special subjects
Exercise in Older Adults
Contraindications
 ( References ) include Acute myocardial infarction (MI), within 2 days Ongoing unstable angina Uncontrolled cardiac arrhythmia with hemodynamic compromise Active endocarditis Symptomatic severe aortic stenosis Decompensated heart failure Acute pulmonary embolism, pulmonary infarction, or deep vein thrombosis Acute myocarditis or pericarditis Acute aortic dissection Physical, mental, or emotional disability that precludes safe and adequate exercise ( References ) include Known obstructive left main coronary artery stenosis Moderate to severe Aortic Stenosis with uncertain relation to symptoms Overview of Arrhythmias with uncontrolled ventricular rates Acquired advanced or complete Atrioventricular Block None Hypertrophic obstructive cardiomyopathy with severe resting gradient Recent Overview of Stroke or Mental impairment with limited ability to safely cooperate Resting Hypertension with systolic or diastolic blood pressures > 200/110 mmHg Uncorrected medical conditions, such as significant Overview of Decreased Erythropoiesis , important electrolyte imbalance (eg, Most patients with relative contraindications can exercise in some form, although typically at lower levels of intensity and in more structured circumstances than other patients (see Cardiovascular Rehabilitation ). At times, shorter bursts of higher intensity (and sometimes even low or moderate intensity) exercise with rests between attempts can be more accommodating than sustained moderate-intensity exercise. Intensity and duration can be modified over time as appropriate. The exercise program may be modified for patients with other disorders (eg, arthritic disorders, particularly those involving major weight-bearing joints, such as the knees, ankles, and hips). Patients must be instructed to stop exercising and seek medical attention if they develop chest pain, light-headedness, or palpitations. 