Introduction to Cardiac Rehabilitation and CVD Overview

What does CVD stand for and what does it encompass?

CVD stands for Cardiovascular Disease, which includes conditions affecting the heart and blood vessels such as heart attacks, strokes, arrhythmias, and hypertension.

Why is CVD significant in public health?

CVD is the leading cause of death in the US, highlighting the importance of prevention and treatment strategies.

What is Coronary Artery Disease (CAD)?

CAD is the blockage of coronary arteries that supply blood to the heart muscle, leading to ischemia and potential heart attacks.

What are some risk factors for Coronary Artery Disease?

Risk factors include high cholesterol, smoking, hypertension, and diabetes.

What is the difference between a heart attack and cardiac arrest?

A heart attack occurs when an artery is blocked, preventing blood flow to the heart muscle, while cardiac arrest is an electrical malfunction of the heart that stops it from beating effectively.

What was the Framingham Heart Study and its significance?

Initiated in 1948, the Framingham Heart Study significantly contributed to understanding CVD risk factors and prevention.

What are the phases of cardiac rehabilitation?

Phase 1: Acute phase with inpatient monitoring; Phase 2: Sub Acute phase focusing on outpatient conditioning; Phase 3: Training and maintenance phase emphasizing ongoing exercise.

What are some symptoms suggestive of cardiovascular, pulmonary, or metabolic disease?

Symptoms include anginal pain, shortness of breath at rest or with mild exertion, dizziness/syncope, orthopnea, ankle edema, palpitations, intermittent claudication, known heart murmur, unusual fatigue, or shortness of breath with usual activities.

What is atherosclerosis?

Atherosclerosis is the thickening of the internal layer of blood vessel walls due to lipid accumulation, leading to reduced blood flow.

What are fatty streaks and plaques in relation to atherosclerosis?

Fatty streaks are early signs of atherosclerosis consisting of lipid deposits in arterial walls, while plaques are buildups of fats, cholesterol, and other substances in arteries leading to blockages.

What is myocardial ischemia and angina?

Myocardial ischemia is insufficient blood flow to the heart muscle, causing pain due to lack of oxygen; angina is chest pain resulting from ischemia, which can be stable (predictable) or unstable (acute).

What is a myocardial infarction?

A myocardial infarction occurs when a portion of the heart muscle dies due to prolonged ischemia, often caused by thrombus or severe atherosclerosis.

What percentage of myocardial infarctions are asymptomatic?

30% of myocardial infarctions are asymptomatic, making awareness of risk factors crucial for prevention.

What are thrombolytic events?

Thrombolytic events involve blood clots that can lead to serious complications like a pulmonary embolism.

What is congestive heart failure and how is it classified?

Congestive heart failure can be classified into diastolic and systolic types, with various stages from acute to chronic.

What is the ventilation process in the respiratory system?

Air enters through the trachea, branches into bronchi and bronchioles, and reaches the alveoli, where gas exchange occurs.

Why are alveoli important in the respiratory system?

Alveoli have the largest blood supply, facilitating efficient oxygen and carbon dioxide exchange.

What is tidal volume?

Tidal volume is the amount of air inhaled or exhaled during normal breathing.

What is Inspiratory Reserve Volume?

The additional volume of air that can be inhaled with effort.

What is Expiratory Reserve Volume?

The additional volume of air that can be exhaled with effort.

What is Total Lung Capacity?

The sum of all lung volumes, crucial for assessing respiratory health.

What imaging tests are commonly used to diagnose pulmonary diseases?

X-Rays and CT scans.

What do pulmonary function tests measure?

Lung capacity and airflow, helping diagnose conditions like asthma and COPD.

What is the purpose of a Chest X-Ray?

To visualize the lungs and detect abnormalities such as infections, tumors, or fluid accumulation.

What does a Chest CT provide?

Detailed cross-sectional images of the lungs.

What is the function of an Echocardiogram?

An ultrasound of the heart that assesses heart function and structure.

What does Spirometry measure?

Lung function, specifically the volume and flow of air during inhalation and exhalation.

What is Oximetry?

A noninvasive method to measure blood oxygen saturation, important for assessing respiratory efficiency.

What are non-modifiable risk factors for pulmonary disease?

Age and gender; men over 45 and women over 55 are at higher risk.

How does race affect the likelihood of heart disease in Black/African Americans?

They are 30% more likely to die from heart disease and are 2x more likely to have a stroke.

What characterizes Obstructive Pulmonary Disease?

Difficulty in expelling air from the lungs, leading to air trapping; includes conditions like COPD and asthma.

What is Asthma?

A chronic condition that typically begins in childhood, characterized by inflammation and narrowing of the airways.

What characterizes Restrictive Pulmonary Disease?

Conditions that restrict lung expansion, resulting in reduced blood volume; examples include interstitial lung disease and obesity.

What is the difference between Obstructive and Restrictive diseases?

Obstructive diseases are flow problems (difficulty getting air out), while restrictive diseases are volume problems (difficulty getting air in).

What is COPD?

A progressive disease with no cure, primarily caused by smoking, leading to chronic bronchitis and emphysema.

What is the purpose of Pulmonary Rehabilitation?

To improve quality of life for individuals with chronic respiratory diseases.

What are the goals of Pulmonary Rehabilitation?

To reduce symptoms, optimize functional status, increase participation in daily activities, and reduce healthcare costs.

What components are included in Pulmonary Rehabilitation?

