Chest Physiotherapy in the Presence of Cardiovascular Instability: Balancing Secretion Clearance and Arrhythmia (SVT) Risk content: The Respiratory-Cardiac Crossroads: Reviewing the patient’s T2RF secondary to fluid overload/HAP versus recurrent SVT episodes. Physiological Effects of Chest Clearance: How manual vibrations, percussion, or positioning (e.g., trendelenburg or side-lying) alter venous return, vagal tone, and cardiac rhythm. Safety Parameters & Real-Time Monitoring: What red flags you watch for on the bedside monitor during chest PT. Collaborating with nursing staff to time interventions around medication peaks or stability windows. Reflective Takeaway: Learning when not to perform chest physiotherapy is just as vital as knowing how to perform it.