Cardiac PT 1 Flashcards
define normal BP
< 120 AND < 80
define elevated BP
120-129 AND < 80
define HTN stage 1
130-139 OR 80-89
define HTN stage 2
> 140 OR > 90
CO = ____ x ____
HR and SV
T/F: elevated blood pressure leads to clinical manifestations/symptoms
false: elevated BP may be asymtpomatic
what is the most important general goal for someone with HTN
educate on how to assess cardiac distress/intolerance
it is prudent to maintain SBP _____ and/or DBP _____ when exercising
<220 and <105
how do beta blockers impact exercise
they may reduce max/submax exercise capacity
what is a consideration for working with patients on CCBs and vasodilators
excessive reductions in postexercise BP may occur without proper cool down
at what RPE should you train your HTN patients?
no more than 13
what is the hallmark sign of acute coronary syndrome
ischemic chest pain
what are the four determinants of myocardial perfusion
- DBP - primary driving force
- resistance - atherosclerosis can increase it
- vasomotor tone - determines volume
- LVEDP
RPP = ____ x _____; what does this mean for us
HR and SBP; during ischemia, stop the aggravating activity to decrease O2 demand
what are 4 non-modifyable risk factors for CHD
- male
- age
- fam hx
- ethnicity
what are 4 biological modifiable risk factors for CHD
- HBP
- blood lipid abnormalities
- pre-DM and DM
- obesity
what is the difference in confirming STEMI v NSTEMI
STEMI confirmed by biomarkers and EKG and NSTEMI confirmed mainly by biomarkers
where else can pain be referred in chronic stable angina
left shoulder, jaw, and between the shoulder blades
what two EKG signs suggest cardiac ischemia
ST depression and T wave inversion
what is the best goal for PT for pts with chronic stable angina
increase the amount of activity the patient can perform before experiencing chest pain
what are FITT considerations for aerobic activity for patients with chronic stable angina
F: min 3 but optimally >5 days per week
I: no closer than 10 beats below anginal threshold
T: 20-60 min
T: large muscle group rhythmic
what are FITT considerations for strength for patients with chronic stable angina
F: 2-3 nonconsecutive days per week
I: 10-15 reps w/o major fatigue RPE 11-13
T: 1-3 sets of 8-10 exercises
T: whatever is safe and comfortable for the pt
sxs of unstable angina v variant angina
unstable and variant - chest pain at rest or with min exertion
what is a major PT consideration for patients following percutaneous coronary interventions
bed rest 6-8 hours after PCI
what are the physical activity recommendations for PCI patients
mod intensity for min 30 min 5 days/wk
what are inpatient activity considerations for patients receiving stents
early mobility working at 11-12 RPE
WHAT ARE STERNAL PRECAUTIONS
- no pushing or pulling
- no supporting the body with arms
- no driving for 4-6 weeks
- no lifting more than 5 pounds
- no arms > 90
in what position should you NOT exercise post-op cardiac patients?
supine b/c increases fluid shifting to the central system
what are exercise recommendations for the acute care setting 1-2 weeks post CABG
RPE < 12
1-2x/day
walking lasting 3-5 min progressing to 10-15 min
how long is typical hospital stay for a heart attack patient
1-2 days in the CCU and 3-4 days in the hospital
when is the heart at its weakest following an MI, which phases ensue?
days 4-10 necrotic phase (6d) tissue easily ruptures fibrosis phase (5d-4w) collagen phase (4w-2m)
what are considerations for strength training following an MI (4)
- avoid heavy lifting esp UE work
- avoid valsalva
- avoid isometrics
- avoid working in supine
what are aerobic, inpatient considerations following an MI
- RPE < 12
- 1-2x/day almost all days per week
- include warm up and cool down
- walking 3-5 min per session increasing to 10-15 within RPE
