Patient screening and management

6. Comprehensive assessment, risk stratification and exercise prescription must initially be undertaken with each patient and reviewed and revised as required.

7. There should be local protocols defining inclusion and exclusion criteria for the exercise group, a medical consent procedure to participate in exercise and clinical guidelines for excluding a patient with the following contraindications from exercise (see also Chapter 2):

• Unresolved/unstable angina;

• New or recurrent symptoms of breathlessness, palpitations, dizziness, swelling of ankles or significant lethargy;

• Resting systolic blood pressure >200mm/Hg and diastolic >110mm/Hg;

• Significant unexplained drop in blood pressure;

• Tachycardia >100 beats per minute;

• Fever and acute systemic illness;

8. All patients should have an exercise induction, be closely observed throughout exercise and for 15 minutes after the cool-down is completed.

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