cardiac rehabilitation

Cardiac Rehabilitation

Definition

Cardiac rehabilitation is a comprehensive exercise, education, and behavioral modification program designed to improve the physical and emotional condition of patients with heart disease.

Purpose

Heart attack survivors, bypass and angioplasty patients, and individuals with angina, congestive heart failure, and heart transplants are all candidates for a cardiac rehabilitation program. Cardiac rehabilitation is prescribed to control symptoms, improve exercise tolerance, and improve the overall quality of life in these patients.

Precautions

A cardiac rehabilitation program should be implemented and closely monitored by a trained team of healthcare professionals.

Description

Cardiac rehabilitation is overseen by a specialized team of doctors, nurses, and other healthcare professionals. Members of the cardiac rehabilitation team may include a dietician or nutritionist, physical therapist, exercise physiologist, psychologist, vocational counselor, occupational therapist, and social worker. The program frequently begins in a hospital setting and continues on an outpatient basis after the patient is discharged over a period of six to 12 months.

Components of a cardiac rehabilitation program vary by individual clinical need, and each program will be carefully constructed for the patient by his or her rehabilitation team.

Exercise. Exercise programs typically start out slowly, with simple range-of-motion arm and leg exercises. Walking and stair climbing soon follow. Blood pressure is carefully monitored before and after exercise sessions, and patients are taught how to measure their heart rate and evaluate any possible cardiac symptoms during each session. Patients with advanced coronary disease may require continuous ECG monitoring throughout their exercise sessions. Once discharged from the hospital, the patient works with his cardiac team to create an individual exercise plan.
Diet. Cardiac patients will work with a nutritionist or dietician to develop a low-fat, low-cholesterol diet plan. Patients with high blood pressure may be put on a salt-restricted diet and instructed to limit alcohol intake. Weight loss may also be a goal with obese cardiac patients.
Counseling. A psychologist or social worker can help cardiac patients with issues that may be contributing to their heart condition, such as stress and anxiety. Relaxation techniques may be taught to patients to help them deal with these feelings. Cardiac patients frequently experience a period of depression, and group or individual counseling can be beneficial in overcoming these feelings. Vocational counselors can assist cardiac patients in returning to the workforce.
Education. The patient and family should be fully educated on the physical limitations of the patient, his recommended diet and exercise plan, his emotional status, and the lifestyle changes required to improve the patient's overall health.
Smoking cessation. Cardiac patients who smoke are twice as likely to have a heart attack in the following five years than non-smoking patients. These patients are strongly encouraged to enroll in a smoking cessation program, which typically includes patient education and behavioral counseling. Nicotine replacement therapy, which uses nicotine patches, nose spray, or gum to wean patients off of cigarettes, may also be part of the program. Antidepressants and anti-anxiety medication may be helpful in some cases.

Aftercare

Long-term maintenance is a critical feature of cardiac rehabilitation. Patients require support from their healthcare team, family, and friends to continue the lifestyle changes they implemented during the rehabilitation period.

Risks

The risks of another heart attack during cardiac rehabilitation are slight, and greatly reduced by careful, continuous monitoring of the physical status of the patient.

Normal results

The outcome of the cardiac rehabilitation program depends on a number of variables, including patient follow-through, type and degree of heart disease, and the availability of an adequate support network for the patient. Patients who successfully complete the program will ideally reach an age-appropriate level of physical activity and be able to return to the workforce and/or other daily activities.

Resources

Organizations

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. http://www.americanheart.org.

Key terms

Angina — Chest pain.

Bypass surgery — A surgical procedure that grafts blood vessels onto arteries to reroute the blood flow around blockages in the arteries (arteriosclerosis).

cardiac rehabilitation

Etymology: Gk, kardia, heart; L, re + habilitas, ability

a supervised program of progressive exercise, psychologic support, education, and training to enable a patient to resume the activities of daily living on an independent basis following a myocardial infarction. The patient may require special training to adapt to a new occupation and life-style.

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active exercise aerobic exercise bypass surgery cardiac exercise stress test cardiovascular exercise Coronary Artery Bypass Graft Surgery coronary artery disease corrective exercise endurance exercise exercise healing Heart Valve Repair Heart Valve Replacement isokinetic exercise isometric exercise isotonic exercise muscle-setting exercise myocardial myocardial infarction			After treatment in Manchester Royal Infirmary, Ysbyty Gwynedd and Ysbyty Glan Clwyd, I've found my cardiac rehabilitation amazing. WITHOUT IT I'D BE BACK IN HOSPITAL by Daily Post (Liverpool, England) Checks by the National Audit of Cardiac Rehabilitation found only 40% of 2,032 heart attack sufferers took part in rehabilitation programmes in south-east Wales last year - slightly higher than the UK average of 38%. Flaws in heart attack services; Heart attack survivors missing out on ... by South Wales Echo (Cardiff, Wales) Of the 7,250 heart patients in the region in a recent survey, a third had completed a cardiac rehabilitation programme. Heart victims lack help by Coventry Evening Telegraph (England)			cardiac infarction cardiac injury panel cardiac insufficiency cardiac jelly cardiac marker cardiac massage cardiac monitor cardiac monitoring cardiac murmur cardiac muscle Cardiac Negro cardiac nerves cardiac notch cardiac nuclear scanning cardiac opening cardiac output cardiac pacemaker cardiac pain cardiac plexus cardiac precautions cardiac profile guideline cardiac pump effectiveness cardiac radionuclide imaging cardiac reflex cardiac regurgitation cardiac rehabilitation cardiac reserve cardiac rhythm cardiac risk evaluation panel Cardiac shunt cardiac souffle cardiac sound cardiac sphincter cardiac standstill cardiac stenosis cardiac stimulant cardiac syncope cardiac tamponade cardiac thrombosis cardiac valve cardial notch cardialgia cardiasthenia cardiectasia cardiectasis cardiectomy cardiectopia Cardigan Welsh corgi cardinal cardinal flower cardinal frontal plane			Cardiac passion Cardiac passion Cardiac passion Cardiac Patients Learning Needs Inventory Cardiac Phase to Order Reconstruction cardiac plexus cardiac plexus cardiac plexus cardiac precautions cardiac preload cardiac preload cardiac preload cardiac pressure load cardiac pressure load cardiac pressure load cardiac profile guideline Cardiac Progressive Care Unit Cardiac pump Cardiac pump Cardiac pump cardiac pump effectiveness cardiac racing syndrome cardiac racing syndrome cardiac racing syndrome cardiac radionuclide imaging cardiac reflex Cardiac region Cardiac region Cardiac region cardiac regurgitation cardiac rehabilitation Cardiac Rehabilitation and Exercise Training Cardiac Rehabilitation Association of New Zealand cardiac rehabilitation disease management Cardiac Rehabilitation Interest Group Scotland Cardiac Rehabilitation Program Cardiac Rescue Technician cardiac reserve cardiac reserve cardiac reserve cardiac reserve cardiac reserve Cardiac Respiratory Care Unit cardiac respiratory reflex cardiac respiratory reflex cardiac respiratory reflex cardiac respiratory reflex cardiac resuscitation cardiac resuscitation cardiac resuscitation Cardiac Resynchronization Therapy Cardiac Resynchronization Therapy - Defibrillators Cardiac Resynchronization Therapy Defibrillator Cardiac Resynchronization Therapy Pacemaker cardiac rhythm cardiac rhythm Cardiac Rhythm Disease Management Cardiac rhythm management Cardiac Rhythm Management Laboratory Cardiac Rhythm Medical Device Cardiac Risk Assessment