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Aging > Lecture 6 > Flashcards

Lecture 6 Flashcards

1
Q

common cardiovascular conditions

A
  • Hypertension
  • Coronary artery disease
  • Heart failure
  • Arrhythmias
  • Valve disease
  • TIA and stroke
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2
Q

Hypertension

A
  • Hypertension – pathological increase in BP
  • Systolic >140mmHg diastolic >90mmHg
  • Isolated systolic hypertension:
  • systolic >140 but diastolic <90
  • Increased risk of stroke, kidney disease and heart disease
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3
Q

treament for hypertension

A

• Lifestyle change – diet, exercise, smoking and stress
• Medications – Angiotensin-converting enzyme (ACE)
inhibitors that relax blood vessels by preventing the
formation of a hormone called angiotensin, a substance in
your body that narrows blood vessels.
• Frequently prescribed:
• enalapril (Vasotec),
• lisinopril (Prinivil, Zestril)
• ramipril (Altace).

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4
Q

exercise for hypertension

A

• non-hypertensive (to reduce the possibility of becoming
hypertensive) or for hypertensive patients (to reduce their
BP):
• accumulation of 30-60 minutes of moderate intensity dynamic
exercise (e.g., walking, jogging, cycling, or swimming) 4-7 days per
week in addition to the routine activities of daily living (Grade D).
• Higher intensities of exercise are not more effective
(Grade D).
• For non-hypertensive or stage 1 hypertensive:
• resistance or weight training exercise (such as free weight lifting,
fixed weight lifting, or handgrip exercise) does not adversely
influence BP (Grade D).

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5
Q

coronary heart disease

A 
• Atherosclerosis of
coronary arteries
• Decreases blood flow to
cardiac muscle
• Angina pectoris signals
partial blockage (some
dont feel any pain)
• Complete blockage =
myocardial infarction
(heart attack)
• death of portion of heart –
doesn’t recover
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6
Q

fixing the problem: coronary HD

A
  • Lifestyle changes
  • Medicine
  • Surgery
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7
Q

heart failure

A

• Inability of heart to maintain cardiac output sufficient to
meet metabolic needs of body

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8
Q

exercise for coronary HD

A

• Aerobic activity
• moderate intensity (RPE 3-5 or 65-85% max HR), or moderate
intervals (15-30 minutes with 15-30 minutes rest – RPE 3-5)
• 10 to 15 minutes 2-3 d/week working to 30 minutes 5 d/week
• Resistance training
• 10-20 reps using 5-10 lb free weight 2-3 days/week
• Flexibility
• Recommended

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9
Q

common arrhythmias

A

• Bradycardia – heart beats too slowly
• Tachycardia – heart beats too quickly
• Atrial fibrillation – atria do not contract completely with
each beat but “quiver”

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10
Q

how are rhythm disorders treated

A

Rhythm disorders are treated with medications,

cardioversion, ablation and a few other procedures

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11
Q

ventricular fibrillation

A

• The ventricles quiver and the heart can’t pump any blood,
causing cardiac arrest
• The heart’s electrical system becomes disordered and the
heart does not beat in one strong contraction

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12
Q

pacemakers

A

• Not enough O2 is pumped through the body by the heart
to meet metabolic needs
• Made up of a generator or “battery” and leads inserted
into heart muscle

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13
Q

implantable cardioverter-defibrillators

A

A pager-sized device with leads into the heart - inserted
(usually) under the left collar bone.
• If the heart enters ventricular fibrillation, the following may
occur:
• Low-energy pacing therapy. Mild electrical impulses
that keep electrical activity steady. May feel nothing or a
painless fluttering in chest when ICD responds to mild
disruptions in heartbeat.
• Cardioversion therapy. A higher energy shock is
delivered for a more serious heart rhythm problem. It may
feel as if you’re being thumped in the chest
Defibrillation therapy. This is the strongest form of
electrical therapy used to restore a normal heartbeat. Feels
like a kick in the chest and may knock a person off their
feet.
The pain from this therapy usually lasts only a second.
There should be no discomfort after the shock ends.

