Discussion 1: Health History & Contradictions to Exercise Testing Flashcards Preview

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Flashcards in Discussion 1: Health History & Contradictions to Exercise Testing Deck (13):
1

What is the first step when an individual is referred for an exercise test?

Obtain a health history to identify safety and procedural concerns

2

What are the primary exceptions that predispose individuals to not benefitting from exercise?

People w/ unstable, undiagnosed, or untreated diseases of the cardio-respiratory or metabolic systems

3

What is the goal of a pre-exercise medical history?

  • To detect the presence of unstable, undiagnosed, or untreated diseases of the cardio-respiratory or metabolic systems
  • Identify any other physical impairments that may modify how you proceed w/ exercise testing

4

What are you looking for when taking a health history for exercise testing and prescription?

  • Signs or symptoms of CV disease
  • Risk factors of CV disease
  • Contraindications to exercise testing

5

Characterize each risk stratification category.

  • Low risk: no symptoms,
  • Moderate risk: no symptoms, > 2 risk factors
    • Okay for low to moderate intensity exercise
    • Needs medical clearance for vigorous exercise
  • High risk: known CV disease or has symptoms
    • Needs medical clearance for any exercise

6

What does it mean for an individual to have a relative contraindication?

Individual can participate in exercise testing if it's determined that the potential benefits from info gained from test outweigh the potential risks of participating in the test

7

What does it mean for an individual to have an absolute contraindication?

Individual should not participate in an exercise test at all until the condition is resolved

8

What is informed consent?

Individual needs to be fully informed and they need to willingly give full consent

9

List the risk factors for CV disease.

  • Age:
    • Men > 45 years old
    • Women > 55 years old
  • Fam history of heart probs, sudden death of male 1st deg relative < 55 years old or female relative < 65 years old
  • Cigarette smoking
    • Current smoker
    • Quit w/in previous 6 months
  • Sedentary lifesyle: not doing at least 30 mins moderate intensity exercise at least 3 days/week for at least 3 months
  • Obesity: BMI > 30 kg m2
  • Hypertension: SBP > 140 and/or DBP > 90
  • Dyslipidemia
  • Prediabetes

10

List the major signs and symptoms suggestive of CV, pulmonary, or metabolic disease.

  • Pain, disconfort in chest, neck, jaw, arms
  • Shortness of breath at rest or w. mild exertion
  • Dizziness or syncope (temp loss of consciousness b/c fall in BP)
  • Difficulty or labored breathing
  • Ankle edema
  • Abnormally rapid HR
  • Intermittent claudation (limping b/c inadequate blood supply to muscle)
  • Heart murmur
  • Unusual fatigue or shortness of breath w/ usual activities

11

List the absolute contraindications to exercise testing.

  • A recent, significant change in the resting ECG suggesting significant ischemia, recent myocardial infarction, or other acute cardiac event
  • Unstable angina
  • Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
  • Symptomatic severe aortic stenosis
  • Uncontrolled symptomatic heart failure
  • Acute pulmonary embolus or pulmonary infarction
  • Acute myocarditis or pericarditis
  • Suspected or known dissecting aneurysm
  • Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands

12

List the relative contraindications to exercise testing.

  • Left main coronary stenosis
  • Moderate stenotic valvular heart disease
  • Electrolyte abnormalities
  • Severe arterial hypertension at rest
  • Tachydysrhythmia or bradydysrhythmia
  • Hypertrophic cardiomyopathy and other forms of outflow tract obstruction
  • Neuromotor, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise
  • High-degree AV block
  • Ventricular aneurysm
  • Uncontrolled metabolic disease (diabetes)
  • Chronic infectious disease (HIV)
  • Mental or physical impairment leading to inability to exercise adequately

13

What is special about HDL as a risk factor for CVD?

If above 40 --> subtract one risk factor