ACE inhibitor (angiotensin-converting enzyme inhibitor) A category of drug used to treat high blood pressure and heart failure.

Acute myocardial infarction An event caused by death of heart muscle due to obstruction or blockage of a coronary artery.

Adult Respiratory Distress Syndrome (ARDS) This is a life threatening acute syndrome that causes injury to the air sacs and small blood vessels in the lung and results in respiratory failure due to the lack of oxygen.

Aerobic exercise Exercise characterized by repetitive movement of large muscle groups; the energy needed is supplied by inspired oxygen.

Alpha1 Antitrypsin (AAT) Deficiency A hereditary disorder in which there are low blood and lung levels of AAT that causes a high risk for the development of emphysema in the third to fifth decades of life, and an increased risk for the development of liver disease, primarily in childhood.

Altitude simulation test A test done with mixed gases to predict the effects of various altitudes on the blood oxygen.

Aneurysm A sac formed by the dilatation of the wall of an artery, a vein, or a heart chamber.

Angina pectoris Pain or discomfort in the chest due to inadequacy of blood supply to meet oxygen demands of the myocardium, commonly precipitated by effort or emotion.

Angiographically significant CAD A 70 percent or greater diameter blockage of one or more major epicardial coronary artery segments or a 50-percent diameter stenosis of the left main coronary artery shown by x-ray examination after injection of fluid opaque to x-rays.

Anticholinergic A drug that antagonizes the parasympathetic nervous system producing relaxation and dilation of the bronchi (airways) to improve the flow of air into and out of the lungs.

Arrhythmia Alteration of the normal rhythm of the heart; abnormal heart rhythm.

Arterial Blood Gas A blood sample drawn from an artery (usually in the wrist) that provides measures of the blood pH (acid balance), partial pressures of oxygen and carbon dioxide, and the concentration of bicarbonate.

Asthma This is a condition affecting the airways of the lung. Airways are sensitive to certain conditions. Nerves stimulate the muscles surrounding the airways causing them to constrict or tighten. Airways become swollen and inflamed causing them to narrow and produce mucus. This can lead to increased difficulty breathing, wheezing, and coughing.

Atherosclerosis A common form of arteriosclerosis in which yellowish plaques (atheromas) containing cholesterol, lipoid material, and lipophages form within or beneath the intima of large- and medium-size arteries.

Behavioral intervention Systematic instruction in techniques to modify health-related behaviors.

Beta blocker (b-adrenergic blocking agent) A drug that antagonizes the effect of sympathetic stimulation, producing a decrease in heart rate, blood pressure, myocardial contractility, and stroke volume, and thereby lessens oxygen demand in the myocardium and decreases angina pectoris.

Beta-agonist A drug that mimics sympathetic nervous system stimulation producing relaxation and dilation of the bronchi (airways) to improve the flow of air into and out of the lungs.

Bipap A bilevel pressure generating device for increasing oxygenation and ventilation

Bronchiectasis A condition that is characterized by abnormal dilatation of the bronchi (airways) and excessive mucus production. The mucus accumulation may obstruct the bronchi. Is often associated with repeated bronchial infections.

Bronchiolitis Inflammation of the bronchioles, or small airways often caused by a virus. May cause increased mucus production that can result in airway obstruction leading to bronchiolitis obliterans, a permanent occlusion of the airway.

Bronchodilator A drug that relaxes and dilates the bronchi (airways) to improve the flow of air into and out of the lung.

Bronchospasm A narrowing of the airways in the lung impairing the flow of air into and out of the lung.

Cardiac catheterization Passage of a catheter into the heart through a vein or artery, under x-ray control, used to diagnose cardiac abnormalities.

Cardiac mortality Death due to disease of the heart.

Cardiomyopathy Primary heart muscle disease, often of obscure or unknown etiology, unassociated with coronary disease, hypertension, valve disease, and so on.

Chest Percussion Manual clapping of the hands on the chest wall over designated areas of the lungs done in conjunction with gravity assisted positions to help mobilize secretions in the lungs from the peripheral airways into the more central airways for expectoration.

Chest Physical Therapy (CPT) This is a treatment intervention employed for improving pulmonary hygiene including postural drainage, chest percussion, and vibration to assist in mobilizing secretions in the lungs from the peripheral airways into the more central airways so that they can be expectorated.

Cholesterol A lipid or fatty substance found in tissues or blood. Elevated levels in the blood predispose to atherosclerosis in the coronary and other arteries.

Chronic Bronchitis This condition is defined as a recurrent or chronic productive cough for a minimum of 3 months per year for at least 2 consecutive years in persons whom other causes have been eliminated. It is characterized by enlargement of the bronchial mucus glands with excessive mucus production and inflammation (swelling) of the bronchi and bronchioles (airways).

Chronic Obstructive Pulmonary Disease (COPD) This is a long-term blockage or obstruction of the airways leading to pulmonary compromise and illness. It includes the following common lung diseases: chronic bronchitis, emphysema, asthma, bronchiectasis, and cystic fibrosis.

Comorbidity A concomitant but unrelated disease, usually used to indicate coexistence of two or more disease processes.

