OS T#3: S1 Flashcards
When is Symptom limited exercise testing normally performed?
Before stating Phase II outpatient cardiac care
how do you find out your target HR?
Age predicted method: (220-age=HR max)
(less error: 208 - 0.7 x age= HR max)
Karvonen’s Formula:
((HRmax - HRresting) x intensity ) + resting = target zone
What are the conditions for a submax Exercise tolerance Test (ETT)?
The test is symptom limited and terminated at 85% of of age predicted HR
When is submax used?
to evaluate patients for early exercise after MI, coronary bypass, or coronary angioplasty
When can maximal ETT take place?
Only when there is advanced cardiac life support o hand to handle any abnormal reactions
What should happen do diastolic BP during exercise?
It should remain about the same
What are the absolute indications for terminating an ETT? (7)
- Drop in SBP by more than 10 mmHg from baseline despite increase in workload (with evidence of ischemia)
- Moderately severe angina (3 out of 4 pain)
- Signs of poor perfusion
- Sustained V-tach
- 1.0 mm ST elevation in leads without diagnostic Q waves
- Increasing nervous system symptoms
- severe claudication
What are relative indications for terminating an ETT? (7)
- Drop in SBP by more than 10 mmHg from baseline despite increase in workload (without evidence of ischemia)
- More than 2 mm ST segment depression
- Arrhythmia’s other than sustained V-Tach
- Fatigue SOB wheezing, leg cramps, mild claudication
- Increasing chest pain
- SBP at or above 250 mmHg, DBP at or above 115 mm Hg
- Development of bundle branch block or intra-ventricular delay
Describe a 3rd degreed heart block
All impulses are blocked at the AV node, atria and ventricles beat at different rates (atria faster than ventricle)
Considered a medical emergency and needs pace maker
Pt may faint if ventricular output is too low
What causes a 3rd Degree heart block?
Digitalis
Degenerative changes in the conduction system
Heart Surgery
Acute MI
What does a depressed ST segment indicate?
Sub-endocardial ischemia
Digitalis toxicity
Hypokalemia
What is phase I of Cardiac Rehab?
Inpatient Cardiac Rehab (acute)
What is the exercise limitations for Phase I of Cardiac Rehab?
Starting from 2-3 METS (walking 2mph) progress to 5 METS(walking 3.5-4 mph)
Post MI: limited to 70% of HR max and/or 5METs until 6 weeks post MI
Post surgery normally progresses quicker
Lifting actives are restricted for 6 weeks
What is Phase II of Cardiac Rehab?
Outpatient Cardiac Rehab (subacute)
What is the exercise limitations for Phase II of Cardiac Rehab?
Frequency: 2-3x/week
Duration: 30-60 mins with 5-10min warm up/cool-down
Single/Multiple mode(s) of training
Suggested Exit point 9 METs (running 5.5 mph, biking 13 mph)
What is Phase III of Cardiac Rehab?
Community Exercise Programs
What is an Extremely low APGAR scale?
0-3 at 1 and 5 minutes (exhibit need for resuscitation) if scores remain this low neurological complications can be expected.