Contraindications to Exercise Flashcards
(13 cards)
What are the two broad categories of contraindications to exercise in cardiac rehab?
(“List the groups of factors that can stop a session”)
- Cardiac / Medical Factors
- Practical considerations
Clinical use: Always screen both domains before every supervised or home-based session.
Name five key cardiac / medical contraindications to starting exercise.
(“Give examples of medical red flags that halt rehab today”)
- Unstable hypertension
- Left main stem coronary obstruction
- Systemic infection
- 3rd-degree heart block without pacemaker
- Acute heart failure with major symptoms (≥2 kg sudden weight gain, severe breathlessness / palpitations, unstable angina)
Immediate medical review → reschedule the class.
Why is unstable hypertension a hard stop?
(“Explain the risk of exercising with uncontrolled BP”)
- ↑ Afterload → ↑ myocardial oxygen demand
- Heightened risk of stroke / aortic dissection during exertion
- Poor BP control often signals sub-optimal meds → stabilise first
Check BP pre-class; refer to GP / cardiology if SBP > 180 mmHg or DBP > 100 mmHg at rest.
State the danger of a left main stem obstruction in rehab.
(“Why can’t we exercise LMS disease patients unsupervised?”)
- Supplies 60–70 % of LV myocardium → critical perfusion territory
- Exercise-induced tachycardia can provoke ischaemia / VF arrest
- Requires cardiology clearance ± revascularisation first
If detected on angiogram → ensure MDT sign-off before Phase 3 classes.
Why does a systemic infection contraindicate exercise?
(“What’s the pathophysiological risk?”)
- ↑ Core temperature & HR → exaggerated cardiac workload
- Cytokine surge may destabilise plaques / rhythm
- Risk of myocarditis / sepsis progression
Postpone until afebrile ≥48 h and CRP trending down.
Explain why 3rd-degree heart block without a pacemaker is prohibitive.
(“Complete AV block – what’s the issue with exercise?”)
- Ventricular escape rhythm (30-40 bpm) can’t meet metabolic demand
- High risk of syncope / sudden cardiac death under load
- Needs pacing before any structured exercise
Basic observation – check for broad QRS, dizziness history.
List the symptoms that flag acute decompensated heart failure.
(“What patient clues mean ‘no class today’?”)
- ≥ 2 kg rapid weight gain (fluid)
- Severe breathlessness at rest or mild effort
- New palpitations / arrhythmias
- Unstable angina chest pain
Document weight change trend; escalate to HF nurse.
Give two practical considerations that stop an exercise session.
(“Non-cardiac reasons we cancel?”)
- Dizziness or postural hypotension on standing (check standing BP)
- Visible signs of infection or systemic illness (fever, malaise)
Simple seated → standing BP test before treadmill start.
Define unstable diabetes as a long-term (Phase IV) contraindication.
(“When is diabetes ‘unsafe’ for unsupervised exercise?”)
- Medication changed / reviewed within last month to regain control
- Risk of unpredictable hypo-/hyperglycaemia during activity
Wait until HbA1c & self-monitoring stabilised; educate on glucose checks pre/post.
At what resting HR is tachycardia considered a contraindication?
(“Cut-off for uncontrolled tachycardia?”)
- > 100 bpm resting or uncontrolled atrial arrhythmia
Check for new AF; seek rate / rhythm control first.
Quote the BP thresholds linked to the tachycardia contraindication.
(“Resting SBP/DBP numbers that shout STOP”)
- Resting SBP > 180 mmHg OR
OR - Resting DBP > 100 mmHg
Re-measure after 5 min seated; confirm with upper-arm cuff.
What is symptomatic hypotension and why avoid exercise?
(“Explain the risk of dizzy patients”)
- Light-headedness, dizziness, fainting on standing or post-exercise
- Suggests poor autonomic / volume status → fall & perfusion risk
Hydration advice; adjust meds; reassess next session.
