AHA Risk Stratification Criteria - Cardiac Rehab Lecture Flashcards

1
Q

Class A - Apparently Healthy

A

Children, adolescents, men < 45, women < 55 w/ no sx or presence of heart disease or major RFs

Men 45 or older and women 55 or older w/ no sx/presence of HD w/ < 2 major CV RFs

Men 45 or older and women 55 or older w/ no sx/presence of HD and w/ 2 or more RFs

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2
Q

Class A Guidelines

A

No activity restrictions
45-85% HRR (Karvonen)
12-16 BORG

No medical clearance required
No EKG
No supervision
Classes A2&3 should undergo medical supervision for HIGH INTENSITY exercise

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3
Q

Class B: Known Stable Cardiovascular Disease - Low Risk

A
Any of the dx:
MI
CABG
PTCA
Angina
Abnormal exercise test
Abnormal angiogram
Valve disease that is stable 

AND

NYHA classes I & II
Exercise capacity 6 METs or less (4.5mph walking)
No ischemia or angina @ rest or w/ GXT when workload < 6 METs
BP appropriately rises w/ exercise
No tachycardia @ rest
Can self-monitor activity

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4
Q

NYHA Class I

A

No limitation of physical activity

Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea

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5
Q

NYHA Class II

A

Slight limitation of physical activity

Comfortable @ rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea

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6
Q

Class B Guidelines

A

MEDICAL CLEARANCE PRIOR TO EXERCISE INITIATION
Supervised exercise program during initial sessions:
Supervised sessions by non-medical personnel after first few sessions of normal response to exercise
Can be unsupervised when person able to self-monitor
Useful to have EKG during first 6-12 sessions (to monitor rhythm)

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7
Q

Class C: Known Cardiovascular Disease - Moderate-High Risk

A
CAD
Valve disease
Congenital heart disease
Cardiomyopathy w/ EF < 30%
Dysrhythmia not well-controlled 

NYHA Class III or IV
Exercise capacity < 6 METs
Angina or ischemic ST depression @ workload 6 METs or lower
Fall in SBP w/ exercise
Non-sustained ventricular tachycardia w/ exercise
Previous cardiac arrest

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8
Q

Class C Guidelines

A

Medical clearance required
Exercise stress test
Medical supervision during sessions
ECG monitoring

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9
Q

Class D: Unstable Disease with Activity Restriction

A

Unstable ischemia
Severe valve stenosis or regurgitation
Uncompensated HF
Uncontrolled dysrhythmia

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10
Q

Class D Guidelines

A

No activity until medically cleared!

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