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14
Q

valvular disease

A

Valve disease is when any of the valves in the heart don’t
open or close properly
• Stenosis is when the valve opening becomes narrow and
restricts blood flow.
• Prolapse is when a valve slips out of place or the valve
flaps (leaflets) do not close properly.
• Regurgitation is when blood leaks backward through a
valve, sometimes due to prolapse

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15
Q

valve repair or replacement

A

Parts of valves or their supporting structures can be
surgically repaired
• Mechanical or live tissue valves can replace any of the
valves in the heart

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16
Q

objectives of a cardiac rehab program

A

• Regardless of cardiac condition, cardiac rehab programs
have very similar objectives:
• Optimize function within the limits imposed by the disease
• Educate patients and family on risk factors
• Return patient to daily activities and roles

17
Q

benefits of exercise for the cardiac patient

A 
• Controls hypertension
• Decreases/increases weight
• Improves lipid profile
• Decreases stress
• Improves endothelial function
• Increase in strength, flexibility &amp; endurance to maintain
ADL’s and independence
18
Q

program structure

A

4 month program (paid for by private insurance)
• Run by nurses, kinesiologists
• Start and end with GXT and bloodwork (lipids, glucose)
• One month of 3x/week classes
• 30 minutes lecture
• 60 minutes exercise
• Rest of the three months on own with what has been
learned.
• After 4 months – encouraged to buy a membership
• South end of city: Reh –Fit centre
• North end of city: Wellness Institute

19
Q

exercise prescription for cardiac rehab

A

• Aerobic: large muscle activities, arm/leg ergometry
• RPE 11-16/20
• > 3 days/week, 20-60 minutes, 5010 minute warm-up and cool-down
• Strength: circuit training
• 30-40% 1RM upper body, 50-60% 1RM lower body. Avoid Valsalva
• 2-3 days/week, 2-4 sets, 12-15 reps, 8-10 exercises
• Gradually increase resistance over time
• Flexibility: upper and lower ROM. Static stretches holding 10-30
sec
• 2-3 days/week

20
Q

stretching considerations

A
  • Total body stretch
  • Be aware of incisions
  • Shoulder pain (position during surgery)
  • Head higher than heart reduces dizziness
21
Q

other considerations when working with a cardiac rehab patient

A
  • Be aware of signs of distress
  • Avoid extreme temperatures
  • Discourage large meals before activity
  • Help client with emotional distress
22
Q

authorities on exercise prescription

A

• CACPR – Canadian Association of Cardiovascular
Prevention and Rehabilitation
• ACSM – American College of Sports Medicine
• AAVCPR – American Association of Cardiovascular and
Pulmonary Rehabilitation
• AHA – American Heart Association

23
Q

what does TIA stand for

A

Transient ischemic attack

& stroke

24
Q

transient ischemic attack & stroke

A

TIA – cerebral blood flow is hampered and O2 is not
reaching brain tissue
• Causes non-permanent neurological symptoms
• Stroke is a complete blockage or hemorrhage of blood
circulation to the brain tissue

25
Q

signs of stroke

A

F- face is it drooping
A- arms can you raise both
S- Speech is it slurred or jumbled
T- time to call 911 right away

26
Q

outcomes of stroke

A
  • Speech/language impediments
  • Loss of balance
  • Emotional changes
  • Memory loss
  • Altered self-concept
  • Loss of intellectual function
  • Depression
  • Hemiparesis or hemiplegia
27
Q

effect of stroke on ability to exercise

A

• Lowered functional capacity
• Reduced aerobic capacity partly due to impaired motor function
following brain trauma (VO2max up to 70% lower than healthy
counterparts)
• More rapid fatigue and less efficient movement and ADLs
• More breathlessness

28
Q

benefits of exercise for stroke

A

Improved peak oxygen consumption, better workload response,
improved blood pressure, lower resting heart rate, and lipids
• faster walking speed and less ambulation assistance required

29
Q

exercise prescription for stroke

A

• Aerobic:
• Cycle ergometer, treadmill, seated stepper, arm ergometer
• 40-70% estimated max VO2, 3-5 days/week, 20-60 min or multiple
bouts of 10 min
• Strength:
• Isometric, wt machines, free weights (grip?)
• 3 sets, 8-12 reps, 2 days/week
• Flexibility:
• 2 days/week before or after aerobic or strength – no ballistic mvmt
• Balance: 2 days a week

30
Q

exercise considerations

A

• Exercise Positioning ?
• Resistance Training ?
• Communication ?
Blood pressure, pain, coordination, balance, enjoyment…

Aging (17 decks)

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