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HWE 420 AC Wellness for Special Populations Myocardial Infarction Question

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Title

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Brenna Norman

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HWE420: Wellness for Special Populations (HWG2122A)

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Claudia Medeiros

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6/1/21

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Medical Clearance Worksheet

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Answer the following questions in paragraph form. 

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  1. Compare and contrast the function of the human body in someone who has heart disease to someone who does not have heart disease. (Consider what happens within the cardiovascular system when someone has coronary artery disease.  Why can heart disease put a person at risk when exercising?) Use scholarly references to support your comparison. 
  2. Explain four of the signs and symptoms suggestive of cardiovascular, metabolic, and renal disease. Refer to Table 2.1 in the textbook. Use the textbook as a reference as necessary.
  3. Read each case study below and assess the need for medical clearance by filling out the table. 

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A healthy human body without heart disease, would be able to perform normal functions easily, without struggle. Having a coronary artery disease would require extreme caution and awareness from the individual. While it is true that being active as much as possible when one has a heart disease is beneficial, being active must be done with much consideration and caution. When exercising, the cardiovascular system is tasked to a much more difficult work. The task of delivering nutrients and oxygen to all cells in the body is harder when one is exercising because as energy is used, the body would need to compensate, thus an increase in the heart rate is the result. The heart would need to keep pumping and pumping to all the cells in the body to maintain the oxygen needed to perform what is needed to be performed. This means that the heart would be strained even harder and if it couldn’t keep up, well. According to Thompson PD, Ades PA. Exercise-based, comprehensive cardiac rehabilitation. It is important that one pays attention to the warning signs when exercising such as dizziness, chest pain, irregular heartbeat, shortness of breath, etc. and take necessary actions from there. A person without heart disease would be able to perform the exercise and only show signs of tiredness or shortness of breath, while a person with heart disease will feel the mentioned symptoms or signs.

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One of the signs and symptoms would be chest pain/chest tightness. Chest pain is related to many causes, but most of the time it is because of the heart. Chest pain may be associated with Coronary artery disease, Myocardial infarction, Myocarditis, etc. The pain in the chest itself varying between which diseases the person have. Shortness of breath is another significant symptom that can be related to a whole lot of different causes, one of which is due to cardiovascular diseases but is not limited only to it. Tiredness or weakness is a symptom that is associated with cardiovascular, metabolic, and renal diseases. Although tiredness is quite general or vague, it could be a warning sign for the mentioned diseases. A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. And lastly swelling of the lower extremities could also be symptoms of cardiovascular or renal disease. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles. Decreased kidney function can lead to sodium retention, causing the swelling.

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Refer to Figure 2.2 on pp. 33-34 to assist you in filling out the table below. 

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Example: Alex, a 45-year-old male, would like to run a 10K in four months.  He has been running 3 days a week for 60 minutes.  Lately, he has been noticing a slight twinge of chest discomfort and dizziness during his cool down. He does not have a medical history of cardiovascular, metabolic, or renal disease or take any medications. 

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Case Study 1: Susan, 68-year-old female. Currently a non-smoker. She quit smoking after having a heart attack 5 years ago.  She reports taking medication for high cholesterol and high blood pressure. She attended a cardiac rehab program after her heart attack but quit exercising when her insurance quit paying for her sessions. Lately, she has been having shortness of breath with mild activity.  She has not seen a doctor in 2 years. 

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Case study 2: Jermaine is a 26-year-old male. He was a swimmer in college and would like to get started again. He cannot remember the last time he saw a doctor.  He states he does not have any signs or symptoms of disease or have any history of disease.  He takes a multivitamin every day.  

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Case Study 3: Louis is a 53-year-old male with a history of metabolic disease.  He walks regularly 5 days a week for 30 minutes each session. He is interested in increasing his workouts to a vigorous level by running 3 days a week. He currently reports no signs or symptoms.  He takes insulin twice a day.

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Case Study Table

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Example

Case 1

Case 2

Case 3

 

Currently participates in regular exercise

Yes

No

No

Yes

 

Known CV, metabolic, or renal disease

No 

Yes

No

Yes

 

Symptomatic or asymptomatic

Yes- chest discomfort and dizziness

Yes – shortness of breath with mild activity

Asymptomatic

Asymptomatic

 

Suggested intensity level

Progress as tolerated. Student may state no intensity at   this time. 

No Intensity

Low intensity level

Progress as tolerated. Additional progress depending on   clearance results

 

Medical Clearance needed

Yes

Yes

Yes 

Yes 

 

Rationale for recommending medical   clearance or not recommending it

Alex needs to be cleared by a doctor due to symptoms   suggestive of CV, Metabolic, or renal disease. 

Susan needs to be cleared by the doctor due to previous   medical history. Added to the fact she hasn’t seen a doctor in 2 years.

Jermaine doesn’t remember the last time he went to a   doctor. Doctor recommendation may decide if he is fit to be back.

As Louis has a history of metabolic disease a medical   clearance is in order to be sure. Additional progression of intensity would   depend on the clearance result

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Notes: When participants are identified for whom medical clearance is warranted, they should be referred to an appropriate physician or other health care provider. Importantly, the type of medical clearance is left to the discretion and clinical judgment of the provider to whom the participant is referred because there is no single, universally recommended screening test. The type of procedures conducted during clearance may vary widely from provider to provider and may include verbal consultations, resting or stress electrocardiogram (ECG)/echocardiogram, computed tomography for the assessment of coronary artery calcium, or even nuclear medicine imaging studies or angiography (American College of Sports Medicine, 2018, p. 37).

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References

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American College of Sports Medicine. (2018). ACSM’s guidelines for exercise testing and prescription (10th ed.). Philadelphia, PA: Wolters Kluwer.

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References: Add references below

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Thompson PD, Ades PA. Exercise-based, comprehensive cardiac rehabilitation.

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Nazario, B. (2020, April 3). Dyspnea (Shortness of Breath). https://www.webmd.com/lung/shortness-breath-dyspne…

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Ferry AV, et al. (2019). Presenting symptoms in men and women diagnosed with myocardial infarction using sex-specific criteria. Journal of the American Heart Association doi:10.1161/JAHA.119.012307.

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What is cardiomyopathy? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/cm#.