Cardiac Rehab Of Special Groups

Question 1

Prevention of stroke in a fib is best prevented by

Answer 1

Anticoagulation with warfarin

Question 2

Heart transplant patients are at high risk for what infection?

Answer 2

CMV. They get prophylaxis with acyclovir or ganciclovir

Question 3

Pharmacological mgmt of arrhythmias includes

Answer 3

Nitrates, beta-blockers and amiodarone

Question 4

What effect does Heart Transplant have on resting HR? Exercise HR?

Answer 4

There is higher resting HR because of parasympathetic denervation. There is a delayed increase in HR with exercise because of loss of vagal inhibition to SA node. There is also slower return to baseline. There is also a lower peak exercise HR.

Question 5

MC type of heart transplantation

Answer 5

Orthotopic heart transplantation

Question 6

What is normal ABI? Severe? Very Severe?

Answer 6

Normal > 1.0
Severe 0.4 - 0.6
Very Severe < 0.4

Question 7

What is used for exercise stress test in an amputee that is unable to do upper extremity cycle stress test?

Answer 7

Pharmacological stress testing using dipyridamole

Question 8

Percentage of people with stroke that have A fib

Answer 8

15-20%

Question 9

For similar walking speed, how much more energy is required for BKA, B/L BKA, AKA, B/L AKA?

Answer 9

BKA - 25%
B/L BKA - 40%
AKA - 65%
B/L AKA - 280%

Question 10

What happens in a heterotopic heart transplantation?

Answer 10

The recipient heart is left in place to assist the donor heart

Question 11

What is exercise intensity in cardiac rehab program for PAD?

Answer 11

Intensity that produces moderate claudication pain within first 5 minutes

Question 12

What exercise machine can be used for someone who has impaired LE? For someone who has LE weakness?

Answer 12

Impaired LE - UE cycle ergometer

LE Weakness - Air Dyne Arm

Question 13

Hemiplegic ambulation compared to normal ambulation in terms of speed and energy cost

Answer 13

Hemiplegics are 40% slower and use 50% more energy

Question 14

What is the name of the study that measured consequences of stroke with A fib compared to those with sinus rhythm

Answer 14

Copenhagen stroke study

Question 15

How is ankle brachial index measured

Answer 15

SBP at ankle : brachial SBP

Question 16

What can patients with life threatening ventricular tachycardia have done?

Answer 16

Ablation or ICD

Question 17

For people with a fib and high hemorrhage risk, what can you give other than warfarin?

Answer 17

ASA 325 qd

Question 18

In heart transplant patients, what do you base intensity of exercise on?

Answer 18

Can’t use HR, so use Borg RPE

Question 19

What modifications to exercise intensity, frequency, duration and target HR are made to patients with ventricular arrhythmias?

Answer 19

Decrease intensity and target HR, and increase frequency and duration

Question 20

Energy expenditure for unilateral BKA with prosthesis vs amputation with no prosthesis and using crutches

Answer 20

No prosthesis with crutches = 50%

Unilateral BKA with prosthesis = 25%