ACSM EP-C Exam 2026 \LATEST UPDATE
WITH COMPLETE QUESTIONS AND
ACCURATE DETAILED ANSWERS \LATEST
UPDATE 2025-2026 For Both MIDTERM &
FINAL EXAMS
Unusual sounds caused by blood flowing through the heart
Heart murmur All murmurs should be evaluated by a physician to
avoid exertion-related sudden cardiac death
Often described as a cramp
Severe calf pain when walking that disappears 1-2
min after stopping Indicates lack of blood flow to
Intermittent claudication
the working muscles
Does not occur when standing
or sitting Reproducible from
day to day
Worse walking upstairs or a hill
Palpitations An unpleasant awareness of the forceful or rapid beating of the
heart
Trouble breathing while
Orthopnea laying down Indicative of poor
left ventricular function
Relieved by sitting upright or
standing
Syncope Fainting
Shortness of breath
Dyspnea Abnormally uncomfortable awareness of breathing
One of the principle symptoms of cardiac and pulmonary disease
40-60% of HR reserve or maximal
oxygen uptake reserve 3-6 METs
Moderate physical activity
Rating of perceived exertion of 12-13
on 6-20 scale Causes noticeable
, increase in HR and breathing
1. consider past physical activity history
3 steps in
2. evaluate for the presence of known cardiovascular, metabolic,
preparticipation
or renal disease
activity screening 3. assess signs and symptoms that could be suggestive of CMR
process disease
Developed in Canada as a tool that a physician can
ePARmed-X+Physician
use to refer individuals to a professionally supervised
clearance follow up
program and make recommendations for that program
questionnaire
Used when there is a "yes" on the Par-Q+
PAR-Q: designed in Canada to screen out clients
from not participating in physical activity that may be
PAR-Q and PAR-Q+ too strenuous; good for screening high risk, not low or
moderate risk
PAR-Q+: includes word changes to better classify all
individuals; high sensitivity, low specificity
2 basic approaches to 1. Self-guided screening
preparticipation physical 2. Professionally supervised screening
activity screening
What is the most popular Walking - 30% of adults
exercise in the US?
Where in the body are the Lower body, especially knee or foot
most common
musculoskeletal injuries
regardless of gender?
, aka skill-related
fitness Subcomponent
Performance-related fitness of physical fitness
Includes most attributes of physical fitness
Agility, balance, coordination, power,
reaction time, and speed Can result in
increased desire to participate in physical
activity
Subcomponent of physical fitness
Health-related fitness Confined to cardiorespiratory fitness, muscular fitness,
endurance, muscular strength, flexibility, and body
composition
A set of attributes that people have or achieve that
relates to the ability to perform physical activity
Physical fitness Includes cardiorespiratory endurance, muscle strength,
muscle endurance, muscle power, flexibility, agility,
balance, reaction time, and body composition
Implies specificity of training toward a goal
Any planned, structured, repetitive, and purposeful
Exercise
activity that seeks to improve or maintain any
component of fitness for life or sport
Any bodily movement produced by contracting skeletal
Physical activity
muscles with a concomitant increase in energy
expenditure
aka double product
Rate pressure product Product of heart rate and systolic blood pressure
that occurs concomitantly Serves as an estimate
of myocardial oxygen demand
MVO2
Myocardial oxygen demand
The amount of oxygen required by the heart during exercise
Mean arterial pressure The average blood pressure in the arterial system over one
complete cardiac cycle
Point during exercise at about 50-80% VO2max when
Ventilatory threshold ventilation begins to increase exponentially
Indicator of performance and training intensity
Tidal volume Volume of air moved per breath
Volume of air inhaled and exhaled per minute
Pulmonary ventilation
Multiply frequency of breathing times volume of air moved per
, breath (tidal volume)
Reflects the difference in oxygen content between
arterial and venous blood Provides a measure of the
Arteriovenous oxygen amount of oxygen take up by the working muscles from
difference
the arterial blood
20 arterial and 15 venous is normal resting, and
difference should increase with activity
Used to determine VO2max
VO2max = HRmax x SVmax x a-
VO2differencemax VO2 = oxygen
Fick equation/principle consumption
HR = heart rate
SV = stroke volume
a-VO2difference = arteriovenous oxygen difference
VO2max is dictated by max cardiac output and max
arteriovenous oxygen difference
Highest volume of oxygen the body can consume
VO2max
Often used as an indicator of aerobic fitness and endurance
exercise performance
VO2 remains elevated because of the increased work
Excess postexercise oxygen associated with resynthesis of ATP+CP within muscle
consumption (EPOC) cells, lactate removal, elevated body temp, hormones,
HR, and respiratory rate
