## ACSM CES (clinical exercise specialist)

1 MET is equal to?

3.5 ml.Kg-.min-

Cardiac output(Q) at rest is appoximatley

5L/min

Cardiac output(Q) is the product of?

Stroke volume(SV)xHeart Rate(Hr)

Predicted Heart Rate maximum formula is

220-age

Stroke volume is found by what equation?

EDV(End Diastolic Volume)-ESV(End Systolic Volume)

diastolic is relaxation phase. systolic is contraction

diastolic is relaxation phase. systolic is contraction

Heart Rate Reserve=

(MHR-RHR)%+RHR

max. HR – resting HR x percent target + resting Hr

max. HR – resting HR x percent target + resting Hr

VO2 reserve=

(vo2max-vo2rest)% + vo2rest

vo2rest= 3.5 ml.kg-.min-

vo2rest= 3.5 ml.kg-.min-

1mph= to want in m/min

26.8

1 watt=

6 kg.m.min-

1 lbs of Fat= how many Kcals

3500 Kcals

1L of consumed o2 infers how many kcal ?

5 Kcals

1 in to cm and m

2.54 cm or .0254 m

1l is how many ml?

1000ml

MAP(mean arterial pressure)=

(SBP-DBP)/3 + DBP

where SBP=sysytolic BP and DBP is diastolic

where SBP=sysytolic BP and DBP is diastolic

EF(ejection Fraction)=

(SV/EDV)x 100 = ef in % of 100

SV= stroke volume

EDV= end diastolic volume

SV= stroke volume

EDV= end diastolic volume

Double Product(Rate Pressure Product)=

SBPxHR

SBP= systolic BP

SBP= systolic BP

formula for Vo2 on leg ergometer is?

(10.8x W)/m + 7.0 or (1.8xW)/m + 7.0

where W is work rate in Watt or Kg.m.min-1 respectively

m is Mass in Kg

7.0 is a constant taking into account vertical and horizontal components of resting metabolism.

where W is work rate in Watt or Kg.m.min-1 respectively

m is Mass in Kg

7.0 is a constant taking into account vertical and horizontal components of resting metabolism.

formula for Vo2 on arm ergometer is?

(18x W)/m + 3.5 or (3.0xW)/m + 3.5

where W is work rate in Watt or Kg.m.min-1 respectively

m is Mass in Kg

3.5 is resting vo2

where W is work rate in Watt or Kg.m.min-1 respectively

m is Mass in Kg

3.5 is resting vo2

formula for Vo2 walking on a treadmill is?

(0.1xS)+(1.8xSxG)+ 3.5

S is speed in m/min

G is grade in decimal form so 10% grade is .1

S is speed in m/min

G is grade in decimal form so 10% grade is .1

formula for Vo2 running on a treadmill is?

(0.2xS)+(0.9xSxG)+ 3.5

S is speed in m/min

G is grade in decimal form so 10% grade is .1

S is speed in m/min

G is grade in decimal form so 10% grade is .1

formula for Vo2 on a step ergometer is?

(0.2xF)+(1.33×1.8xFxH)+3.5

where F is frequency in steps per min

H is height in meters

where F is frequency in steps per min

H is height in meters

Formula for finding Work rate on bike or arm ergo?

RxRPMXD

where R is the resistance on the flywheel.

RPM is Rotations per Minute

and D is the distance the flywheel travels in on revolution.

where R is the resistance on the flywheel.

RPM is Rotations per Minute

and D is the distance the flywheel travels in on revolution.

o2 carrying capacity of hemoglobin is?

~1.34 ml of O2 / gram of Hb.

~ grams of Hemoglobin per 100 ml of blood?

20 g of Hb/ 100 ml blood

formula for the Fick equation?

Vo2= Q x a-vo2 diff

where Q is cardiac output

and a-vo2 diff is the difference in arterial and venous oxygen concentration.

where Q is cardiac output

and a-vo2 diff is the difference in arterial and venous oxygen concentration.

absolute indications to terminate exercise testing are?

-drop in systolic BP > or = to 10mm Hg w/ increase work rate when -s/s present w/ the drop

-angina > or = 3/ 4 on the scale

-increasing nervous system symptoms

-signs of poor perfusion

-difficulties monitoring ECG or BP

-patient requests to terminate test

-sustained VT

-ST elevation greater than 1mm in leads w/o diagnostic Q wave (other than v1 or aVR)

-angina > or = 3/ 4 on the scale

-increasing nervous system symptoms

-signs of poor perfusion

-difficulties monitoring ECG or BP

-patient requests to terminate test

-sustained VT

-ST elevation greater than 1mm in leads w/o diagnostic Q wave (other than v1 or aVR)

relative indications to terminate exercise testing are?

-drop in systolic BP > or = to 10mm Hg w/ increase work rate not accompanied by s/s’s

-ST or QRS changes such as >2mm st depression downsloping or horizontal.

