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).

cardiac rehabilitation

Etymology: Gk, kardia, heart; L, re + habilitas, ability
a supervised program of progressive exercise, psychological 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.

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.

cardiac rehabilitation

a structured, planned programme, originally restricted to patients following myocardial infarction, designed to achieve and maintain the maximum degree of physical and psychological independence of which they are capable. Now extended to include all patients with any cardiovascular disease. The programme is exercise based, with a gradual increase in activity individually tailored to suit clinical status and level of symptoms. Educational (risk factor modification) and nutritional sessions are included for both patient and spouse/partner and the psychosocial aspects such as return to work, resumption of sexual intercourse, etc. are covered.
References in periodicals archive ?
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.
A combination of various personalised physiological activities and counselling, cardiac rehabilitation programme aims to restore heart patients to self-reliance in daily active life and help them return to formal work activities as quickly as possible.
Outpatient cardiac rehabilitation among heart attack survivors helps to reduce these recurrences and improve health outcomes.
Specific lifestyle changes aimed at reducing health risks and improving patients' quality of life, including fitness and diet advice for cardiac rehabilitation, were discussed.
Market Segment by Regions, this report splits Global into several key Region, with production, consumption, revenue, market share and growth rate of Cardiac Rehabilitation market in these regions, from 2011 to 2021 (forecast), like North America, China, Europe, Japan, India, Southeast Asia split by product type, with production, revenue, price, market share and growth rate of each type Split by application, this report focuses on consumption, market share and growth rate of Cardiac Rehabilitation market in each application.
Candidates for cardiac rehabilitation include patients who've had a heart attack; have a heart condition such as stable angina (heart-related chest pain), coronary artery disease or heart failure; and those who have undergone a cardiac procedure, such as angioplasty or stenting, bypass surgery, heart valve repair/replacement, cardiac device implantation, or a heart or heart/lung transplant.
The expertise of the inpatient cardiac rehabilitation team is vital at this point.
A retrospective analysis was performed for 50 outpatients enrolled in the cardiac rehabilitation program (CRP) from November 2011 to May 2013 in Afyon Kocatepe University Hospital Department of Physical Medicine and Rehabilitation.
Just 38% of patients in Wales who have a heart attack, angioplasty or bypass surgery receive cardiac rehabilitation, new statistics from the British Heart Foundation (BHF) Cymru have revealed.
Based on the latest statistics released by the World Health Organization (WHO), coronary artery diseases (CAD) was introduced as the most common cause of death worldwide in 2004 [1], The prevalence of CAD has also been reported to be high in Iran [2], Like patients with other heart conditions, those who go under coronary artery bypass grafting (CABG) and angioplasty require cardiac rehabilitation [3], The cost of initial treatment, subsequent disability, and mortality resulting from ischemic heart diseases (IHD) are the causes of an enormous loss in financial resources as well as loss of human lives in society.
Medicare will begin covering cardiac rehabilitation for patients with stable, chronic heart failure with a left ventricular ejection fraction of 35% or less.
Now his family and friends have made a donation to North Tees and Hartlepool NHS Foundation Trust's cardiac rehabilitation team, which it is hoped will help keep other people suffering from heart problems fit and healthy.