Week 3 - Cardiopulmonary Diseases II Flashcards
ACE inhibitors
cause vasodilation - limits total peripheral resistance and overall circulation of blood around periphery.
Beta blockers
act on the sympathetic nervous system (slow HR) reduce the intensity of heart requirements.
Statins
decrease cholesterol production (most common)
However side effects e.g nausea/headache are common
Diuretics
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.
Myocardinal Infarction
decrease in blood flow to the myocardium through a arterial blockage (atherosclerotic plaque rupture)
Symptoms of myocardinal infarction
chest pain (dec blood flow) ‘angina’
shortness of breath
anxiety
Treatment of myocardinal infarction
vasodilators - nitroglycerin, O2 treatment, defibrillation
Chronic Heart Failure (often occurs in conjunction with MI)
inability for the heart to deliver adequate blood
caused by blockages, valve malfuncion, inhibited O2 delivery.
Cardiac Valvular Disease
malfunction of cardiac valves (mitral + tricuspid)
Valvular Regurgitation
leaflets of valves fail to close = back flow of blood = hypertrophy of cardiac tissue –> overloads ventricles –> increases chamber size, wall thickness
Stenosis
leaflets fail to open properly = hypertrophy and thickening of ventricular walls = change in chamber dynamics = heart failure.
Treatment of Cardiac Valvular Disease
Surgical
Exercise Prescription for CHD + MI
GOAL: increase efficiency + decrease CV load
Primary goal is to increase aerobic capacity and muscular endurance –> improve ADL
Exercise Prescription for hypertension
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.
Exercise Prescription for PVD
GOAL: increase claudication response –> develops a work response –> reduces risk of coronary artery disease CAD
increase ADL = increased QOL
Exercise Prescription for valvular disease
GOAL: prevent the need for surgical intervention (dec risk of heart attack and MI
Prescription for HD
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
Prescription for MI
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)
Prescription for hypertension
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
Prescription for PVD
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
Prescription for heart failure
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
Prescription for cardiac valvular disease
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