-arrhythmia other than VT(multifocal pvc’s, triplet pvc’s, SVT, high grade Heart blocks or bradycardia.

-fatigue, SOB, wheezing, claudication

-BBB or IVCD that can not be differentiated from VT ( such as new onset LBBB)

-increasing CP

-hypertensive response SBP >250 or DBP>115

-ST or QRS changes such as >2mm st depression downsloping or horizontal.

-arrhythmia other than VT(multifocal pvc’s, triplet pvc’s, SVT, high grade Heart blocks or bradycardia.

-fatigue, SOB, wheezing, claudication

-BBB or IVCD that can not be differentiated from VT ( such as new onset LBBB)

-increasing CP

-hypertensive response SBP >250 or DBP>115

absolute contraindications to exercise testing are?

-recent change in resting EKG suggestive of significant ischemia, recent MI or other acute cardiac event.

-unstable angina

-uncontrolled cardiac dysrhythmias causing symptoms.

-symptomatic severe aortic stenosis

-symptomatic Heart Failure

-acute myo- or peri- carditis

-dissecting aneurysm

-unstable angina

-uncontrolled cardiac dysrhythmias causing symptoms.

-symptomatic severe aortic stenosis

-symptomatic Heart Failure

-acute myo- or peri- carditis

-dissecting aneurysm

relative contraindications to exercise testing are?

-left main coronary stenosis

-moderate stenotic valvular heart disease

-electrolyte abnormalities

-severe arterial Htn SBP>200 DBP>110 @ rest

-tachy or brady dysrhythmias

-hypertrophic cardiomyopathy

-neuromotor, musculoskeletal, rheumatiod disorders worsened by exercise.

– High degree AV blocks

– Ventricular aneurysm

-uncontrolled metabolic disease

-Chronic infectious disease

-mental or physical impairments

-moderate stenotic valvular heart disease

-electrolyte abnormalities

-severe arterial Htn SBP>200 DBP>110 @ rest

-tachy or brady dysrhythmias

-hypertrophic cardiomyopathy

-neuromotor, musculoskeletal, rheumatiod disorders worsened by exercise.

– High degree AV blocks

– Ventricular aneurysm

-uncontrolled metabolic disease

-Chronic infectious disease

-mental or physical impairments

CVD Risk stratification as Low Risk

<2 RF and asymptomatic

CVD Risk stratification as moderate Risk

>=2 RF and asymptomatic

CVD Risk stratification as High Risk

Symptomatic or known known cardiovascular, pulmonary, renal or metabolic disease.

cardiovascular RF are?

-Age >= 45 in men; 55 in women

-Family Hx; MI, CABG, SCD before 55 yoa in men and 65 in women owith 1st degree relative.

-Smoking within 6 months or exposure to environmental (2nd hand ex. working in a Bar)

– sedentary lifestyle. <30 min of moderate intensity physical activity(40-<60%vo2R) on at least 3d/week for at least 3 months -obesity BMI >= 30kg.m^2 or waist girth >102cm in men, >88 cm in women.

– hypertension sbp >= 140 dbp >= 90 confirmed on at least 2 occasions or on BP Rx.

-Dyslipidemia ldl >= 130, hdl <40, total chol >= 200 or on cholesterol Rx.

-Prediabetes aka impaired fasting glucose. >= 100 ans <=125 HVL>= 60 is a negative RF and one positive RF can be subtracted from the total.

-Family Hx; MI, CABG, SCD before 55 yoa in men and 65 in women owith 1st degree relative.

-Smoking within 6 months or exposure to environmental (2nd hand ex. working in a Bar)

– sedentary lifestyle. <30 min of moderate intensity physical activity(40-<60%vo2R) on at least 3d/week for at least 3 months -obesity BMI >= 30kg.m^2 or waist girth >102cm in men, >88 cm in women.

– hypertension sbp >= 140 dbp >= 90 confirmed on at least 2 occasions or on BP Rx.

-Dyslipidemia ldl >= 130, hdl <40, total chol >= 200 or on cholesterol Rx.

-Prediabetes aka impaired fasting glucose. >= 100 ans <=125 HVL>= 60 is a negative RF and one positive RF can be subtracted from the total.

also of importance is if a RF is not known or available it should be counted except prediabetes. for prediabetes it should be counted if their over the age of 45 or if under 45 with a bmi of >=25.

Timmy is a 43 Y.o male who smokes, his HDL is 65 , BMI 31 and He exercises moderately for 1 hr a day 3 time a week. everything else is WNL. what is his Risk Stratification for CVD?

Low.

Why, he has 2 positive RF; smoking and Weight but one negative RF HDL >60

2-1=1

1 RF puts him in the low RS

Why, he has 2 positive RF; smoking and Weight but one negative RF HDL >60

2-1=1

1 RF puts him in the low RS

## Get help with your homework

By clicking "SEND" below, you agree to our terms of service and privacy policy.

We'll occasionally send you account related and promo emails

We'll occasionally send you account related and promo emails