Cardiac PT 2 Flashcards
what is a major feature of L sided heart failure
backflow into the lungs causing pulmonary edema
what is HRpEF and how are EF and CO affected?
diastolic dysfunction - L ventricle hypertrophy - EF is normal but CO decreases
what is HRrEF and how are EF and CO affected?
systolic dysfunction - reduced myocardial contractility - EF and CO both decrease
what are three unique characteristics of R sided HF
peripheral edema, weight gain, and JVD
what are 3 unique characteristics of L sided HF
dyspnea/tachypnea, crackles, orthopnea
what is NYHA HF stage 1
no limitations to activity - usually new dx
what is NYHA HF stage 2
SOB and fatigue with activity
what is NYHA HF stage 3
comfortable at rest but marked limitation with activity
what is NYHA HF stage 4
severe activity difficulty even at rest
what is the difference between compensated and decompensated heart failure
decompensated heart failure happens when a patient is unable to maintain adequate circulation
what is the cardiac biomarker for heart failure
B-type natriuretic peptide (BNP)
what does digitalis do
increases contractility
what does a diuretic do
decreases fluid
what do ace inhibitors, beta blockers, and vasodilators do?
decrease preload and/or afterload
what are the differences between NYHA 1-2 and 3-4 FITT recommendations for strength training
- RPE 11-15 (10-13 for 3-4)
2. 3x6-15 reps (2x4-10 for 3-4)
what are the inpatient aerobic exercise FITT recommendations for HF patients
F: daily
I: RPE 9
T: 3-5 min bouts 2-3x/day
T: walking
what is a vitals consideration for exercising heart failure patients
no desat more than 4%
what should be RPE for exercising heart failure patients in the OP clinic
no more than 14
what is CRT
cardiac resynchronization therapy - synchronizes AV and R/L ventricles to make the heart more effective
what are the PT implications for an intraaortic balloon pump
- no OOB activities until the catheter is removed
2. bed mobility and ROM allowed if hip flexion is below 70
an implantable cardioverter defibrillator detects life-threatening rhythms. what are its implications for us in PT
- need to know its upper limit of HR detection
2. exercise intensity should be 10 bpm below programmed threshold
an LVAD is a device that assists the LV in HF pts waiting for transplants. what are its implications for us in PT?
- know EAP
- BP can only be taken by doppler
- increased exercise tolerance
T/F: Patients with LVADs are not allowed to exercise
F: keep em 11-13 RPE
for patients with an LVAD, average days till first stand ____ days, till first ambulation > 5 ft ______ days
4, 10
what are RPE recommendations for patients following heart transplant
12-13
when does PT begin after transplant
12-26 hours post op
what is an artifact regarding post op heart transplant patients
no ANS input post op therefore HR will be approx 100 bpm
what does cardiac denervation mean for us PTs?
Pts need an adequate warm up and cool down after a heart transplant
what are aerobic inpatient exercise recommendations post heart transplant
- RPE < 12
- 2-4x/day
- 3-5 min walking progressing to 10-15 min
- warm up and cool down
