Cardiac Rehab Flashcards
What are some inclusion criteria for cardiac rehab?
- Acute MI
- Revascularisation procedures
- Stable angina
- Hospitalisation for unstable angina
- Unstable angina
- CHF
- Cardiac valve surgery
- Cardiomyopathy
- Atrial fibrillation
- Risk of CAD
What are some appropriate exercise tests for functional capacity after an operation? (Inpatient)
- 6MWT
- Incremental shuttle walk test
- Low level exercise treadmill tests (E.g. Naughton)
- Anything that is symptom limited
True or false, in order for a patient to leave the hospital, they must reach stage 5 and be able to walk 5 minutes a day and shower independently
True!
What are some appropriate exercise assessments for outpatient rehabilitation?
- Exercise stress test on bike or treadmill
- 6MWT
- Harvard step test
Why is the 6MWT limited?
Has a ceiling effect, doesn’t assess the patient at different intensity and has a poor correlation between VO2peak and future risk of CV
What are signs of exercise test termination?
Onset of angina, signs of poor perfusion (light-headedness, ataxia), patient requests, physical or verabl manifestations of fatigue, tachycardia, SpO2 <88%, exercise hypotension
What are some relative contraindications for exercise testing?
Resting heart rate >125bpm, SBP >200mmHg or DBP >110mmHg, left main coronary stenosis, moderate stenotic valvular heart disease, electrolyte abnormality, atrial fibrillation, hypertrophic cardiomyopathy, high degree atrioventricular block
What are some absolute contraindications for exercise testing?
- Recent changes in ECG, ischemia (or AMI 2 days ago)
- Unstable angina
- Uncontrolled cardiac dysrhythmias
- Severe aortic stenosis
- Acute pulmonary embolus
- Acute myocarditis or pericarditis
- Suspected or known dissecting aneurysm
After heart transplantation, what does the heart rely on apart from sympathetic and parasympathetic innervation (as it has been cut off)?
Circulating catecholamines to provide adrenergic stimulation
What happens to a persons resting heart rate after transplantation?
It increases as there is less nerve activity to slow it down
What is the usual heart rate response during exercise in heart transplantation patients?
Onset of increased heart rate is delayed for first several minutes, then it increases more gradual than normal, peak heart rate is also lower then normal
What are some common medication in heart transplantation patients?
Corticosteroids, Calcineurin inhibitors, inosine monophosphate dehydrogenase inhibitor, Mammalian target rapamycin inhibitor
What type of exercise test should you perform on heart transplantation patients?
Treadmill or stationary bike with progressive stages
What is the usual peak VO2 in heart transplant patients?
Around 20-25ml.kg.min
What is SpO2?
Peripheral capillary oxygen saturation, it is an indirect measure of arterial oxygenation
