Cardiac rehabilitation

 

Overview

Cardiac rehabilitation, also called cardiac rehab, is a customized outpatient program of exercise and education. The program is designed to help you improve your health and recover from a heart attack, other forms of heart disease or surgery to treat heart disease.

Cardiac rehabilitation often involves exercise training, emotional support and education about lifestyle changes to reduce your heart disease risk, such as eating a heart-healthy diet, maintaining a healthy weight and quitting smoking.

The goals of cardiac rehabilitation include establishing a plan to help you regain strength, prevent your condition from worsening, reduce your risk of future heart problems, and improve your health and quality of life.

Research has found that cardiac rehabilitation programs can reduce your risk of death from heart disease and reduce your risk of future heart problems. The American Heart Association and American College of Cardiology recommend cardiac rehabilitation programs.

Why it's done

Cardiac rehabilitation is an option for people with many forms of heart disease. In particular, you might benefit from cardiac rehabilitation if your medical history includes:

  • Heart attack
  • Coronary artery disease
  • Heart failure
  • Peripheral artery disease
  • Chest pain (angina)
  • Cardiomyopathy
  • Certain congenital heart diseases
  • Coronary artery bypass surgery
  • Angioplasty and stents
  • Heart or lung transplant
  • Heart valve repair or replacement
  • Pulmonary hypertension

Risks

Cardiac rehabilitation isn't appropriate for everyone who has had heart disease. Your health care team will evaluate your health, including reviewing your medical history, conducting a physical exam and performing tests, to make sure you're ready to start a cardiac rehabilitation program.

Rarely, some people suffer injuries, such as strained muscles or sprains, while exercising as a part of cardiac rehabilitation. Your health care team will carefully monitor you while you exercise to lower this risk and will teach you how to avoid injuries when you exercise on your own. There is also a small risk of cardiovascular complications.

How you prepare

If you've had a heart attack, heart surgery or another heart condition, ask your doctor about joining a cardiac rehabilitation program. Insurance and Medicare often cover the costs of cardiac rehabilitation in the United States. Check with your insurance company to see if your cardiac rehabilitation will be covered.

Your treatment team will work with you to set goals for your cardiac rehabilitation program and design a program that meets your needs. In some cases, a case manager will track your care.

Cardiac rehabilitation can begin while you're still in the hospital or, more likely, as an outpatient. For some people, a home-based program might work, especially at certain times, such as a pandemic.

What you can expect

During cardiac rehabilitation

The first stages of most cardiac rehabilitation programs generally last about three months, but some people will follow the program longer. In special situations, some people might be able to do an intensive program for several hours a day that can last one or two weeks.

During cardiac rehabilitation, you'll likely work with a team of health care professionals, possibly including cardiologists, nurse educators, nutrition specialists, exercise specialists, mental health specialists, and physical and occupational therapists.

Cardiac rehabilitation includes:

  • Medical evaluation. Your health care team will generally perform an initial evaluation to check your physical abilities, medical limitations and other conditions you may have. Ongoing evaluations can help your team keep track of your progress over time.

    During your evaluation, your health care team might look at your risk factors for heart complications, particularly during exercise. This can help your team tailor a cardiac rehabilitation program to your needs, making sure it's safe and effective for you.

  • Physical activity. Cardiac rehabilitation can improve your cardiovascular fitness through physical activity. Your health care team will likely suggest low impact activities that have a lower risk of injury, such as walking, cycling, rowing and jogging. Your program might include yoga, which has been shown in some studies to be beneficial for cardiac health.

    You'll usually exercise at least three times a week. Your health care team will likely teach you proper exercise techniques, such as warming up and cooling down.

    You might also do muscle-strengthening exercises, such as lifting weights or other resistance training exercises, two or three times a week to increase your muscular fitness.

    Don't worry if you've never exercised before. Your health care team can make sure the program moves at a comfortable pace and is safe for you.

  • Lifestyle education. This involves support and education on making healthy lifestyle changes, such as eating a heart-healthy diet, exercising regularly, maintaining a healthy weight and quitting smoking.

    It can include guidance about managing conditions such as high blood pressure, diabetes, high cholesterol and obesity.

    You'll likely have opportunities to ask questions about such issues as sexual activity. You'll also need to continue taking medications you've been prescribed by your doctor.

  • Support. Adjusting to a serious health problem often takes time. You might feel depressed or anxious, lose touch with your social support system, or have to stop working for several weeks.

    If you get depressed, don't ignore it. Depression can make your cardiac rehab program more difficult, and it can affect your relationships and other areas of your life and health.

    Counseling can help you learn healthy ways to cope with depression and other feelings. Your doctor might also suggest that you take an antidepressant or other medication. Vocational or occupational therapy can teach you skills to help you return to work.

Although it may be difficult to start a cardiac rehabilitation program when you're not feeling well, you can benefit in the long run. Cardiac rehabilitation can guide you through fear and anxiety as you return to an active lifestyle with more motivation and energy to do the things you enjoy.

Cardiac rehabilitation can help you rebuild your life, both physically and emotionally. As you get stronger and learn how to manage your condition, you'll likely return to a normal routine, along with your new diet and exercise habits.

Your chances of having a successful cardiac rehabilitation program rest largely with you. The more dedicated you are to following your program's recommendations, the better you'll do.

After cardiac rehabilitation

After your program ends, you'll generally need to continue the diet, exercise and other healthy lifestyle habits you learned for the rest of your life to maintain heart-health benefits. The goal is that at the end of the program you'll have the tools you need to exercise on your own and maintain a healthier lifestyle.

Results

To get the most benefits from cardiac rehabilitation, you'll need to continue the habits and follow the skills you learned in the program for the rest of your life.

Over the long term, sticking to your cardiac rehabilitation can help you:

  • Improve strength
  • Adopt heart-healthy behaviors, such as regular exercise and a heart-healthy diet
  • Cut bad habits, such as smoking
  • Manage your weight
  • Find ways to manage stress
  • Learn how to cope with heart disease
  • Decrease your risk of coronary artery disease and other heart conditions

One of the most valuable benefits of cardiac rehabilitation is often an improvement in your overall quality of life. If you stick with your cardiac rehab program, you might end up feeling better than before you had a heart condition or had heart surgery.

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