Read the first response ....then read the second response to CHF. PLEASE answer
ID: 3479214 • Letter: R
Question
Read the first response ....then read the second response to CHF.
PLEASE answer the question to the second response.
you are correct with it comes to people with CHF and exercise. They are at a higher risk for complications while exercising and supervision is needed during that time.
Exercise is a necessity to recovering from CHF, but it is reduced dramatically. People who have CHF can only achieve 50% of the age-predicted VO2 peak of healthy individuals. Exercise therapy has its benefits with it comes to CHF. As Nicole mentioned exercise therapy of individuals with CHF improves physical functioning, quality of life and morbidity and mortality. Not to mentioned exercise has been proven to accelerate recovery time from CHF.
There are many exercises and ways to strengthen the heart, but you used the word recovery... Chronic means that is constantly, so wouldn't always have this issue or will the exercise eventually help cure heart failure?
Explanation / Answer
CHF or congestive heart failure occurs when pumping action of heart, being suboptimal cannot meet the metabolic demand of body. Being a chronic condition mostly seen in older age group, it has a series of profound pathophysiological effects.
Common complaints of CHF is marked shortness of breath,fatigue, tachycardia, jugular venous distension,peripheral edema,chest pain to name a few.
Pathophysiology of CHF: A pathological event in heart(ischaemia,Infarction, inflammmation) leads to damage of myocardium. Myocardial damage increases wall stress which will further deterirate the cardiac output. At the same time Renin Angiotenesin system and Sympathetic nervous system gets activated which , after a time ,will further increase the wall stress and detiorates cardiac function.
Management of heart failure should include proper exercise and drugs(Betablockers,ACE inhibitors,Ivabradine,Inotropes etc).
It is known that a CHF patient has reduced exercise tolerance however recent research has shown that exercise is beneficial.
HOW EXERCISE HELPS in CHF?
CHF has a number of derogatory effects on body e.g. decreased performance, decreased skeletal muscle mass, decreased bone mass, altered endothelial functions,low mood,depression,altered sympathetic parasympathetic balance,Hypertension,poor tissue perfusion etc.
Benefits of exercise:
Exercise improves the muscle mass, tolerance,
Decreases plasma levels of Angiotensin,Atrial Natriuretic peptide, Vasopressin,NPY etc leading to less remodelling of myocardium--> physiologically beneficial
Exercise decreases afterload, so favorable effect on Cardiac output and Blood pressure.
Exercise secretes some SSRI like substances and "happy hormones" which improves mood and alleviate depression.
Exercise trains respiratory muscles too,therefore improving respiratory functions .
Properly designed exercise can revert most of the pathophysiological processes.
However exercise should only be started after a proper screening. Patients should be motivated and explained about exercise in detail,should start exercise after a short and thorough warm up session, followed by a combo of Resistance training and aerobic workout at reduced VO2max and should end the session with a thorough cool down phase. The recommended intensity of exercise can be prescribed based on BORG'S perceived exertion scale. Patient may be advised to undertake the exercise regimen 3-5 days a week.
In summary we can say Exercise designed properly and performed properly has an ability to reverse some of the pathophysiological processes associated with CHF, improve cardio respiratory functions,decreases stress chemicals (Noradrenaline,ANP,Adrenaline,Angiotensin),improve tissue perfusion, better nutrition, improve mood .
Being a chronic condition, even if CHF is not cured by exercise only, EXERCISE will Definitely slow down the pathophysiological progress along with IMPROVING overall quality of patients' life.
And that,under any circumstance is highly recommened.
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