ABSTRACT
Exercise and activity depend on the physiologic functioning of the skeletal and cardiac muscle in the body. Muscle fatigue is based on (1) genetic characteristics, (2) training of the individual athlete, and (3) presence or absence of disease states that may adversely affect either cellular metabolism or overall functioning of the exercising body tissues. Patients with coronary artery disease (CAD) may have a combination of diseased cardiac muscle, localized vascular disease in the myocardium, or ischemia/infarction to a region of the heart affecting cardiac ejection fraction and cardiac output. This abnormal function can manifest clinically as poor exercise duration, electrocardiograph (ECG) changes of ischemia, and overall poor exercise duration with formal exercise testing. In general, maximal aerobic power decreases with age but can be maintained by active training and absence of disease states (Table 22.1).
