Topic 10 (Cardiac Rehab) Flashcards
(35 cards)
Risk Factors for Heart Disease:
Modifiable:
1) smoking
2) obesity
3) physical __________
4) diet
5) drug/alcohol abuse
6) stress
7) __
8) Diabetes
Nonmodifiable
1) ___
2) ___
3) race
4) _____ history
3) inactivity
7) BP
1) age
2) sex
4) family
Lifestyle changes to reduce risk of Hypertension (HTN)
1) lower weight
2) lower ____ intake
3) lower alcohol intake
4) exercise
Lifestyle changes to reduce risk of Smoking
1) ________ to combat the desire
2) salt
1) exercise
BP monitoring at rest
Optimal: <___/<__
HTN stage 1: ___-139/ __-89
HTN stage 2: >=___/>=__
Emergency: >= 180/>=120
<120/<80
130-139/80-89
>=140/>=90
Atherosclerosis: buildup of ______ in the arteries
Can lead to MI (_____ attack), CVA (_____), Peripheral artery disease, CAD (Coronary artery disease)
Atherosclerosis begins in _________, but it can be ________
plaque
heart
stroke
childhood, reversed
Peripheral Artery Disease (PAD):
Atherosclerosis in the ____ and ____ arteries. Can lead to intermittent claudication (also called ________) due to oxygen ______ exceeding oxygen ______. People with this disease need frequent ____ breaks.
arms and legs
cramping
demand, supply
rest
Physiological Consequences of Coronary artery disease (CAD):
- myocardial tissue (the heart) depends on O2
- Blockage causes a supply-demand mismatch
- The _____________ of the heart suffers first
- The ____ ventricle cannot pump blood effectively; these changes precede any ________ of pain or ECG changes)
-ECG: electrocardiogram - records the electrical activity of the heart
contractility
left
symptoms
Angina - _____ pain caused by insufficient O2 to the heart muscle.
Silent ischemia - ECG changes indicate inadequate O2 to the heart, but not angina
chest
Common Procedures
- Percutaneous Coronary Intervention (PCI): non-surgical procedure to open narrowed or blocked coronary arteries. _______ angioplasty widens the artery, followed by a stent to keep it open. Short period of bed rest or taking it easy necessary.
Balloon
Common Procedures Continued
- Coronary Artery Bypass Graft: The heart is exposed, so sternal precautions are necessary. Must not lift more than _lbs, arms should not reach above ________ height, and arms should not reach ______ the body. These precautions will be followed for roughly _ months.
5lbs, shoulder, behind
2
Common Procedures Continued
- Pacemaker: must be careful with arm movement for roughly _ months, electric stimulation precautions must be taken
-Exercise after pacemaker: many pacers only pace the ventricles, thus fixing __. Intensity must be set using modified Karvonen formula (substituting systolic BP for HR); warmups and cool-downs should be ________; O2 consumption & HR no longer have a ______ relationship.
2
HR
extended
linear
Common Procedures Continued
- Heart Transplant: lengthy ___ rest required, take immunosuppressive drugs, Tachycardia (heart beats ______ than normal) at rest, intensity should be based on _______.
bed
faster
testing
Heart Transplants
- Need to monitor __
- Use ___ to set intensity
- Increase ____-__ and ____ ____ time
- Aerobic exercise - days/wk
- Increase from 15-60 mins per bout gradually
- Wait at least _ months, or when sternal precautions are lifted to begin low resistance training: - days/wk, emphasis on _________ properly, and proper technique)
BP
RPE
warm-up and cool down
4-6
2
2-3, breathing
Heart Failure
- Loss of myocardial contractility leads to reduced __
- Causes of heart failure: CAD, cardiomyopathy, hypertension, valvular heart disease
CO
Symptoms of Heart Failure
- Edema: peripheral - _____ ventricle cannot pump effectively. Leads to the accumulation of _____ in the body, the body has a _______ look. Pulmonary - ____ ventricle cannot pump effectively, leading to accumulating fluid in the _____. Both right and left ventricle heart failure leads to dyspnea (shortness of ______, fatigue, and exercise intolerance. The ______ (laying down) position should be avoided.
right
fluid
swollen
left
lungs
breath
supine
Joseph Myers et al. - for every 1 MET increase in functional capacity, there was a 12% increase in ________ rates. Takeaway: the #1 predictor of death in heart failure population is ________ capacity.
survival
exercise
Congestive Heart Failure
Criteria needed to begin exercise: speak without _______ (shortness of breath), exercise capacity > _ METS, RR (respiratory rate or breaths per min) < 30, < moderate fatigue, resting HR < ___. Overall Goal: improve ________ capacity in a safe fashion.
dyspnea
>3
<120
exercise
Congestive Heart Failure Continued
- warm-up & cool down should be extended to __-__ min
- training should start at 10-20 min total (2-6 min work followed by 1-2 min rest)
- Gradually increase to __-__ min sessions, 3-7 days/wk, 40-75% VO2max
- Avoid _________ contractions and ______ position
- Focus on increasing ____ first, then intensity
- emphasis on elevating the head while sleeping, monitoring weight in the morning (1 day >= 2 lb, 1 week >= 5 lb gain)
10-15
20-40
isometric, supine
time
Angina & Exercise
- Exercise only if angina is stable/predictable
- Special considerations: warm-up and cool down should be _______, THR (______ heart rate) should be at least 10 beats below that with angina, monitoring until person can self-monitor. Overall goal - improve intensity
longer
target
Acute Myocardial Infarction (_____ Attack)
- People are mobilized early
- Special considerations: no angina or signs of poor perfusion)
Overall goals - they have an appropriate ________ response (such as BP, HR) while inpatient (in the hospital), reduced risks of another heart attack while outpatient (discharged from the hospital).
Heart
exercise
Emergency Signs
For Stroke (lack of blood to the _____): dizziness, sudden weakness/numbness, loss of ______ or ability to understand others, loss of vision, sudden severe headache.
For Heart Attack: _____ and upper body discomfort, shortness of breath, cold sweat, nausea, or light headedness
brain
speech
chest
When to stop exercise (when any of these apply)
1) Angina
2) SBP > ___
3) DBP > ___
4) Plateau or decrease in SBP
5) unusual HR response
6) ECG ischemia (electrocardiogram suggests that the heart isn’t getting enough blood and O2)
7) Increase in arrhythmias (irregular heart beat)
8) signs/symptoms of intolerance to exercise
9) mental confusion, dizziness
10) cold sweat, ataxia (hard to control muscle movements)
If any of these signs are shown, exercise should be stopped ______, then contact a medical professional.
2) > 250
3) > 110
slowly
Exercise Testing
- days after MI (heart attack) for a ______ test, >2 weeks for a max test
-Determine the severity and prognosis (predicting the development are likelihood of disease)
- job or exercise clearance
- Assess the situation after cardiac event (gotten better, worsened?)
4-6, submax
Terminate Exercise Testing (if one criteria applies)
1) Angina (_____ pain)
2) SBP drops by __ mmHg, or no rise in SBP
3) SBP > ___ mmHg, or DBP > ___ mmHg
4) poor perfusion
5) no increase in __ with increased intensity
6) irregular change in _____ rhythm
7) subject wishes to stop
8) severe fatigue
9) instrument failure
1) chest
2) 20
3) > 260, > 115
5) HR
6) heart
If Exercise Testing Cannot Occur
- Start with THR (______ heart rate) of 20 bpm over resting
- start training at - METs
- Increase by 0.5-1 METs as tolerated
- Monitor RPE and ECG
target
2-3
