#1 - Cardiovascular Disease and Prevention

Class Description
The purpose of this presentation is to enable the learner to understand the levels of cardiac rehabilitation and disease prevention (primary, secondary and other descriptors that are seen in the literature and heard in academic cirlces), risk factors for heart disease as well as emerging risk factors, heart disease in the US and emerging global trends, and the new role of resistance training in cardiac rehabilitation.

Topics:

I. Primary prevention

A. Goals of primary prevention

II. Secondary prevention

A. Goals of secondary prevention

III. Major risk factors

A. Modifiable
B. Nonmodifiable

IV. Emerging risk factors

V. Resistance training in cardiac rehabilitation

A. Candidates
B. Precautions

Behavioral/Learning Objectives:

1. Define primary and secondary disease prevention.
2. List risk factors for heart disease and categorize as to whether they are modifiable or nonmodifiable.
3. Discuss resistance training and specify which patients are candidates.

#2 - What Really Happens in Phase II Cardiac Rehabilitation

Class Description
The purpose of this program is to enable the learner to anticipate what will happen in Phase II cardiac rehabilitation in terms of arrhythmias, hypotension, ischemic events, and resultant revisions of medical management as a result of their detection. In addition, specific outcomes will be examined, such as improvement in functional capacity, body weight, and depression scores. One of the ECG dilemmas that every cardiac rehabilitation professional faces is differentiating the wide QRS complex, so a portion of the program will be devoted to this.

Topics:

I. Event definition

A. Significant arrhythmias

1. New supraventricular tachycardia
2. Non sustained ventricular tachycardia
3. Sustained ventricular tachycardia

B. Ischemia

1. ST segment depression
2. Exercise-induced hypotension

II. Subject characteristics

A. Gender, age, diabetes, left ventricular function, smoking status, etc.
B. Minutes of exercise
C. Diagnoses

III. Revision of medical management

IV. Outcomes

V. Differential diagnosis of wide QRS complexes

A. Leads to use in differential diagnosis
B. RBBB
C. LBBB
D. VT versus SVT

Behavioral/Learning Objectives:

1. Describe typical arrhythmias encountered in outpatient cardiac rehabilitation setting.
2. Differentiate wide QRS complexes including ventricular ectopy and bundle branch blocks.
3. Describe the best ECG lead to use to differentiate wide QRS complexes.

#3 - Diagnosing Ischemia in the Phase II Cardiac Rehabilitation Patient

Class Description
In addition to helping the learner identify the ECG characteristics of myocardial ischemia, this section will enable the learner to recognize in which patients ischemia would be likely be noted and in which patients its ECG identification is not recommended.

Topics:

I. Leads used in the cardiac rehabilitation setting to detect ischemia

II. Diagnostic quality

III. ECG characteristics of myocardial ischemia

IV. Conditions in which ECG ischemia is not diagnosed accurately

V. Actions to take when ischemia is noted in the patient in cardiac rehabilitation

Behavioral/Learning Objectives:

1. Define myocardial ischemia and discuss what type of ECG system and leads are best in detecting it in the outpatient cardiac rehabilitation setting.
2. List in which patients/conditions myocardial ischemia is not diagnosed accurately.
3. Describe actions to take if ischemia is noted on the ECG.

#4 - Women and Heart Disease

Class Description
The purpose of this activity is to enable the learner to recognize differences between men and women in terms of disease presentation in cardiac rehabilitation and prepare the clinician for what to expect during Phase II cardiac rehabilitation.

Topics:

I. Risk factors for heart disease with emphasis on women

A. Major risk factors
B. Emerging risk factors
C. Genetic factors

II. Risks of insufficient exercise for women

A. Exercise and menopause

III. Risks of exercise in women

IV. Heart disorders more common in women

A. Takotsubo cardiomyopathy
B. Microvascular disease

V. Presentation, ECG and BP differences between men and women

Behavioral/Learning Objectives:

1. Define differences in disease presentation between men and women.
2. Delineate disease conditions that are more common with the female patient.
3. Describe differences in the ECG and BP of female and male patients.

#5 - The Elderly Patient in Cardiac Rehabilitation

Class Description
This section will examine the risks of inactivity and how it applies to the elderly. The most recent guidelines physical activity guidelines will be reviewed as well as application to the cardiac rehabilitation patient. Expected outcomes for the elderly will be covered so the cardiac rehabilitation professional will have realistic expectations. In addition, advantages of cardiac rehabilitation for the elderly patient will be described.

