If a patient exhibits exercise-induced ischemia at a heart rate of 140 bpm, what should be their maximum heart rate for the exercise session?

In determining the maximum heart rate for a patient who demonstrates exercise-induced ischemia at a heart rate of 140 beats per minute (bpm), it is essential to consider the principle of exercising at a level that avoids exacerbating the patient's condition.

Given that exercise-induced ischemia occurred at 140 bpm, this indicates that the patient's cardiovascular system is unable to adequately meet the oxygen demands of the heart at this level of exertion. To ensure safety and prevent further complications, the maximum heart rate during exercise should be set below this threshold. Choosing a maximum heart rate of 130 bpm allows for a sufficient margin to minimize the risk of causing ischemic events during the session.

It is also crucial to recognize that individual tolerance levels can vary; thus, monitoring the patient's response during exercise becomes paramount to adjust the intensity of activity as needed. This emphasis on safety and adherence to an appropriately conservative approach underscores why establishing a maximum heart rate below the point of symptom onset is critical for patient care in geriatric physical therapy.