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Myocardial Infarction

The Heart attack

Effects on the Exercise


Response
AMI (Acute Myocardial Infarction)
Can alter an individuals cardiorespiratory and hemodynamic responses to
both submaximal and maximal exercise.

Individuals who have suffered a previous MI often have a reduced level of


cardiorespiratory fitness
50-70% of age and gender predicted.
The reduced oxygen transport capacity is primarily due to diminished cardiac
output.

Ventricular Arrhythmias
Occur more commonly in individuals with a history of an MI than in
individuals without heart disease.

Medications
Clients with a history of MI are often taking medication to decease HR and BP.

Effects on Exercise
Training
Positive Effects
Normal effects of regular exercise.
Relief of anginal symptoms secondary to reductions in heart rate or blood
pressure (or both) and myocardial oxygen demand at any given somatic
oxygen uptake or submaximal work rate.
Modest decreases in body weight, fat stores, blood pressure (particularly in
hypertensives), total blood cholesterol, serum triglycerides, and LDLcholesterol.
Improved psychosocial well-being and self-efficacy.

Disclaimer
Conventional exercise training as an isolated intervention generally has
little effect on increasing left ventricular ejection fraction and myocardial
perfusion.

Management &
Medications
Management
Is essentially palliative, undertaken to minimize the severity of
clinical sequel and to potentially slow, halt, or even reverse the
progression of disease
Coronary artery bypass graft surgery
For moderate to high-risk

Risk Factor Interventions


Smoking cessation
Lipid and lipoprotein modification(diet)
Hypertension control
Increasing physical activity
Effective drugs
Beta-blockers
Aspirin

Foods with omega-3 fatty acids

Medications cont.
Diuretics (water pills)
Use: To help your body get rid of unneeded water and salt through the
urine (hypertension).
Exercise effects:
Possibly dehydration
Hyperkalemia

Beta-blockers
Use: to target beta receptors
Exercise Effects:
Decrease submaximal and maximal heart rate and sometimes exercise
capacity.

Vasodilators/Calcium channel blockers


Use: To relax and dilate vessels (hypertension)
Exercise effects:
May be subjected to hypotensive episode in post-exercise period

Recommendations for Exercise Testing


Low-level exercise testing (generally 5 METs)
Is utilized with individuals recovering from uncomplicated MIs
to assess functional status, as well as to provide diagnostic,
prognostic, and therapeutic guidance.
Promotes client confidence, providing reassurance that
routine activities can be undertaken safely.

The test protocol for peak or symptom-limited testing


should focus on accommodating the individuals ability to
perform lower-extremity exercise.
People who are unable to perform treadmill or cycle
ergometer exercise may be alternatively evaluated with arm
crank ergometry or pharmacologic stress testing (e.g.,
dobutamine, dipyridamole, Persantine, and adenosine) at
rest.

Considerations for
Exercise Testing
Abnormal findings (e.g., angina, ischemic
ST-segment depression)
That additional areas of myocardium are
served by stenosed coronary vessels and
remain in jeopardy.

Long-acting beta-blockers
Testing should be conducted at
approximately the same time of day the
subject will be exercising, because the
significant reduction in exercise heart rate
may dissipate over time.

Recommendations for Exercise


Programming
Intensity
Corresponds to 40% to 80% of VO2R or maximal heart rate
reserve.

Frequency
At least four to seven( nonconsecutive) days per week.

Duration
20 to 60 min of continuous or accumulated (interval) exercise,
Warm-up and cool-down periods of 5 to 10 min.

Mode
A formal or structured program.
While increasing the adoption and maintenance of physical activity
in daily living.
Maximum benefit requires 5 to 6 h per week of physical activity.

Exercise Program
Monday

Tuesda
y

Yoga for
Beginner
s

Wednes
day

Thursda Friday
y

Walk

Resistan
ce
Bands
5 min
stretchi
ng

Yoga for
Beginner
s

Saturda
y

Sunday
Walk

Resistan
ce Bands
5 min
5 min
stretching stretchin
g

5 min
stretchin
g

Special Considerations
Medications
In most cases AMI survivors will need to take medications
along side with exercise. So you must be thorough in the
schedule and administration of their medication usage.

Incision
Should be noted and thought around accordingly (ex. Bench
press).

Hypertension
Make sure they are breathing properly (ex. strength training).

Bed-ridden symptoms
Must remember that these individuals may have muscle
hypotrophy and other symptoms.

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