Continuous Positive Airway Pressure (CPAP) A machine used to enhance oxygenation and treat obstructive sleep apnea.

Coronary angiography A diagnostic technique that involves the injection of fluid opaque to x-rays into the coronary arteries and heart chambers.

Coronary artery bypass graft surgery (CABG) Bypass of an obstructed coronary artery using an artery in the chest or a vein segment from the leg attached to the aorta.

Coronary artery disease (CAD) A progressive atherosclerotic narrowing of the coronary arteries with resultant reduction in the blood and oxygen supply to the heart muscle.

Coronary heart disease (CHD) Heart disease resulting from atherosclerotic coronary artery obstruction (CAD).

Corticosteroids A drug that decreases inflammation and swelling.

Counseling Providing advice, support, and consultation.

Cystic Fibrosis This is an inherited disease of the exocrine glands affecting the lungs and the digestive systems. The lungs in these persons can become infected easily which may cause permanent damage to the alveoli, bronchioles and bronchi. Production of thick, sticky mucus blocks the airways and obstructs normal ventilation and function of the lungs.

Diaphragmatic Breathing A technique to enhance diaphragmatic excursion.

Dyspnea Difficult or labored breathing.

Echocardiocardiography Use of ultrasound to detect and record intracardiac structures and their motion and measure cardiac chamber size, shape, and wall thickness.

Education Systematic instruction.

Ejection fraction A measure of pumping action of the left ventricle of the heart, normally 65 ± 8 percent; lower values indicate ventricular dysfunction. The difference between left ventricular end diastolic volume and left ventricular end systolic volume divided by left ventricular end diastolic volume.

Electrocardiogram A graphic record of the electrical activity of the heart, obtained with electrocardiograph. Also called an "ECG" or "EKG."

Endurance Training Exercise training to increase an individual’s duration tolerance for aerobic exercise.

Ergometer An apparatus - such as a treadmill, stationary bicycle, or steps - used to measure the physiologic effects of exercise.

Ergometry Measurement of the physiologic effects of exercise, using standard equipment.

Exercise test A diagnostic test in which the patient exercises on a treadmill, bicycle, or other equipment with ECG and blood pressure monitoring, also referred to as a stress test.

FEV1 (Forced Expiratory Volume in 1 second) The volume of air that can be exhaled during the first second of a forced exhalation. It is a reflection of the flow of air in the large airways of the lung.

Fibrillation Chaotic rapid contraction or twitching of atrial or ventricular muscle.

Gastroesophageal Reflux Disease (GERD) A group of conditions that cause reflux of gastric and duodenal contents into the esophagus, otherwise known as heartburn.

Heart failure Failure of the heart to maintain adequate flow of blood to the tissues.

Heart rate Number of beats of the heart per minute.

High-density lipoprotein A complex of lipid and protein molecules to transport cholesterol, also called "HDL." The cholesterol component that transports cholesterol to the liver for metabolism.

Hypercapnea An excess of carbon dioxide in the blood.

Hypercholesterolemia Excess cholesterol level in the blood.

Hyperlipidemia Abnormally high concentration of any lipid in the blood.

Hypertension Elevation of arterial blood pressure above normal range. Commonly called high blood pressure.

Hypotension Abnormally low blood pressure.

Hypoxemia An insufficient amount of oxygen in the blood.

Immune Deficiency A disease of the immune system in which part of the immune system is either not working or is missing. This can lead to frequent infections that are difficult to fight.

Inspiratory Muscle Trainer A device to assist in building inspiratory muscle strength.

Interstitial Fibrosis A group of restrictive lung diseases characterized by thickening or fibrosis of the space between the air sacs and the capillary.

Left ventricular function Pumping function of the chamber supplying body circulation.

Leukotriene Modifier A drug that inhibits the formation of chemicals called leukotrienes, thereby improving lung function by blocking contraction of the airway, and by decreasing mucus production and inflammation in the airways.

Lipid Any of a variety of fat and fat-like substances characterized by being water-insoluble.

Lipoprotein A complex of lipid and protein molecules that transports lipids, primarily cholesterol. And triglycerides, from one organ to another; LDL and HDL are lipoproteins.

Low-density lipoprotein A complex of lipid and protein molecules to transport cholesterol, also called " "LDL." The cholesterol component that transports cholesterol from the liver to the rest of the body.

Lung Volume Reduction Surgery Surgical technique used in persons who have emphysema to remove the non-functional diseased portion of the lung in attempt to restore more normal and efficient breathing mechanics.

MET (metabolic equivalent unit) A resting metabolic unit, the equivalent of 1.2 calories per minute or 3.5 - 4.0 mL/kg/min; 1 MET equals the amount of energy expended at rest.

Metered dose inhaler Manually activated portable device to deliver medicated aerosol to the airway.

Morbid Obesity Pathologic or abnormal excessive accumulation of fat in the body beyond that considered desirable with regard to age, height, and body frame size. It is defined as 45 kg (100 lbs) over the desirable weight.

Multidisciplinary Of, pertaining to, or arising through the action of many disciplines or professions.

Myocardial ischemia Deficiency of blood supply to heart muscle.

