ACSM CH. 2
COPD
(Pulmonary Disease) Chronic Obstructive Pulmonary Disease
HIGH-SERUM HDL CHOLESTEROL: NEGATIVE Risk Factors for Atherosclerotic Cardiovascular Disease
> or equal to 60mg*dL-1 (1.55 mmol*L-1) *Negative risk factors cancel out ONE positive risk factor.
Define: Dyspnea
Abnormally uncomfortable awareness of breathing. One of the principal symptoms of cardiac and pulmonary disease. Abnormal when it occurs at level of exertion that isn't expected to evoke this symptom. Suggests the presence of cardiopulmonary disorders.
LOW RISK: ACSM Risk Stratification categories for Atherosclerotic cardiovascular Disease
Asymptomatic men and women who have < or equal to ONE CVD risk factor from Table 2.3 (A CODFISH)
MODERATE RISK: ACSM Risk Stratification categories for Atherosclerotic cardiovascular Disease
Asymptomatic men and women who have > or equal to TWO risk factors from Table 2.3 (A CODFISH). Advisable to have med exam & exercise test before vigorous exercise.
OBESITY: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Body mass index > or equal to 30 kg * m2 or waist girth >102 cm (40 inches) for men and >88 cm (35 inches) for women
Asthma Medications
Bronchodilators
Types of CARDIOVASCULAR disease: (from Table 2.1 pg 23)
Cardiac, peripheral vascular, or cerebrovascular disease
Types of PULMONARY disease (from Table 2.1 pg 23)
Chronic obstructive pulmonary disease, asthma, interstitial lung disease, or cystic fibrosis
CIGARETTE SMOKING: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Current cigarette smoker or those who quit within the previous 6 months or exposure to environmental tobacco smoke
Medication effect on HR and BP: BETA-BLOCKER
Decreases BOTH HR and BP
Types of METABOLIC DISEASE (from Table 2.1 pg 23)
Diabetes mellitus (type 1, type 2), thyroid disorders, renal, or liver disease
Hypertensive Medications / Blood Pressure Control
Diuretics Beta-blockers ACE inhibitors Calcium channel blockers Nitrates
Define: Paroxysmal Nocturnal Dyspnea
Dyspnea (abnormally uncomfortable awareness of breathing), beginning usually 2-5 hrs after onset of sleep. May be relieved by sitting on side of bed or getting out of bed.
PREDIABETES or IMPAIRED GLUCOSE: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Impaired fasting glucose (IFG) = fasting plasma glucose > or equal to 100 mg*dL-1 (5.50 mmol*L-1) but <126 mg*dL-1 (6.93 mmol*L-1) OR impaired glucose tolerance (IGT) = 2-hr values in oral glucose tolerance test (OGTT) > or equal to 140 mg*dL-1 (7.70 mmol*L-1) BUT <200 mg*dL-1 (11.00 mmol*L-1) confirmed by measurements on at least two separate occasions
HIGH RISK: ACSM Risk Stratification categories for Atherosclerotic cardiovascular Disease
Individuals who have know cardiovascular, pulmonary or metabolic disease OR one or more signs and symptoms listed in Table 2.2. *Med. exam should be done & clearance given before PA or exercise at any intensity.
SYNCOPE (One of the nine major signs/symptoms of CVD, Pulmonary, or Metabolic Disease)
Loss of consciousness. Dizziness/syncope during exercise may result from cardiac disorders that prevent the normal rise in cardiac output.
DYSLIPIDEMIA: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Low-density lipoprotein (LDL-C) cholesterol > or equal to 130 mm*dL-1 (3.37 mmol*L-1) OR high-density lipoprotein (HDL-C) cholesterol <40 mg*dL-1 (1.04 mmol*L-1) OR on lipid -lowering medication. If total serum cholesterol is all that is available use > or equal to 200 mg*dL-1 (5.18 mmol*L-1)
Medication effect on HR and BP: ACE INHIBITORS
Lowers BP
Medication effect on HR and BP: CALCIUM CHANNEL BLOCER
Lowers BP
Medication effect on HR and BP: Diuretics
Lowers BP
Medication effect on HR and BP: NITRATE
Lowers BP
AGING: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Men > or equal to 45 yr Women > or equal to 55 yr
FAMILY HISTORY: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Myocardial infarction, coronary revascularization, or sudden death before 55 yr of age in father or other male first-degree relative, or before 65 yr of age in mother or other female first-degree relative
SEDENTARY LIFESTYLE: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Not participating in at least 30 min of moderate intensity (40%-60% VO2R) physical activity on at least three days of the week for at least three months
Define: Orthopnea (one of the 9 major signs/symptoms of CVD, pulmonary, or metabolic diseases)
Orthopnea = dyspnea occurring at rest in the recumbent position that is relieved promptly by sitting upright or standing.
Nine Signs/Symptoms (of CVD, Pulmonary, Metabolic diseases) Mnemonic PSDOEPCHF
Plants Shoot Donuts Once Embarrassing Potatoes Create Hairy Faces
Medication effect on HR and BP: BRONCHODILATORS
Raises HR AND BP
Medication effect on HR and BP: NICOTINE* (not a med, but what how does it affect HR and BP?)
Raises HR AND BP
Medication effect on HR and BP: THYROID MEDS
Raises HR and BP
Cholesterol Lowering Medications
Statins (Lipitor, Zocor, Provachol) *a defining criteria for Hypertension
HYPERTENSION: Positive Risk Factors for Atherosclerotic Cardiovascular Disease
Systolic blood pressure > or equal to 140 mm Hg and/or diastolic > or equal to 90 mm Hg, confirmed by measurements on at least two separate occasions, or on antihypertensive medication
Define: Palpitations
Unpleasant awareness of the forceful or rapid beating of the heart. May be induced by various disorders of cardiac rhythm.
Intermittent claudication
claudication = a limp or lameness Refers to the pain that occurs in a muscle with an inadequate blood supply that is stressed by exercise. Pain doesn't occur with standing or sitting, is reproducible from day to day, is more severe when walking upstairs or uphill, often described as a cramp that disappears w/in 1-2 min. after stopping exercise. Coronary artery disease is more prevalent in persons with intermittent claudication. Patients with diabetes are at increased risk for this condition.
NINE major signs or symptoms suggestive of Cardiovascular, Pulmonary, or Metabolic disease (Table 2.2, pg 26)
1. Pain, discomfort in the chest, neck, jaw, arms, or other areas that may result from ischemia 2. Shortness of breath at rest or with mild exertion 3. Dizziness or syncope (loss of consciousness) 4. Orthopnea or paroxysmal nocturnal dyspnea 5. Ankle edema 6. Palpitations or tachycardia 7. Intermittent claudication 8. Known heart murmur 9. Unusual fatigue or shortness of breath with usual activities
Thyroid Medications
Thyroid hormone medicine
