How much of a recovery the heart makes depends on the extent of damage and how diligently the person follows the various steps of the cardiac rehab program.

The perfect candidate for Cardiac Rehabilitation is anyone with a history of heart issues such as angina, heart attack, or heart failure or if you have undergone any cardiovascular procedures such as angioplasty, heart or lung transplant, heart valve repair or bypass surgery. As the term ‘rehab’ suggests, the goal is to work on the heart that has weakened due to any of the above-mentioned conditions and make it healthy once again. How much of a recovery the heart makes depends on the extent of damage and how diligently the person follows the various steps of the cardiac rehab program.

Broadly speaking the phases of the cardiac rehab program are divided into three parts:

1.In-patient Rehab

Phase 1 usually begins when the patient is admitted to the hospital. Soon after he is treated for the heart condition that brought him to the hospital, the doctor will assess his heart’s functioning and the first phase of cardiac rehab will commence. The program is designed by a multidisciplinary team of medical experts including the cardiologist, pulmonologist, physiotherapist, psychologist, dietitian and other medical staff. The main goal is to encourage the patient to indulge in controlled and gentle physical activity to boost heart health and to also provide him with tools to live a full life despite heart disease.

Components of In-patient Cardiac Rehab include:

• – Slow, gentle exercises done under supervision
• – Dietary changes upon consultation with the nutrition expert
• – Physiotherapy
• – Educating the patient on the need and usage of medication
• – Counselling and psychotherapy to cope with life after heart disease
• – Smoking cessation treatment, is a vital component if the patient is a smoker

In-patient Cardiac Rehab plays a significant role in helping the patient make a steady recovery and reduces the possibility of rehospitalization.

2.Out-patient Rehab

Upon discharge from the hospital, the patient will be required to return to the hospital on a regular basis for phase 2 of cardiac rehab. The goal of phase two is to ensure that the patient is making a good recovery post-procedure and to help improve the quality of his lifestyle by improving heart function. It is advisable to begin phase 2 of cardiac rehab within 12 months of the incident. In most cases, out-patient cardiac rehab lasts for 12 weeks or 36 sessions. If the program needs to be extended, there should be proper documentation to justify the same.

Components of Out-patient Cardiac Rehab:

• – 20 to 60-minute session of supervised workout
• – the duration of the exercise starts at a bare minimum and the patient gradually gets better.
• – ECG is monitored during and after the workout session.
• – Based on improvement, the doctor will review and revise the program.

If the patient is showing signs of stress or anxiety as a result of the program or the heart condition, regular consultation with a therapist will be included in phase 2.

3.At-home Rehab

Once the doctor deems the patient fit to work out on his own, without supervision Out-patient Cardiac Rehab gradually comes to an end. Rehab must continue at home. The patient is educated on the benefits of the same and is trained as well.

Home-based cardio rehab is a structured program that needs to be followed diligently for long-term benefit. It is carried out through a combination of sessions guided by professionals who make house calls and through online consultation. The patient may be required to wear devices that monitor heart functions during the sessions, to help the doctors evaluate the impact and efficacy of the program.

After a few weeks of being monitored at home, the patient is then evaluated and if he is showing considerable progress, he is then given a plan of exercises to continue long-term as part of maintenance therapy. The patient will have to visit the doctor periodically for assessment.

Eating the right kind of food and measured quantities of water, play a part in cardiac rehab. Through every phase of rehab, the cardiologist and dietician guide the patient with a proper diet chart that needs to be adhered to strictly.

WHEN SHOULD CARDIAC REHAB STOP?

Ideally, some form of exercise for the heart needs to be followed forever, to keep the heart pumping and healthy. However, if the patient shows the following symptoms, it is best to avoid/stop cardiac rehab and re-evaluate the patient’s cardiovascular health before proceeding:

• If the patient shows a significant change in resting ECG within two days of the first cardiac episode.
• If angina continues after the cardiac issue has been treated
• If the person has uncontrolled arrhythmias
• If blood pressure shoots up and is difficult to control
• If there is an onset of an acute systemic infection accompanied by fever, body aches and swollen lymph glands
• If the patient shows symptoms of acute heart or lung conditions
• If the patient has a Symptomatic severe aortic stenosis

The main goals of Cardiac Rehab are:

• Lower risk of a future cardiac event
• Improve health and functioning of the heart.
• Reduce emotional stress caused by heart disease.
• Encourage the patient to lead a healthy lifestyle.
• To achieve these goals, it is important that the patient follows the cardiac rehab plan set by the doctors.

Reviewed By:

DR.ASHOKKUMAR

CONSULTANT – CARDIOLOGY

MBBS, MD (MEDICINE), DM (CARDIOLOGY)