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Health Related Exercise Prescription > Topic 10 (Cardiac Rehab) > Flashcards

Topic 10 (Cardiac Rehab) Flashcards

1
Q

Risk Factors for Heart Disease:
Modifiable:
1) smoking
2) obesity
3) physical __________
4) diet
5) drug/alcohol abuse
6) stress
7) __
8) Diabetes
Nonmodifiable
1) ___
2) ___
3) race
4) _____ history

A

3) inactivity
7) BP
1) age
2) sex
4) family

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2
Q

Lifestyle changes to reduce risk of Hypertension (HTN)
1) lower weight
2) lower ____ intake
3) lower alcohol intake
4) exercise
Lifestyle changes to reduce risk of Smoking
1) ________ to combat the desire

A

2) salt
1) exercise

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3
Q

BP monitoring at rest
Optimal: <___/<__
HTN stage 1: ___-139/ __-89
HTN stage 2: >=___/>=__
Emergency: >= 180/>=120

A

<120/<80
130-139/80-89
>=140/>=90

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4
Q

Atherosclerosis: buildup of ______ in the arteries
Can lead to MI (_____ attack), CVA (_____), Peripheral artery disease, CAD (Coronary artery disease)
Atherosclerosis begins in _________, but it can be ________

A

plaque
heart
stroke
childhood, reversed

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5
Q

Peripheral Artery Disease (PAD):
Atherosclerosis in the ____ and ____ arteries. Can lead to intermittent claudication (also called ________) due to oxygen ______ exceeding oxygen ______. People with this disease need frequent ____ breaks.

A

arms and legs
cramping
demand, supply
rest

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6
Q

Physiological Consequences of Coronary artery disease (CAD):
- myocardial tissue (the heart) depends on O2
- Blockage causes a supply-demand mismatch
- The _____________ of the heart suffers first
- The ____ ventricle cannot pump blood effectively; these changes precede any ________ of pain or ECG changes)
-ECG: electrocardiogram - records the electrical activity of the heart

A

contractility
left
symptoms

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7
Q

Angina - _____ pain caused by insufficient O2 to the heart muscle.
Silent ischemia - ECG changes indicate inadequate O2 to the heart, but not angina

A

chest

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8
Q

Common Procedures
- Percutaneous Coronary Intervention (PCI): non-surgical procedure to open narrowed or blocked coronary arteries. _______ angioplasty widens the artery, followed by a stent to keep it open. Short period of bed rest or taking it easy necessary.

A

Balloon

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9
Q

Common Procedures Continued
- Coronary Artery Bypass Graft: The heart is exposed, so sternal precautions are necessary. Must not lift more than _lbs, arms should not reach above ________ height, and arms should not reach ______ the body. These precautions will be followed for roughly _ months.

A

5lbs, shoulder, behind
2

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10
Q

Common Procedures Continued
- Pacemaker: must be careful with arm movement for roughly _ months, electric stimulation precautions must be taken
-Exercise after pacemaker: many pacers only pace the ventricles, thus fixing __. Intensity must be set using modified Karvonen formula (substituting systolic BP for HR); warmups and cool-downs should be ________; O2 consumption & HR no longer have a ______ relationship.

A

2
HR
extended
linear

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11
Q

Common Procedures Continued
- Heart Transplant: lengthy ___ rest required, take immunosuppressive drugs, Tachycardia (heart beats ______ than normal) at rest, intensity should be based on _______.

A

bed
faster
testing

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12
Q

Heart Transplants
- Need to monitor __
- Use ___ to set intensity
- Increase ____-__ and ____ ____ time
- Aerobic exercise - days/wk
- Increase from 15-60 mins per bout gradually
- Wait at least _ months, or when sternal precautions are lifted to begin low resistance training: - days/wk, emphasis on _________ properly, and proper technique)

A

BP
RPE
warm-up and cool down
4-6
2
2-3, breathing

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13
Q

Heart Failure
- Loss of myocardial contractility leads to reduced __
- Causes of heart failure: CAD, cardiomyopathy, hypertension, valvular heart disease

A

CO

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14
Q

Symptoms of Heart Failure
- Edema: peripheral - _____ ventricle cannot pump effectively. Leads to the accumulation of _____ in the body, the body has a _______ look. Pulmonary - ____ ventricle cannot pump effectively, leading to accumulating fluid in the _____. Both right and left ventricle heart failure leads to dyspnea (shortness of ______, fatigue, and exercise intolerance. The ______ (laying down) position should be avoided.

