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首页> 外文期刊>Journal of cardiopulmonary rehabilitation >Exertional hypotension: the possible role of cardiovascular autonomic neuropathy.
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Exertional hypotension: the possible role of cardiovascular autonomic neuropathy.

机译：运动性低血压：心血管自主神经病的可能作用。

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A 45-year-old woman was referred to cardiac rehabilitation (CR) in July 2004 after a myocardial infarction in March 2004 and a quintuple coronary artery bypass graft surgery in April 2004. There were no complications, and a 2-month postsurgery echocardiogram demonstrated normal left ventricular function.Her cardiac risk factors included hypercholesterolemia,hypertension, history of heavy smoking before her myocardial infarction, and a 20-year history of poorly controlled insulin-dependent diabetes mellitus (DM). Table 1 shows the results of her CR entry graded exercise test (GXT), prescribed medications, and anthropometric measures.She takes her first set of morning medications, as prescribed, with breakfast at 7:30 am and her second set in the evening at 9:00 pm. She is believed to be adequately nourished and hydrated. She reports a delay in hypoglycemic awareness as, several times a month, she requires assistance with administering glucose either upon waking or at work because of hypoglycemia.On one occasion, she required assistance after her CR exercise session. She also complains of chronic, general "fogginess" during morning activities, clearing up by the afternoon.The patient's exercise prescription is walking 5 days/wkat a pace of 18 to 19 min/mile for 40 minutes, . yielding a moderate to somewhat hard (3-4/10) rating of perceived exertion, at training heart rates (HRs) of 78 to 84 bpm. She reports feeling more energetic during evening walks at home than during morning CR sessions. During her morning CR sessions (9:30 am), a drop in systolic blood pressure (SBP) below resting levels was observed (Table 2).After discussion with the program's medical consultant, it was decided that her CR appointments bechanged to evening sessions (5:30 pm) to accommodate her vague symptom of fogginess and to observe whether there was a change in her exertional hypotension (EH). Although, the evening CR sessions yielded a higher HR and blood pressure (BP) during rest and exercise walking relative to the morning sessions, EH was still observed (Table 2). There was no feeling of fogginess during the evening sessions.
机译：一名45岁的女性在2004年3月发生心肌梗塞和2004年4月进行了五重冠状动脉搭桥手术后于2004年7月接受心脏康复（CR）。无并发症，术后2个月超声心动图证实左心室功能正常。她的心脏危险因素包括高胆固醇血症，高血压，心肌梗塞前大量吸烟史以及胰岛素依赖型糖尿病（DM）控制不良20年史。表1显示了她的CR入门分级运动测验（GXT），处方药和人体测量学的结果。她按照处方服用第一组早上药物，并于早上7:30享用早餐，第二天晚上在9:00 PM。人们认为她足够营养和水分。她报告了低血糖意识的延迟，因为每月一次几次，由于低血糖，她需要在醒着或工作时给予葡萄糖管理方面的帮助。有一次，她在进行CR运动后需要帮助。她还抱怨在早上的活动中会出现慢性的，普遍的“雾气”，直到下午才消失。患者的运动处方是每5天/每分钟以18到19分钟/英里的速度行走40分钟。在78至84 bpm的训练心率（HRs）下，可产生中等程度至稍强（3-4 / 10）的感知劳累等级。她报告说，晚上在家散步比早上进行CR训练时更有活力。在她早上的CR会议期间（上午9:30），观察到收缩压（SBP）降至休息水平以下（表2）。在与该计划的医疗顾问讨论后，决定将她的CR任命改为晚上的会议（下午5:30）以适应她模糊的起雾症状，并观察她的运动性低血压（EH）是否有所变化。尽管相对于早晨，CR傍晚在休息和锻炼步行时产生较高的HR和血压（BP），但仍观察到EH（表2）。晚上的会议上没有雾气。

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