Cardiac PT 2

Question 1

what is a major feature of L sided heart failure

Answer 1

backflow into the lungs causing pulmonary edema

Question 2

what is HRpEF and how are EF and CO affected?

Answer 2

diastolic dysfunction - L ventricle hypertrophy - EF is normal but CO decreases

Question 3

what is HRrEF and how are EF and CO affected?

Answer 3

systolic dysfunction - reduced myocardial contractility - EF and CO both decrease

Question 4

what are three unique characteristics of R sided HF

Answer 4

peripheral edema, weight gain, and JVD

Question 5

what are 3 unique characteristics of L sided HF

Answer 5

dyspnea/tachypnea, crackles, orthopnea

Question 6

what is NYHA HF stage 1

Answer 6

no limitations to activity - usually new dx

Question 7

what is NYHA HF stage 2

Answer 7

SOB and fatigue with activity

Question 8

what is NYHA HF stage 3

Answer 8

comfortable at rest but marked limitation with activity

Question 9

what is NYHA HF stage 4

Answer 9

severe activity difficulty even at rest

Question 10

what is the difference between compensated and decompensated heart failure

Answer 10

decompensated heart failure happens when a patient is unable to maintain adequate circulation

Question 11

what is the cardiac biomarker for heart failure

Answer 11

B-type natriuretic peptide (BNP)

Question 12

what does digitalis do

Answer 12

increases contractility

Question 13

what does a diuretic do

Answer 13

decreases fluid

Question 14

what do ace inhibitors, beta blockers, and vasodilators do?

Answer 14

decrease preload and/or afterload

Question 15

what are the differences between NYHA 1-2 and 3-4 FITT recommendations for strength training

Answer 15

1. RPE 11-15 (10-13 for 3-4)

2. 3x6-15 reps (2x4-10 for 3-4)

Question 16

what are the inpatient aerobic exercise FITT recommendations for HF patients

Answer 16

F: daily
I: RPE 9
T: 3-5 min bouts 2-3x/day
T: walking

Question 17

what is a vitals consideration for exercising heart failure patients

Answer 17

no desat more than 4%

Question 18

what should be RPE for exercising heart failure patients in the OP clinic

Answer 18

no more than 14

Question 19

what is CRT

Answer 19

cardiac resynchronization therapy - synchronizes AV and R/L ventricles to make the heart more effective

Question 20

what are the PT implications for an intraaortic balloon pump

Answer 20

1. no OOB activities until the catheter is removed

2. bed mobility and ROM allowed if hip flexion is below 70

Question 21

an implantable cardioverter defibrillator detects life-threatening rhythms. what are its implications for us in PT

Answer 21

1. need to know its upper limit of HR detection

2. exercise intensity should be 10 bpm below programmed threshold

Question 22

an LVAD is a device that assists the LV in HF pts waiting for transplants. what are its implications for us in PT?

Answer 22

1. know EAP
2. BP can only be taken by doppler
3. increased exercise tolerance

Question 23

T/F: Patients with LVADs are not allowed to exercise

Answer 23

F: keep em 11-13 RPE

Question 24

for patients with an LVAD, average days till first stand ____ days, till first ambulation > 5 ft ______ days

Answer 24

4, 10

Question 25

what are RPE recommendations for patients following heart transplant

Answer 25

12-13

Question 26

when does PT begin after transplant

Answer 26

12-26 hours post op

Question 27

what is an artifact regarding post op heart transplant patients

Answer 27

no ANS input post op therefore HR will be approx 100 bpm

Question 28

what does cardiac denervation mean for us PTs?

Answer 28

Pts need an adequate warm up and cool down after a heart transplant

Question 29

what are aerobic inpatient exercise recommendations post heart transplant

Answer 29

1. RPE < 12
2. 2-4x/day
3. 3-5 min walking progressing to 10-15 min
4. warm up and cool down