Test

Question 0

Hr recovery

Answer 0

Comparison of peak hr and recovery hr 1-2 min into recovery

Question 1

Chronotropic incompetence

Answer 1

An attenuated hr response to exercise
85% of max
B blocker 62% of max
Sign of possible CAD

Question 2

Abnormal hr recovery

Answer 2

Decrease <22 at 2 min supine

Question 3

Exertional hypotension

Answer 3

SBp drop > 10 mm hg despite increase in work load

Question 4

Max O2 uptake healthy adult

Answer 4

30-45 ml kg min

Question 5

Peak vo 2 cad

Answer 5

13-25 ml kg min men

10-18 ml kg min women

Question 6

Factors effecting vo2

Answer 6

⬇️ cardiac output ( may be ⬇️ due chronotropic incompetence or LV disfunction secondary to prior MI, ischemia, cardiomyopathy
⬇️ peak bld flow peripheral muscle
Peripheral skeletal muscle cellular abnormalities

Question 7

Result of cardio myopathy

Answer 7

⬇️ EF

⬇️ stroke volume

Question 8

Ischemic cascade

Answer 8

1. Imbalance between myocardial oxygen supply and demand
2. Ischemic event causing cellular abnormalities
3. Abnormalities in diastolic function ( reduced vent compliance and impaired filling
4. Abnormalities in systolic function
5. ECG changes like ST depression
6. Angina

Question 9

Rate pressure product

Answer 9

Myocardial O2 demand

HRxSBP

Question 10

Variables determining myocardial 02 demand

Answer 10

HR
LV pre load
Myocardial contractility

Question 11

Four pathogenic factors that affect myocardial 02 demand

Answer 11

1. Coronary artery stenosis w endothelial dysfunction
2. Microvascular dysfunction
3. Abnormalities of the autonomic nervous system
4. Abnormalities of coagulation and fibrinolytic systems

Question 12

CAD exercise intensity

Answer 12

40-80% hrr 1500-2000 kcal expenditure

Question 13

Angina exercise intensity

Answer 13

40-80% hrr or 10 beats below ischemic threshold

Question 14

Initial cardiac exrx

Answer 14

5-10 min warm up cool down including stretching rom low intensity aerobic activity
Progressing to 30-60 min aerobic exercise as tolerated
40-80% hrr or 10 beats below ischemic threshold or defibrillation threshold
RPE 11-14
Resistance training 50-60/80% 1 RM
8-10 or 10-15 reps 1set 2-3 days
RPE 11-14

Question 15

Cardiac transplant exrx resistance

Answer 15

7-10 exercises legs back arms shoulders
6-12 weeks post transplant
2x per wk

Question 16

PAD Treatment

Answer 16

Risk factor modification
Weight bearing exercise
Drug therapy
Surgical revascularization

Question 17

CAD surgical procedures

Answer 17

Catheter through arm or groin into occluded artery
Angioplasty- balloon
Stent- tube for structural integrity/ can be drug coated
Artherectomy- laser or rotating burr to break up plaque

Coronary artery bipass graph CABG

Question 18

Exercise testing order

Answer 18

Resting measures
Hr
Bp
Body comp

Cardio respiratory fitness
Vo2 max/ open circuit spirometer ( research primarily)
Vo2 max estimate sub max testing

Question 19

Step test

Answer 19

CRF
Max or sub max
Ex: Queens college

Question 20

Absolute Contraindications for exercise testing 9

Answer 20

A recent change in resting ECG (ischemia/MI/cardiac event)

Unstable angina

Uncontrolled symptomatic dysrhythmias or hemodynamics compromise

Symptomatic aortic stenosis

Uncontrolled heart failure

Acute pulmonary embolus or pulmonary infarction

Acute myocarditis or pericarditis

Dissecting aneurysm

Acute systemic infection

Question 21

Relative contraindications to exercise testing 12

Answer 21

Left main coronary stenosis

Mod steno tic valvular heart disease

Electrolyte abnormalities

S bp of >200 and d bp > 110 at rest

Tachy or bradydysrythmia

Hypertrophic cardiomyopathy outflow obstruction

Musculoskeletal or nueromotor disorder exacerbated by exercise

Av block

Ventricular aneurysm

Uncontrolled metabolic disease

Chronic infection

Mental or physical impairment

Question 22

Bruce max exercise protocol

Answer 22

3 min stages

1. 7 10
2. 5 12
3. 4 14
4. 2 16
5. 0 18
6. 5 20