 METS)
- Unable to climb one flight of stairs holding a bag of groceries
- Unable to walk on level ground at 4 miles per hour (1 mile in 15 minutes)
- History of Cerebrovascular Accident
- Uncontrolled Hypertension (diastolic BP >110 mmHg)