cardiac rehabilitation


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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).

car·di·ac re·ha·bil·i·ta·tion

(kahr'dē-ak rē'hă-bil'i-tā'shŭn)
A systematic program of exercise and nutritional, behavioral, and vocational counseling to optimize the recovery and physiologic capacity of the patient with cardiovascular disease.
References in periodicals archive ?
Samsung Electronics revealed the results of a joint cardiac rehabilitation initiative, developed in collaboration with Kaiser Permanente, the largest not-for-profit integrated health system in America.
The global Cardiac Rehabilitation Devices Market is projected to reach over USD 2,839.9 million by 2023 at 6.2% CAGR during the review period of 2018 to 2023.
High-intensity cardiac rehabilitation training of a firefighter after placement of an implantable cardioverter-defibrillator.
The Cardiac Care Network also emphasizes that the use of technology, such as telemonitoring, helps to bridge access to cardiac rehabilitation for people in remote areas (2013).
Furthermore, increase in number of health conscious people is boosting the cardiac rehabilitation market globally.
Cleveland Clinic Abu Dhabi, part of Mubadala's network of healthcare providers, conducted a study on 50 patients suffering from cardiovascular disease who went on to complete the hospital's cardiac rehabilitation programme.
According to a new study by the US Centers for Disease Control and Prevention, only one-in-three heart attack survivors go on to complete cardiac rehabilitation programmes in America.
On the occasion of the World Heart Day, the hospital aims to educate residents and create awareness on cardiac rehabilitation as the essential step towards recovery from a heart disease.
Angela Melvin, cardiac rehabilitation nurse said: "Shelley is a very motivating and enthusiastic individual who is a great asset to us.
The Million Hearts Cardiac Rehabilitation Collaborative, ([paragraph]) a group of over 30 organizations and agencies, has developed an action plan to increase use of cardiac rehab to over 70%.
Hamad Medical Corporation's (HMC) Heart Hospital recently welcomed delegates to its Cardiac Rehabilitation Symposium,providing them with a unique opportunity to learn about the latest medical advances in the rehabilitation and treatment of patients with heart disease.