Exercise training, education on lung health, and nutritional counseling.

What are the blood pressure thresholds for hypertension?

Systolic BP > 130 mmHg and Diastolic BP > 80 mmHg.

What are the cholesterol thresholds for dyslipidemia?

LDL > 130 mg/dL and HDL < 40 mg/dL.

What is the recommended LDL level for individuals with CAD or diabetes?

LDL should be at 100 or lower.

What are the components of exercise training for lung health?

Includes exercise training, education on lung health, and nutritional counseling.

What is the recommended level of triglycerides for health?

Less than 200 mg/dL.

What is the significance of increased LDL levels?

Increased LDL is associated with increased incidence of coronary artery disease (CAD).

What is the BMI threshold for obesity?

BMI greater than 30 kg/m².

What waist girth measurements indicate increased cardiovascular risk?

Waist girth greater than 102 cm for men and greater than 88 cm for women.

What is considered a normal BMI range?

Normal BMI is between 18.5 and 24.9.

What are noninvasive tests for cardiovascular evaluation?

Include resting ECGs, Holter monitoring, and echocardiograms.

What is the purpose of stress testing in cardiac evaluation?

Evaluates heart function under stress and identifies potential ischemic changes.

What does the Ankle Brachial Index test assess?

It assesses peripheral artery disease by comparing blood pressure in the ankle and arm.

What is the definition of action potential in cardiac cells?

The electrical membrane potential of a cell that rapidly rises and falls.

What is the role of myocytes in the heart?

Myocytes are cardiac muscle cells that make up the muscular walls of the atria and ventricles.

What are non-modifiable risk factors for cardiovascular disease (CVD)?

Include age, gender, family history, and ethnicity.

What are some modifiable risk factors for CVD?

Lifestyle choices such as obesity, smoking, and lack of exercise.

What is automaticity in cardiac function?

The spontaneous generation and discharge of electrical impulses.

What is the significance of the P wave in an ECG?

Represents atrial systole, where blood is forced into the ventricles.

What does the QRS complex indicate in an ECG?

Represents ventricular contraction, pushing the AV valves closed.

What occurs during isovolumetric relaxation in the cardiac cycle?

All heart valves are closed, and pressure in the pulmonary artery and aorta exceeds that in the ventricle.

What happens during ventricular diastole?

Semilunar valves close and blood flows to the atria.

What are arrhythmias and why are they important?

Arrhythmias are irregular heartbeats, such as sinus bradycardia and tachycardia, and understanding them is vital for cardiac health.

What is the role of the cardiac pacemaker?

It is part of the conduction system that regulates heart rhythm.

What does the term 'conductivity' refer to in cardiac cells?

The ability to transmit electrical impulses from one cell to the next.

What is the purpose of preventative measures in CVD?

Lifestyle changes that can reduce the risk of developing cardiovascular disease.

What are the indications for cardiovascular testing?

To diagnose cardiovascular conditions and assess exercise tolerance.

What pre-test considerations should be taken into account?

Patient instructions regarding food, medications, and physical readiness.

What is the difference between absolute and relative contraindications in testing?

Absolute contraindications prevent testing under any circumstances, while relative contraindications may allow testing with caution.

What are two common testing protocols used in cardiovascular testing?

Bruce and Balke protocols, chosen based on patient fitness level and clinical conditions.

What monitoring is essential during cardiovascular testing?

Continuous ECG and blood pressure monitoring to detect abnormalities during exercise.

What is the primary function of diuretics in cardiovascular management?

To treat hypertension (HTN) and heart failure by promoting sodium and water excretion.

How do beta blockers assist in managing cardiovascular conditions?

They reduce heart rate and contractility, effective for managing angina and arrhythmias.

What is the role of calcium channel blockers in cardiovascular treatment?

They manage hypertension and angina by relaxing blood vessels and reducing heart workload.

What do ACE inhibitors do in cardiovascular management?

They lower blood pressure and reduce heart failure symptoms.

What is the function of ARBs in cardiovascular treatment?

They prevent angiotensin II from binding to receptors, promoting vasodilation.

What is the purpose of anticoagulants in cardiovascular care?

To prevent thromboembolic events in patients with atrial fibrillation and other conditions.

What are common side effects of cardiovascular medications?

Dizziness, fatigue, and gastrointestinal issues, which can affect patient compliance.

What monitoring requirements are necessary for medications like anticoagulants?

Regular blood tests may be necessary.

Why is patient education important in cardiovascular management?

To inform patients about potential side effects and the importance of adherence to medication.

What are the characteristics of an athlete's heart?

Ventricular hypertrophy, enhanced cardiac output, lower resting heart rate, and improved vasovagal tone.

What ECG changes might indicate an athlete's heart?

First-degree AV block, left ventricular hypertrophy by voltage, and tall T waves.

What is commotio cordis?

A condition caused by blunt chest impact over the heart, requiring precise timing of the blow.

What are the guidelines for resistance training post-myocardial infarction (MI)?

Minimum of 5 weeks post-MI or surgery, with 4 weeks of consistent participation in cardiac rehabilitation.

What are the recommended exercise guidelines for cardiovascular patients?

RPE of 11-13, 12-15 reps comfortably, increase by 5%, avoid straining, and exercise 2-3 days/week.

What conditions are contraindicated for resistance training?

Uncontrolled dysrhythmias, severe valvular disease, uncontrolled hypertension, and unstable symptoms.