Phillip E. is a 65-year-old retired salesman with a 20-year history of heart disease that includes two myocardial infarctions, each followed by a bypass operation. The most recent bypass was last year. He has decided to begin an exercise program, but because he is experiencing shortness of breath, Mr. E. has wisely decided to seek the recommendation of his physician. The physician ordered a cardiopulmonary exercise stress test and an echocardiography test to evaluate Mr. E.'s heart and exercise capacity. The exercise stress test was performed on a treadmill, using the Modified Bruce protocol, and was terminated at volitional exhaustion. Although Mr. E. reported no cardiac symptoms during the exercise stress test, he had to end the test after just five minutes due to shortness of breath. His echocardiography test reported a low ejection fraction, about 30%. His physician determined that Mr. E. was in congestive heart failure, and he prescribed a diuretic, an ACE inhibitor, and a K ⁺ supplement. His physician cleared Mr. E. for exercise and referred him to you. The results of the cardiopulmonary exercise stress test were as follows:

• ECG: old myocardial infarctions (significant Q-wave present)
• Maximum Heart Rate: 115 beats per minute (test stopped due to dyspnea)
• Resting Heart Rate: 85 bpm
• Peak Blood Pressure: 150/90 mm Hg
• Resting Blood Pressure: 100/80 mm Hg
• Vo ₂ max : 12 ml.min ^-1 .kg ^-1

Answer rating: 100% (QA)

solution Here two factors are to be considered The first one is shortness of breath in 5 minutes ... View the full answer