SPSC703 – Clinical Exercise Physiology

Case Study 1 – Coronary Artery Disease

Patient Details
Name Age Gender
Avery Smith 52 Male
Weight Height Waist Blood Pressure
95kg 178cm 112cm 128/82 mHg

Medical History
Condition Treatment Medication
1 Coronary Artery Disease NSTEMI – loss of consciousness and
AED revival
CABG 2x (12 weeks ago)
2 Hypertension Cilazapril
Metoprolol
3 Dyslipidaemia Atorvastatin

Family History
Father – myocardial infarction at age 67yrs

Exercise History
Classification: “Beginner”

Previous

Walking 2x/week @ 10/20 RPE – 30 minute duration

Previous gym attendance (sporadic) – resistance and cardiovascular exercise

Current

6 week physiotherapy led cardiac rehab programme

Walking 3x/week @ 10/20 RPE – 15 minute duration

Prior Symptoms (before CABG)

Shortness of breath

1/4 at rest

3/4 on moderate intensity exertion

Occasional left sided chest pain on exertion (1-2/10)

SPSC703 – Clinical Exercise Physiology
Case Study 1 – Coronary Artery Disease

Current Symptoms

Minor pain around surgical sites

1/10 at rest, increasing to 4-5/10 at worst

Aggravated by dynamic movements and horizontal abduction

Goals

Create sustainable exercise routine

Improve general health and fitness
Reduce risk of secondary cardiac event

CPET Results

GET1 GET2 Peak

VO2 15.7ml.kg.min 21.3ml.kg.min 25.4ml.kg.min

HR 103bpm 118bpm 132bpm
Workload 5.5km/h @ 0% 5.5km/h @ 6% 5.5km/h @ 12%
RER 0.84 1.01 1.10
RPE 11/20 16/20 19/20
1min Rec 119bpm 132/84mmHg
3min Rec 110bpm 126/82mmHg
Symptoms Nill

Sinus rhythm at rest and during the test

ECG
Occasional single PVC’s during final stages

Summary
Avery Smith is a 52 year old male who works as a lawyer. Avery experienced a myocardial infarction (heart
attack) while out walking, requiring defibrillation and subsequent bypass surgery. His work role is mainly
sedentary with an average of 60 hours per week. Avery has a wife and 2 school age children. Avery has
previously been a gym member (workplace gym) but did not attend regularly due to low motivation and
lack of time. Avery has completed a basic hospital cardiac rehab programme and has since been
discharged. He is keen to prevent any further incidents and is committed to setting aside time for his
rehab.