Nebulizer Electrical device to deliver aerosolized medication to the airway.

Noninvasive Positive Pressure Ventilation Use of a face mask to deliver positive pressure to the airway to assist with ventilation of the lungs.

Obstructive Lung Disease A disease characterized by added resistance to flow of air into and out of the lungs caused by narrowing of the airways or blockage of the airways.

Oximetry A technique used for measuring the amount of oxygen in the blood. A noninvasive probe is placed on the ear, finger or forehead. The probe is attached to an oximeter that transmits a beam of light through the blood vessels and determines how much light is absorbed by oxygenated and deoxygenated blood.

Oxygen Medicinal oxygen (> 21%) used to supplement ambient oxygen for normal metabolism.

Oxygen Desaturation Study An exercise test performed to reveal the presence of oxygen desaturation during exertion.

Percutaneous transluminal coronary angioplasty (PTCA) An invasive procedure to enlarge the lumen of a narrowed coronary artery by balloon compression. The angioplasty catheter is inserted into a coronary artery, and the balloon is inflated at the site of an obstructing atheroma.

Pneumothorax An accumulation of air or gas around the lung, resulting in a collapse of the lung on the affected side.

Postural Drainage Gravity assisted positions utilized to help mobilize secretions in the lungs from the more distal and peripheral airways into the more central airways for expectoration.

Pulmonary Embolism A condition caused by plugging of blood vessels in the lung by such things as blood clots, tumors, fragments, air bubbles, or fat droplets.

Pulmonary Function Test A series of breathing maneuvers and measurements that assess the function of the lung, diagnose pulmonary abnormalities and assess the response of the lung to medications.

Pursed Lip Breathing A breathing technique used to maintain resistance in the airway during exhalation to enhance oxygenation.

Radionuclide ventriculography Assessment of cardiac chamber size and performance by intravenous radioisotope injection.

Rate-pressure product Heart rate multiplied by the systolic blood pressure; an index of myocardial oxygen requirement.

Restrictive Lung Disease A disorder that limits the expansion of the lung.

Resuscitation The restoration to life or consciousness of an individual showing no signs of life; it includes such measures as artificial respiration and cardiac massage.

Revascularization The restoration of adequate blood supply, usually to heart muscle; CAT and PTCA are techniques of myocardial revascularization.

Risk factors Characteristics associated with an increased rate of a subsequently occurring disease.

Sarcoidosis A disorder affecting several body systems, which may include the lungs. Collections of specific kinds of white blood cells occur in the lung causing inflammation or granulomas. The granulomas occur in the lungs in about one third of cases and is generally reversible. The cause of this disease has not yet been discovered.

Sleep Apnea Syndrome A disorder in which 30 or more episodes of apnea (absence of breathing) occur in an hour with each episode lasting at least 10 seconds. It is often associated with obesity.

ST-segment displacement Abnormality of repolarization evident on the ECG, important in detecting myocardial ischemia at exercise testing.

Strength Training Resistance training exercise usually involving weights or some other form of resistance designed toward improving an individual’s strength.

Streptokinase A drug that can dissolve blood clots, used to open obstructed coronary arteries in the early hours following myocardial infarction.

t-PA (tissue-type plasminogen activator) A drug used to dissolve blood clots formed within the vascular system.

Tachycardia Abnormally fast heart rate, greater than 100 beats per minute.

Target heart rate Goal heart rate for exercise training; often 60-85 percent of the symptom-limited heart rate at prior exercise testing.

Thoracotomy An incision of the chest wall.

Thrombolytic therapy Pharmacologic agents designed to dissolve blood clots formed within the vascular system.

Tracheostomy An opening or stoma in the trachea made to improve respiration.

Triglycerides A triester of glycerol with one, two , or three acid molecules.

TriNetwork Conference (also known as TriState Conference) A joint meeting held in the spring with NCVPRN (Nebraska Cardiovascular and Pulmonary Rehabilitation Network), and UPCRA (Upper Plains Cardiopulmonary Rehabilitation Association).

Tuberculosis An infectious disease of the lung that is caused by the organism Mycobacterium tuberculosis and is transmitted by the airborne spread of droplets containing tubercle bacilli.

Unstable angina Chest pain of myocardial ischemia that occurs at rest, new onset of pain with exertion, or pain that has accelerated (more frequent, longer in duration, or lower in threshold).

Ventilator A device to assist or control ventilation in a patient who is unable to maintain their ventilation spontaneously.

Ventricular dysfunction Abnormality of the pumping function of the ventricle.

Vibration Manual vibration of the chest wall over designated areas of the lungs done immediately following chest percussion and gravity assisted positions to help mobilize secretions in the lungs from the peripheral airways into the more central airways for expectoration.

Sources:

Clinical Practice Guideline Number 17: Cardiac Rehabilitation, AHCPR Publication No. 96-0672, October 1995

Virtual Hospital: University of Iowa Family Practice Handbook, 3rd Edition: Pulmonary Medicine: Chronic Obstructive Pulmonary Disease (COPD)

U. S. Department of Health and Human Services

	Public Health Service
	Agency for Health Care Policy and Research
	National Heart, Lung, and Blood Institute