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Cardiac Rehab - Page 1

Summary

  1. Cardiac rehabilitation is a medically supervised program to help heart patients recover quickly and improve their overall physical and mental functioning
  2. Outpatient cardiac rehabilitation usually lasts 12 weeks with 3 sessions per week
  3. Cardiac rehabilitation is appropriate for a wide variety of heart patients, including those who have had a heart attack, bypass surgery, or angioplasty
  4. Monitored exercise is the most important part of the rehabilitation program
  5. In addition to exercise, cardiac rehabilitation can include education about risk factor reduction, psychological counseling, and stress management
  6. Cardiac rehabilitation reduces the chance of dying from all causes and heart-related causes by 20% to 25%
  7. Women are significantly less likely than men to be referred to a cardiac rehabilitation program
  8. Even when women receive referrals to cardiac rehabilitation, they are less likely than men to take part in the program
  9. Men are more likely than women to complete a cardiac rehabilitation program

What is a cardiac rehabilitation program?
A cardiac rehabilitation program is a medically supervised program designed to help heart patients recover quickly and improve their overall physical and mental health. You may be referred to a cardiac rehabilitation program after heart surgery, a heart attack, or a diagnosis of heart disease. Programs are available at most hospitals or within local communities across the country.
The main goals of cardiac rehabilitation are to allow you to resume a normal, active, and productive life within the limits of your disease, and to reduce the risk of another heart problem or the worsening of a heart condition.
Specifically, cardiac rehabilitation programs aim to reduce the risk of heart attacks, to alleviate angina (chest pain), and to prevent the progression of heart disease. These goals are achieved by supervised exercise training, nutritional counseling, stress management, aggressive management of risk factors, and careful monitoring of heart health.  Phase II rehabilitation, also known as outpatient cardiac rehabilitation, usually lasts about 12 weeks and includes 36 sessions (about 3 sessions per week).

Who should attend a cardiac rehabilitation program?
Cardiac rehabilitation programs are appropriate for a wide variety of heart patients, including those who have recently had or been diagnosed with:

If you’ve had Bypass surgery, you will probably start your program 4 to 8 weeks after surgery;1 if you've had a heart attack or angioplasty or stent placement, you will probably start sooner.

How is a cardiac rehabilitation program structured?
You’ll probably begin the program while in the hospital by regaining basic skills, such as getting out of bed and going to the bathroom by yourself.  This is often known as Phase I cardiac rehabilitation.  Once you have left the hospital, you begin to work on getting stronger and learning how to avoid future heart-related problems.  Programs are designed to fit each individual, and thus the length of the program can vary from weeks to months, depending on your specific needs.
Exercise is the most important part of the rehabilitation program, because heart patients who exercise are far less likely to have another heart attack compared to those who do not.  You will first have an exercise stress test in order to help design your exercise program.  You will be evaluated for strength, endurance, flexibility, and other aspects of physical functioning.  These tests are painless and noninvasive.  Exercise begins gradually.  You may be asked to come in once a day, several days a week, or only once a week. If you have a low risk of suffering a heart attack, you may be able to start an exercise program independently with guidance from your healthcare provider.  The goal is to experience an overall improvement in physical functioning from the beginning of the program to the end.

Is it safe for me to be exercising?
Cardiac rehabilitation is monitored by health care professionals who are aware of your physical limitations.  Whether you exercise at home or at an outside program, you will only do what you are capable of doing. 
At cardiac rehabilitation centers, heart monitors are often worn during exercise to ensure that the heart is doing well and functioning properly.  Blood pressure is also monitored.  Emergencies are rare, but the health personnel are trained to handle them.  Because most cardiac rehabilitation programs take place in or near a hospital, medical equipment and expertise are ready at the first sign of a problem. 

Besides exercise, what else is part of a rehabilitation program?
Important parts of any cardiac rehabilitation program are education and counseling programs.  Your risk factors will be identified and you will be given advice on how to reduce them, including strategies to quit smoking and dietary tips to reduce fat and cholesterol levels.  Weight loss is often a goal of cardiac rehabilitation and the importance of a heart-healthy diet is stressed.  Counseling programs may focus on depression and other issues experienced by people coping with heart problems or following heart surgery, such as getting back to work, new physical limitations, and managing stress. These mental aspects of rehabilitation are especially important for women, who have more depression and low self-esteem than men after a first heart event.2
Medications are often prescribed as part of the cardiac rehabilitation process.  These include aspirin or other antiplatelet agents, which prevent blood clots and help maintain proper blood flow through the arteries; beta-blockers, ACE inhibitors or angiotensin receptor blockers (ARBs) for controlling blood pressure; and cholesterol-reducing medication, such as statins.

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