A

right
fluid
swollen
left
lungs
breath
supine

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15
Q

Joseph Myers et al. - for every 1 MET increase in functional capacity, there was a 12% increase in ________ rates. Takeaway: the #1 predictor of death in heart failure population is ________ capacity.

A

survival
exercise

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16
Q

Congestive Heart Failure
Criteria needed to begin exercise: speak without _______ (shortness of breath), exercise capacity > _ METS, RR (respiratory rate or breaths per min) < 30, < moderate fatigue, resting HR < ___. Overall Goal: improve ________ capacity in a safe fashion.

A

dyspnea
>3
<120
exercise

17
Q

Congestive Heart Failure Continued
- warm-up & cool down should be extended to __-__ min
- training should start at 10-20 min total (2-6 min work followed by 1-2 min rest)
- Gradually increase to __-__ min sessions, 3-7 days/wk, 40-75% VO2max
- Avoid _________ contractions and ______ position
- Focus on increasing ____ first, then intensity
- emphasis on elevating the head while sleeping, monitoring weight in the morning (1 day >= 2 lb, 1 week >= 5 lb gain)

A

10-15
20-40
isometric, supine
time

18
Q

Angina & Exercise
- Exercise only if angina is stable/predictable
- Special considerations: warm-up and cool down should be _______, THR (______ heart rate) should be at least 10 beats below that with angina, monitoring until person can self-monitor. Overall goal - improve intensity

A

longer
target

19
Q

Acute Myocardial Infarction (_____ Attack)
- People are mobilized early
- Special considerations: no angina or signs of poor perfusion)
Overall goals - they have an appropriate ________ response (such as BP, HR) while inpatient (in the hospital), reduced risks of another heart attack while outpatient (discharged from the hospital).

A

Heart
exercise

20
Q

Emergency Signs
For Stroke (lack of blood to the _____): dizziness, sudden weakness/numbness, loss of ______ or ability to understand others, loss of vision, sudden severe headache.
For Heart Attack: _____ and upper body discomfort, shortness of breath, cold sweat, nausea, or light headedness

A

brain
speech
chest

21
Q

When to stop exercise (when any of these apply)
1) Angina
2) SBP > ___
3) DBP > ___
4) Plateau or decrease in SBP
5) unusual HR response
6) ECG ischemia (electrocardiogram suggests that the heart isn’t getting enough blood and O2)
7) Increase in arrhythmias (irregular heart beat)
8) signs/symptoms of intolerance to exercise
9) mental confusion, dizziness
10) cold sweat, ataxia (hard to control muscle movements)
If any of these signs are shown, exercise should be stopped ______, then contact a medical professional.

A

2) > 250
3) > 110
slowly

22
Q

Exercise Testing
- days after MI (heart attack) for a ______ test, >2 weeks for a max test
-Determine the severity and prognosis (predicting the development are likelihood of disease)
- job or exercise clearance
- Assess the situation after cardiac event (gotten better, worsened?)