Topics:

I. Physical activity guidelines for the elderly

II. Cardiovascular rehabilitation and the elderly

A. Depression in the elderly patient
B. Dose-response of cardiac rehabilitation for the elderly

1. Lower morbidity and mortality

C. Elderly population demographics and physical characteristics

III. The oldest of the elderly: 79-94

A. Characteristics
B. Achievements

Behavioral/Learning Objectives:

1. Discuss physical activity guidelines for the elderly.
2. Delineate realistic expectations for the elderly patient in cardiac rehabilitation.
3. Describe advantages of completing 36 sessions of Phase II cardiac rehabilitation.

#6 - Sexual Activity and the Cardiac Patient/Common Medication in Cardiac Rehabilitation

Class Description
Sexual activity is sometimes a topic that is difficult for the cardiac rehabilitation professional to discuss with patients. This class will describe in terms of METs what kinds of sexual activities are acceptable and at what stage of recovery. Also presented are common medications seen in the cardiac rehabilitation patient and their effects on exercise.

Topics:

I. Sexual dysfunction

A. Before myocardial infarction (MI)
B. After MI
C. After cardiac procedures
D. The patient with heart failure

II. Fear factor

III. Position

IV. Medications

A. Medications for erectile dysfunction
B. Beta blockers
C. Other medications

Behavioral/Learning Objectives:

1. Define at what point the patient in cardiac rehabilitation may return to sexual activity.
2. Describe sexual activity that should be avoided by patients who have undergone a sternotomy.
3. Discuss medications used for erectile dysfunction and their precautions with nitroglycerin use.
4. Describe other medications patients in cardiac rehabilitation are typically prescribed.

Accreditation Information

Respiratory Therapists – This course meets the requirements for continuing education for Respiratory Care Professionals in AL, CA, CT, DE, FL, ID, IL, IN, IA, KS, LA, ME, MA, MN, MS, MT, NE, NV, NY, OH, OK, OR, RI, SC, TN, TX, WA, WV, WY.

Because each state’s continuing education requirements for respiratory therapists is subject to change, please verify this information with your state board. Thank you.

Nurses – Academy Medical Systems is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s COA.

Academy Medical Systems (AMS) is also a provider approved by the California Board of Registered Nursing, provider #CEP14413.

AMS is also a provider approved by the Florida Board of Nursing, provider #50-19.

Iowa Nurses – The Iowa Board of Nurses will recognize the recorded webinars as a home study program. They recognize our ANCC approved provider status as well as our CA and Fl Board of Nursing provider approval for home study products for nurses in Iowa.

All other states recognize our approved provider status listed in the above text for continuing education credit for nurses.

9.0 contact hours will be rewarded to nursing professionals at the completion of this workshop.

Dietitians - Academy Medical Systems is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR.) Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 9.0 continuing professional education units (CPEUs) for completion of this program/material.

Occupational Therapist - Occupational Therapist will receive 9, continuing education hours for completion this program and a test score of 70% or better. AMS is an approved provider for the AOTA , provider # 5470. This course is an intermediate education level.

Exercise Physiologist – ACSM recognizes AMS’s approved provider status with the ANCC and will honor our continuing education for Certified Exercise Physiologist recertification purposes.

Certified Athletic Trainers – Academy Medical Systems is recognized by the Board of Certification (BOC) to offer continuing education for certified athletic trainers. 9 hours will be awarded at the completion of this program.

Physical Therapists - PTs and PTAs in the following states will receive 9 contact hours for completion of all 6 webinars: AK, AL, AZ, CA, CO, CT, GA (Class 1), HI, IA, ID, IN, KS (Cat 2), KY, MA, ME, MI, MN (Cat 2), MO, MS, MT, NE, NM, ND, OK (Cat 2), OR, RI, SC, SD, UT, VA (Type 2), VT, VI, WA, WI, WY.

We are an approved provider to offer continuing competency courses to CA PTs, approval date 4/5/10. The following state boards recognize other state’s approval: AL, AZ, GA (Class 1), KY, MO, MS, OK (Cat 2), WI.

PA PTs – The PA State Board of PT has approved this course for 9 General Hours, Approval # PTCE02919 through 12/31/12.

Because each state’s continuing education requirements for physical therapists is subject to change, please verify this information with your state board. Thank you.  See The Federation of State Boards of Physical Therapy website for more information.

Social Workers - This course meets the qualifications for 9 hours of continuing education credit for MFCCs and/or LCSWs as required by the California Board of Behavioral Sciences, provider #PCE 4947. Please check with your state board’s requirements to determine if this program meets your continuing education requirements or call us at 866-414-3500 to assist you.

Academy Medical Systems has been approved by the TX State Board of Social Workers Examiners to provide continuing education activities for social workers, Provider # 5998.

Certified Cardiovascular Techs – Cardiovascular Credentialing International recognizes our approved provider status with the ANCC for continuing education courses for CCTs – Category A.

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