Week 3 - Cardiopulmonary Diseases II

Question 1

ACE inhibitors

Answer 1

cause vasodilation - limits total peripheral resistance and overall circulation of blood around periphery.

Question 1

Beta blockers

Answer 1

act on the sympathetic nervous system (slow HR) reduce the intensity of heart requirements.

Question 2

Statins

Answer 2

decrease cholesterol production (most common)
However side effects e.g nausea/headache are common

Question 3

Diuretics

Answer 3

excretion of fluid = inc BP + hypertensive responses when blood volume and plasma volume are high.
- decreased Na reabsorption = decrease in water reabsorption = increase pulling of water from tissues to be excreted = extra-cellular fluid content.

Question 4

Myocardinal Infarction

Answer 4

decrease in blood flow to the myocardium through a arterial blockage (atherosclerotic plaque rupture)

Question 5

Symptoms of myocardinal infarction

Answer 5

chest pain (dec blood flow) ‘angina’
shortness of breath
anxiety

Question 6

Treatment of myocardinal infarction

Answer 6

vasodilators - nitroglycerin, O2 treatment, defibrillation

Question 7

Chronic Heart Failure (often occurs in conjunction with MI)

Answer 7

inability for the heart to deliver adequate blood
caused by blockages, valve malfuncion, inhibited O2 delivery.

Question 8

Cardiac Valvular Disease

Answer 8

malfunction of cardiac valves (mitral + tricuspid)

Question 9

Valvular Regurgitation

Answer 9

leaflets of valves fail to close = back flow of blood = hypertrophy of cardiac tissue –> overloads ventricles –> increases chamber size, wall thickness

Question 10

Stenosis

Answer 10

leaflets fail to open properly = hypertrophy and thickening of ventricular walls = change in chamber dynamics = heart failure.

Question 11

Treatment of Cardiac Valvular Disease

Answer 11

Surgical

Question 12

Exercise Prescription for CHD + MI

Answer 12

GOAL: increase efficiency + decrease CV load
Primary goal is to increase aerobic capacity and muscular endurance –> improve ADL

Question 13

Exercise Prescription for hypertension

Answer 13

GOAL: increase caloric expenditure + general aerobic activity (work capacity)
decrease body mass
increase ME
lose subcutaneous fat + adipose tissue –> increases the elasticity of the peripheral arterial network and lowers the hypertensive system.

Question 14

Exercise Prescription for PVD

Answer 14

GOAL: increase claudication response –> develops a work response –> reduces risk of coronary artery disease CAD
increase ADL = increased QOL

Question 15

Exercise Prescription for valvular disease

Answer 15

GOAL: prevent the need for surgical intervention (dec risk of heart attack and MI

Question 16

Prescription for HD

Answer 16

Intensity: % of HR and onset of complications instead of % of MHR
RPE - important indicator if medications e.g beta blockers are used by the client

Work to rest: Intermittent 1:1

Testing & Monitoring for HD: Need to retest and continually monitor RPE + HR

Mode: Resistance training
Class 1 patients –> light lifting, multi joint exercises
Class II - IV patients –> no isometrics because of common ischemic symptoms

Question 17

Prescription for MI

Answer 17

Duration: short as soon as possible
Intensity: low, MHR should be +20b/min
Frequency: 3-4x a day
Testing & Monitoring: frequently = optimised approach to progressive overload + training
Mode: often self selected by the patient
e.g 2-3 sessions/wk of treadmill for 15-20 mins (2.5km-5km/h)
When mode is changed intensity can be changed as well. (BASED ON SYMPTOMS AND TEST RESULTS)

Question 18

Prescription for hypertension

Answer 18

Frequency: 4-7x/week
Intensity: <70% VO2 max intensity
Time: Target 30 mins
Type:
1st approach - aerobic (goal: expend 1000kj/day)
2nd approach - RT (low load, long rest, higher reps, NO Valsalva manoeuvers

Question 19

Prescription for PVD

Answer 19

Frequency: >3x/week
Intensity: 50-80% HR max associated with claudication pain
Time: 15-30 mins
Type: aerobic e.g intermittent walking usually to max claudication pain

Question 20

Prescription for heart failure

Answer 20

Frequency: 3-5 x/week
Intensity: 40-85% VO2 peak (impossible to work at high % of VO2)
Time: 20-60 mins
Type:
- cycling/walking
- resistance training - specifically single joint exercises - works on skeletal muscles more than aerobic based training would and places less strain on myocardium.
HIGH ME focus
GOAL: improve peripheral O2 kinetics –> inc ADL –> inc QOL

Question 21

Prescription for cardiac valvular disease

Answer 21

exercise is NOT a form of treatment
TREATMENT: surgical procedures to repair and replace the faulty valves
When exercise commences dynamic movements are safer than static because they improve venous return + the overall output of the CV network.
GOAL: lower the risk of MI, inc ADL, inc QOL