ACSM CEP Exam Review - September 25th - 1pm. 100% Accurate. Graded A.
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Course
ACSM CEP
Institution
ACSM CEP
ACSM CEP Exam Review - September 25th - 1pm. 100% Accurate. Graded A.
Absolute Contraindications to Exercise Testing (name all 9 ) - -• A recent significant change in the resting ECG suggesting significant ischemia, recent MI (within 2 d), or other acute cardiac event
• Unstable angina
...
ACSM CEP Exam Review - September
25th - 1pm. 100% Accurate. Graded A.
Absolute Contraindications to Exercise Testing (name all 9 ) - ✔✔-• A recent significant change in the
resting ECG suggesting significant ischemia, recent MI (within 2 d), or other acute cardiac event
• Unstable angina
• Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise
• Uncontrolled symptomatic heart failure
• Acute pulmonary embolus or pulmonary infarction
• Acute myocarditis or pericarditis
• Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands
• Symptomatic severe aortic stenosis
• Suspected or known dissecting aneurysm
Relative Contraindications to Exercise Testing ( name all 12 ) - ✔✔-• Left main coronary stenosis
• Moderate stenotic valvular heart disease
• Electrolyte abnormalities (hypokalemia or hypomagnesemia)
• Severe arterial hypertension (SBP>200 mmHg and/or DBP >110 mmHg) 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, thyrotoxicosis, or myxedema)
• Chronic infectious disease (e.g. HIV)
• Mental or physical impairment leading to inability to exercise adequately
,General Indications for Stopping an Exercise Test - ✔✔-• Onset of angina or angina-like symptoms
• Drop in SBP of ≥10 mmHg with an increase in work rate or if SBP decreases below the value obtained
in the same position prior to testing
• Excessive rise in BP: SBP>250 mmHg and/or DBP>115 mmHg
• Shortness of breath, wheezing, leg cramps, or claudication
• Signs of poor perfusion: light-headedness, confusion, ataxia (loss of full control of bodily movements),
(pallor) unhealthy pale appearance, cyanosis (bluish skin color), nausea, or cold and clammy skin
• Failure of HR to increase with increased exercise intensity
• Noticeable change in heart rhythm by palpation or auscultation
• Subject requests to stop
• Physical or verbal manifestations of severe fatigue
• Failure of the testing equipment
Absolute Indications for stopping an exercise test
(7 of them) - ✔✔---ST elevation (>1.0mm) in leads without preexisting Q waves because of prior MI
(other than aVR, aVL, or V1)
--Drop in systolic blood pressure of >10 mmHg, despite an increase in workload, when accompanied by
other evidence of ischemia
-Moderate-to-severe angina
--Central nervous system symptoms (E.G., ataxia, dizziness, or near syncope)
--Signs of poor perfusion (cyanosis or pallor)
--Sustained ventricular tachycardia or other arrhythmia, including second- or third-degree
atrioventricular block, that interferes with normal maintenance of cardiac output during exercise
--Technical difficulties monitoring the ECG or systolic blood pressure
--the subject's request to stop
, Relative Indications for stopping an exercise test - ✔✔---Marked ST displacement (horizontal or down
slopping of >2mm, measured 60 to 80 ms after the J point in a patient with suspected ischemia)
-
-Increasing chest pain
-Fatigue, shortness of breath, wheezing, leg cramps, or claudication
--Arrhythmias other than sustained ventricular tachycardia, including
multifocal ectopy, ventricular triplets, supraventricular tachycardia, and bradyarhythmias that have the
potential to become more complex or to interfere wit hemodynamic stability (mean the the heart
pumps blood efficiently, good circulation).
--Development of bundle-branch block that cannot be distinguished from ventricular tachycardia
--Sp02 less than or greater (or equal???) than 80 percent
ST segment depression - ✔✔-≥1 mm of horizontal or down sloping ST↓ 60-80 ms beyond the J point
suggesting myocardial ischemia
Chronotropic incompetence - ✔✔-1. Peak exercise HR about 20 BPM below the age predicted HRmax or
an inability to achieve > 85% of the age predicted HRmax for subjects limited by volitional fatigue.
2. Chronotropic index <.8
Heart Rate Recovery - ✔✔-less than or equal to 12 BPM at 1 minute for walking, or less than or equal to
22 BPM at 2 mins for supine position
Sensitivity - ✔✔-% of pts. tested with known CVD who demonstrate significant ST segment changes.
Exercise EKG sensitivity usually requires greater than or equal to 70% stenosis
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