Used to be called oxygen debt
WITH COMPLETE QUESTIONS AND
ACCURATE DETAILED ANSWERS \LATEST
UPDATE 2025-2026 For Both MIDTERM &
FINAL EXAMS
Unusual sounds caused by blood flowing through the heart
Heart murmur All murmurs should be evaluated by a physician to
avoid exertion-related sudden cardiac death
Often described as a cramp
Severe calf pain when walking that disappears 1-2
min after stopping Indicates lack of blood flow to
Intermittent claudication
the working muscles
Does not occur when standing
or sitting Reproducible from
day to day
Worse walking upstairs or a hill
Palpitations An unpleasant awareness of the forceful or rapid beating of the
heart
Trouble breathing while
Orthopnea laying down Indicative of poor
left ventricular function
Relieved by sitting upright or
standing
Syncope Fainting
Shortness of breath
Dyspnea Abnormally uncomfortable awareness of breathing
One of the principle symptoms of cardiac and pulmonary disease
40-60% of HR reserve or maximal
oxygen uptake reserve 3-6 METs
Moderate physical activity
Rating of perceived exertion of 12-13
on 6-20 scale Causes noticeable
, increase in HR and breathing
1. consider past physical activity history
3 steps in
2. evaluate for the presence of known cardiovascular, metabolic,
preparticipation
or renal disease
activity screening 3. assess signs and symptoms that could be suggestive of CMR
process disease
Developed in Canada as a tool that a physician can
ePARmed-X+Physician
use to refer individuals to a professionally supervised
clearance follow up
program and make recommendations for that program
questionnaire
Used when there is a "yes" on the Par-Q+
PAR-Q: designed in Canada to screen out clients
from not participating in physical activity that may be
PAR-Q and PAR-Q+ too strenuous; good for screening high risk, not low or
moderate risk
PAR-Q+: includes word changes to better classify all
individuals; high sensitivity, low specificity
2 basic approaches to 1. Self-guided screening
preparticipation physical 2. Professionally supervised screening
activity screening
What is the most popular Walking - 30% of adults
exercise in the US?
Where in the body are the Lower body, especially knee or foot
most common
musculoskeletal injuries
regardless of gender?
, aka skill-related
fitness Subcomponent
Performance-related fitness of physical fitness
Includes most attributes of physical fitness
Agility, balance, coordination, power,
reaction time, and speed Can result in
increased desire to participate in physical
activity
Subcomponent of physical fitness
Health-related fitness Confined to cardiorespiratory fitness, muscular fitness,
endurance, muscular strength, flexibility, and body
composition
A set of attributes that people have or achieve that
relates to the ability to perform physical activity
Physical fitness Includes cardiorespiratory endurance, muscle strength,
muscle endurance, muscle power, flexibility, agility,
balance, reaction time, and body composition
Implies specificity of training toward a goal
Any planned, structured, repetitive, and purposeful
Exercise
activity that seeks to improve or maintain any
component of fitness for life or sport
Any bodily movement produced by contracting skeletal
Physical activity
muscles with a concomitant increase in energy
expenditure
aka double product
Rate pressure product Product of heart rate and systolic blood pressure
that occurs concomitantly Serves as an estimate
of myocardial oxygen demand
MVO2
Myocardial oxygen demand
The amount of oxygen required by the heart during exercise
Mean arterial pressure The average blood pressure in the arterial system over one
complete cardiac cycle
Point during exercise at about 50-80% VO2max when
Ventilatory threshold ventilation begins to increase exponentially
Indicator of performance and training intensity
Tidal volume Volume of air moved per breath
Volume of air inhaled and exhaled per minute
Pulmonary ventilation
Multiply frequency of breathing times volume of air moved per
, breath (tidal volume)
Reflects the difference in oxygen content between
arterial and venous blood Provides a measure of the
Arteriovenous oxygen amount of oxygen take up by the working muscles from
difference
the arterial blood
20 arterial and 15 venous is normal resting, and
difference should increase with activity
Used to determine VO2max
VO2max = HRmax x SVmax x a-
VO2differencemax VO2 = oxygen
Fick equation/principle consumption
HR = heart rate
SV = stroke volume
a-VO2difference = arteriovenous oxygen difference
VO2max is dictated by max cardiac output and max
arteriovenous oxygen difference
Highest volume of oxygen the body can consume
VO2max
Often used as an indicator of aerobic fitness and endurance
exercise performance
VO2 remains elevated because of the increased work
Excess postexercise oxygen associated with resynthesis of ATP+CP within muscle
consumption (EPOC) cells, lactate removal, elevated body temp, hormones,
HR, and respiratory rate
Used to be called oxygen debt
