A7: EXSC 433- LILE RICKARD
Cardiac Disease Case Study [4th ed.]
Mr. CVD is a 72 year old African-American male who sustained an Ml 2 years ago. He has just moved to your city and
desires to have his cardiac rehab under your expert supervision. He has chronic heart failure [HFrEF] and has established
himself as a patient with the local cardiology group. Having retired from the Marine Corps 25 years ago, he has
maintained an active life-style particularly involving distance walking and he continues to be physically active. He
stopped smoking while in the Corps and only occasionally partakes of alcohol fie, champagne at weddings]. He has a
strong family history of Ml's on the maternal side and his mother died from an Ml at 62 years of age. He notes no current
signs/symptoms of CVD.
Other medical problems: intermittent low back pain; hypertension;
Surgeries: Right ankle — 38 years ago — injured while in the Corps — doing well;
Meds: Aspirin --- /2 tablet [325 mg] daily
1
Lisinopril - - 20 mg daily
Lasix --- 20 mg daily
Carvedilol [extended release] - - 20 mg daily
VS: HR 75, BP 118/76, RR 14
LVEF 48%, ECG ischemic threshold-135 [while on the above listed meds].
[1) Studies over the past 3 decades have documented that endurance training enables improvements in heart failure
patients both by [a.] peripheral adaptations and [b.] central hemodynamic changes. List these positive effects.
- improve skeletal muscle metabolism, improve endothelial function, and increased vasodilatory capacity and
redistribution of cardiac output
- Physical functioning, quality of life, and morbidity and mortality.
[2] Should resistance training be performed by Mr. CVD? Why or why not?
Certainly, Mr. CVD should engage in resistance training. Given that muscle loss and weakness significantly contribute to
physical dysfunction in older adults and individuals with HFrEF, the incorporation of strength training is crucial.
[3] What about HIIT for our patient?
No, because there are hesitations regarding the safety and sustained commitment to such routines. It is essential to
assess these concerns before recommending HIIT.
[4] Using the ACSM pre-participation algorithm, indicate any need for medical clearance and what level of exercise is safe
to initiate.
Medical clearance is unnecessary for moderate intensity, but it is advisable to obtain clearance before undertaking
vigorous intensity activities.
[5] What is an appropriate Bible verse that you can share with Mr. CVD?
Romans 8:18 - For I consider that the sufferings of this present time are not worth comparing with the glory that is to be
revealed to us.
[6] Describe how you would implement a "first week" exercise program (Monday through Friday) for your assigned
clinical disease case study using American College of Sports Medicine (ACSM) FITT principle guidelines for
cardiovascular, muscular strength, and flexibility exercise as it pertains to health-related fitness programming. Use the
FITT for Heart Failure. Mention any concerns that need to be monitored regarding his meds and therapy.
[#1-5 = 2 points each; #6 = 10 points]
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Strength
Push-ups
2x10
Leg Press
2x12
Shoulder
press
2x10
RDL with
KB
2x12
Quarter
squat BW
3x 25 secs
OFF OFF OFF