A

4-6, submax

23
Q

Terminate Exercise Testing (if one criteria applies)
1) Angina (_____ pain)
2) SBP drops by __ mmHg, or no rise in SBP
3) SBP > ___ mmHg, or DBP > ___ mmHg
4) poor perfusion
5) no increase in __ with increased intensity
6) irregular change in _____ rhythm
7) subject wishes to stop
8) severe fatigue
9) instrument failure

A

1) chest
2) 20
3) > 260, > 115
5) HR
6) heart

24
Q

If Exercise Testing Cannot Occur
- Start with THR (______ heart rate) of 20 bpm over resting
- start training at - METs
- Increase by 0.5-1 METs as tolerated
- Monitor RPE and ECG

A

target
2-3

25
Q

Cardiac Rehab Definition
- Exercise training for patients with ______________ disease, or after suffering a _____ _____ or heart surgery.
4 Phases of Cardiac Rehab
1) _________
2) __________ with monitoring
3) __________ with intermittent monitoring
4) __ monitoring needed, limited supervision

A

cardiovascular
heart attack
1) inpatient
2) outpatient
3) outpatient
4) no

26
Q

Phase 1 Cardiac Rehab
1) Intensity
- RPE <= __
- Post MI HR <= 120 or HR at rest + 20 (dictated by medical doctor)
- Post surgery HR at rest +30
- Must be asymptomatic
2) Duration
- - minutes of work, followed by rest
- total of __-__ per session
3) Frequency
- Days 1-3: 3-4 bouts/day, Days 4+: 2 bouts/day
4) Progression
- ________ should be increased before _________

A

1) <=13
2) 3-5, 10-15
4) duration, intensity

27
Q

Phase 2 Cardiac Rehab
1) Intensity
- High enough for training effect without symptoms
- RPE __-__
- Target heart rate 40-60% HRR based on exercise test
2) Frequency
- - times/wk at minimum
3) Duration
- 20-60 minutes
4) Progression
- Increase every - weeks
-Do __-__ minutes of continuous exercise prior to increasing intensity

A

1) 12-14
2) 3-5
4) 1-3, 20-30

28
Q

Phases 3-4 Cardiac Rehab
1) Intensity
- RPE __-__
-Target heart rate 40-80% HRR
2) Progression
- Same as phase 2

A

1) 12-16

29
Q

Cardiac Rehab Resistance Training
1) Intensity
- 10-15 reps, 1-3 sets, _-__ different exercises
- __-__% 1 rep max
- Watch for signs & symptoms
2) Frequency
- - times/week

A

1) 8-10, 40-60%
2) 2-3

30
Q

When to reevaluate cardiac rehab
- goals are achieved
- _______ status is changed (ex. medications)

A

medical

31
Q

Grouping of Endurance Activities
- Different from cardiac rehab phases, way to classify mode/type
Group 1: ________ intensity, low variation in energy expenditure, trainer has precise control (ex. stationary bike, walking)
Group 2: rate of expenditure related to _____, individual intensity remains ________, useful in early cardiac rehab (ex. elliptical)
Group 3: skill and intensity vary, useful for group interaction and variety, cautious in high-risk/low-fit/or symptomatic individuals (ex. basketball)

A

constant
skill, constant

32
Q

ACSM Contraindications to Cardiac Rehab (not safe exercising for the day)
1) unstable angina
2) Resting SBP > ___, resting DBP > ___
3) orthostatic hypertension
4) uncontrolled blood glucose
5) fever/illness
6) recent embolism
7) HR > ___ bpm

A

2) >180, >110
7) > 120

33
Q

Common Medications
1) ACE inhibitor: opens up the vessels (lower TPR), thus lowering __
2) Beta Blockers: lowers __, contractility, and SBP
3) Diuretics: decreases blood ______, lowers HR, may cause electrolyte imbalances

A

1) BP
2) HR
3) volume

34
Q

Brewer et al: assessing the effectiveness of _______ cardiac rehab (feasible and may increase accessibility to those with higher CV risk)
Bassett et al: despite the benefits of cardiac rehab, utilization rates are still low due to a number of factors: patients aren’t informed, ease of access, etc. Patients seem to have more interest in private practice and ___-based programs

A

virtual
home

35
Q

Exercise Prescription for HTN Individuals
- Must have SBP <= ___, DBP <= ___ to exercise; exercise test prior may be warranted

A

<= 220, <= 105

Health Related Exercise Prescription (20 decks)

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