Chapter 6

Question 1

What is low, moderate, and high risk? When is a doctor’s clearance needed?

Answer 1

Low risk: asymptomatic, < 2 risk factors. (no doctor approval required)

Moderate risk: 2+ risk factors, asymptomatic. (doctor clearance required only BEFORE vigorous activity)

High risk: symptomatic of or known any cardiovascular, pulmonary, renal, or metabolic disease. (doctor clearance required for EVERYTHING: before, during, and after both light and vigorous activity

Question 2

What are the 8 positive risk factors? What is the 1 negative risk factor?

Answer 2

1. Age: men 45+, women 55+
2. Family history: 1st degree male (before age 55) relative or 1st degree female (before age 65) relative, dying from myocardial infarction, coronary revascularization, or sudden death.
3. Cigarette smoking: current, quit within 6 months, or exposure to 2nd hand smoke.
4. Sedentary: not doing 30 min day, 3 times a week, 3 months.
5. Obesity: 30+ BMI, waist girth men 40” (102 cm)/women 35” (88 cm).
6. Hypertension: Systolic 140+ and/or Diastolic 90+.
7. Dyslipedemia: LDL 130+, HDL less than 40, total 200+.
8. Prediabetes - Fasting glucose 100+.

NEGATIVE RISK FACTOR:

1. HDL 60+ mg/dl.

Question 3

What symptoms are considered “symptomatic” when it comes to risk stratification?

What are two metabolic diseases?

Answer 3

1. Pain/tightness/discomfort in the chest (angina), neck, jaw (ischemia), arms, etc.
2. Claudication - pain sensations or cramping, usually in the lower extremity.
3. Dizziness/syncope.
4. Unusual fatigue.
5. Numbness in face.
6. Dyspnea/orthopnea - shortness of breath at rest or mild exertion, while standing or lying down.
7. Known heart murmur
8. Palpitations/tachycardia.
9. Ankle edema - swelling in the foot.

Two metabolic diseases: diabetes type 2, and thyroid disorders.