ACSM-CEP Exam Questions and Answers: Complete Study Guide, Exams of Physiology

ACSM-CEP Exam Questions and Answers: Complete Study Guide, Exams of
Physiology




Absolute Contraindications to Exercise Testing - ANSWER• A recent significant
change in the resting ECG suggesting significant ischemia, recent MI (within 2
d), or other acute cardiac event

• Unstable angina

• Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic
compromise

• Symptomatic severe aortic stenosis

• Uncontrolled symptomatic heart failure

• Acute pulmonary embolus or pulmonary infarction

• Acute myocarditis or pericarditis

• Suspected or known dissecting aneurysm

• Acute systemic infection, accompanied by fever, body aches, or swollen
lymph glands



Relative Contraindications to Exercise Testing - ANSWER• Left main coronary
stenosis

• Moderate stenotic valvular heart disease

• Electrolyte abnormalities (hypokalemia or hypomagnesemia)

,• Severe arterial hypertension (SBP>200 mmHg and/or DBP >110 mmHg) at
rest

• Tachydysrhythmia or bradydysrhythmia

• Hypertrophic cardiomyopathy and other forms of outflow tract obstruction

• Neuromotor, musculoskeletal, or rheumatoid disorders that are
exacerbated by exercise

• High-degree AV block

• Ventricular aneurysm

• Uncontrolled metabolic disease (diabetes, thyrotoxicosis, or myxedema)

• Chronic infectious disease (e.g. HIV)

• Mental or physical impairment leading to inability to exercise adequately



General Indications for Stopping an Exercise Test - ANSWER• Onset of angina
or angina-like symptoms

• Drop in SBP of ≥10 mmHg with an increase in work rate or if SBP decreases
below the value obtained in the same position prior to testing

• Excessive rise in BP: SBP>250 mmHg and/or DBP>115 mmHg

• Shortness of breath, wheezing, leg cramps, or claudication

• Signs of poor perfusion: light-headedness, confusion, ataxia (loss of full
control of bodily movements), (pallor) unhealthy pale appearance, cyanosis
(bluish skin color), nausea, or cold and clammy skin

• Failure of HR to increase with increased exercise intensity

• Noticeable change in heart rhythm by palpation or auscultation

• Subject requests to stop

• Physical or verbal manifestations of severe fatigue

• Failure of the testing equipment

, Absolute Indications for stopping an exercise test - ANSWER• Drop in SBP ≥10
mmHg with an increase in work rate, or if SBP decreases below the value
obtained in the same position prior to testing when accompanied by other
evidence of ischemia

• Moderately severe angina (defined as 3 on standard scale)

• Increasing nervous system symptoms (e.g. ataxia, dizziness, or near
syncope)

• Signs of poor perfusion (cyanosis or pallor)

• Technical difficulties monitoring the ECG or SBP

• Subject's desire to stop

• Sustained ventricular tachycardia

• ST elevation (+1.0 mm) in leads without diagnostic Q waves (other than V1
or aVR)



Relative Indications for stopping an exercise test - ANSWER• Drop in SBP ≥10
mmHg with an increase in work rate, or if SBP below the value obtained in
the same position prior to testing

• ST or QRS changes such as excessive ST depression (>2 mm horizontal or
down sloping ST-segment depression) or marked axis shift

• Arrhythmias other than sustained V Tach, including multifocal PVCs, triplets
of PVCs, SVT, heart block, or bradyarrhythmias

• Fatigue, shortness of breath, wheezing, leg cramps, or claudication

• Development of bundle-branch block or intraventricular conduction delay
that cannot be distinguished from V Tach

• Increasing chest pain

• Hypertensive response (SBP>250 mmHg and/or DBP>115 mmHg)