HWE 420 Week 1 Assignment

Medical Clearance Worksheet

Answer the following questions in paragraph form.

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.
   The cardiovascular system plays various roles including the circulation of oxygen and
   nutrients to various parts of the body. The cardiovascular system also helps in the elimination of
   waste products. Coronary artery disease interferes with the normal functioning of the
   cardiovascular system (Allender et al., 2007). Coronary artery disease is characterized by
   damaged blood vessels that supply the heart with blood. Plaque builds up in the arterial walls and
   the result is the narrowing down of blood supply to the heart. Plaque can also block the flow of
   blood totally. The symptoms of coronary artery disease include chest pains, shortness of breath
   and general body weakness. Coronary artery disease can affect the heart muscle by weakening it
   and the end result could be heart failure.
   In a healthy person, the blood flow is uninterrupted. On the other hand, a person with
   coronary artery disease has narrow arteries and the blood flow to the heart is decreased
   significantly (Hoffman & Kaplan, 2002). In a person who does not have heart disease, the heart
   is able to receive oxygen-rich blood. On the other hand, the heart of an individual with coronary

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artery disease is unable to receive enough oxygen-rich blood. The arteries of a healthy person are
smooth and elastic. In contrast, coronary artery disease makes the arteries to be stiff and narrow.

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.
   Symptoms of cardiovascular disease include chest pain. A person with coronary artery
   disease is likely to report pain or discomfort in the chest. One may also report pain in the neck,
   jaw, and arms (American College of Sports Medicine, 2018). Shortness of breath or difficulty in
   breathing is also an important symptom of cardiovascular disease. An uncomfortable awareness
   of breathing is a common symptom of cardiac and pulmonary disease. Dyspnea can occur in
   heathy and well-trained individuals. However, it becomes an issue of concern when the level of
   exertion is not significant.
   Dizziness or syncope is also an important symptom. Dizziness is a result of a reduction in
   perfusion of the brain(American College of Sports Medicine, 2018). Syncope when one is
   engaging in physical activity can be a result of cardiac disorders. Other symptoms include ankle
   edema, palpitations and intermittent claudication.

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3. Read each case study below and assess the need for medical clearance by filling out the
   table.
   Refer to Figure 2.2 on pp. 33-34 to assist you in filling out the table below.
   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.

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.
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.

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

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workouts to a vigorous level by running 3 days a week. He currently reports no signs or
symptoms. He takes insulin twice a day.

Case Study Table

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 after
engaging in
minimal physical
activity

No- He shows no
symptoms and is
therefore
asymptomatic

No-
Asymptomatic

Suggested
intensity level

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

Progress as
tolerated with the
aim being to
begin with low-
intensity
activities and
progressing

Progress as
tolerated
beginning with
medium intensity
exercises.

Progress as
tolerated increase
the distance
walked as well as
begin to run.

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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’s cardiac
history makes it
necessary for her
to be cleared by
the doctor

Jermaine has not
been seeing a
doctor. He may
have a condition
that is unknown
to him.

Louis has an
underlying
condition and
therefore needs
to be cleared by
the doctor.

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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Reference:

Allender, S., Peto, V., Scarborough, P., Boxer, A., & Rayner, M. (2007). Coronary heart disease
statistics.
American College of Sports Medicine. (2018). ACSM’s guidelines for exercise testing and
prescription (10th ed.). Philadelphia, PA: Wolters Kluwer.
Hoffman, J. I., & Kaplan, S. (2002). The incidence of congenital heart disease. Journal of the
American college of cardiology, 39(12), 1890-1900.