This article is intended for instructors who teach cardiovascular physiology. In our physiology course exercise physiology is used as a tool to review and integrate cardiovascular and respiratory physiology. It is assumed that the students already have mastered the fundamentals of cardiovascular and respiratory physiology. Because this paper is part of a cardiovascular refresher course, I have deleted much of the respiratory physiology. The objectives of this presentation are for the student to 1) understand the relationship between maximal oxygen consumption and endurance during sustained exercise and be able to define "maximal oxygen consumption"; 2) understand the determinants of maximal oxygen consumption; 3) understand the effects of dynamic exercise on the cardiovascular system and mechanisms for these effects; 4) understand the relationships between exercise intensity and major cardiorespiratory parameters, including heart rate, cardiac output, blood flow distribution, left ventricular stroke volume, arterial pressures, total peripheral resistance, and arterial and venous blood oxygen content; 5) be able to compare and contrast the cardiovascular effects of dynamic and isometric exercise in man and the mechanisms responsible for the major differences; and 6) be able to apply knowledge of the cardiovascular effects of exercise to understanding causes of cardiovascular symptoms in disease and in diagnosis of disease states. This material contains many areas that stimulate discussion with students and allow exploration of concepts that are challenging for the student. This give and take between teachers and student is difficult to summarize in an article of this sort. Therefore, subjects that in my experience often stimulate questions and discussion with the students are indicated in the text.AM. J. PHYSIOL. 277 (ADV. PHYSIOL. EDUC. 22): S244-S259, 1999.