CARDIAC REHABILITATION

What is cardiac rehabilitation?

Cardiac rehabilitation is a medically supervised programme that helps improve the health and well-being of people who have heart problems.

Today cardiac rehabilitation has evolved into a comprehensive system that helps patients not only to recover physically but also makes them more aware of their cardiovascular disease and actions they can take to improve their heart health. Patients get to understand that their own efforts in lifestyle modification can improve their quality of life and reduce the risk of a future event.

Is it evidence based?

Evidence suggests that cardiac rehabilitation reduces mortality, morbidity and unplanned hospital admissions in addition to improvements in exercise capacity, quality of life and psychological well-being. Cardiac rehabilitation is recommended in international health guidelines.

Who should take part in cardiac rehabilitation?

People with various heart problems can benefit from the programme. It is recommended for people who have had:

– A recent heart attack
– Stable angina
– Heart failure
– Heart procedures such as Angioplasty
– Heart surgery
– Heart valve procedures
– Heart transplantation
– Any individual who is at cardiac risk and who wants to prevent the occurrence of cardiac event to him/herself and their family

What happens during cardiac rehabilitation?

Cardiac rehabilitation programme includes systematic evaluation, individual risk stratification, and medication optimisation, supervised aerobic and muscle strengthening exercises (following exercise testing). Also part of the program are education and counselling services to help heart patients increase their physical fitness, reduce cardiac symptoms, improve health and reduce the risk of future heart problems.

Goals of the programme:

Physiological parameters focus on improvement in exercise habits and exercise tolerance and optimisation of coronary risk factors including improvement in lipid and lipoproteins, body weight, blood glucose levels and cessation of smoking. An important aspect, especially for elderly, is functional independence. The aim of the programme is to help cardiac patients get back to a normal routine as quickly and safely as possible, institute lifestyle changes, provide for regular monitoring to reduce future risk of cardiac events and to improve the psychological well-being of cardiac patients and their family.

When can you start the programme after a heart procedure and how long is it?

The programme can be started usually 2-4 weeks after a cardiac procedure. Sessions usually last for 30-45 minutes, 2-3 times a week for 6-12 weeks. The programme is different for each patient based on their functional capacity.

Conclusion:

In India the prevalence of coronary heart disease and heart failure is increasing. There is an exponential increase each year of PCI procedures and a trend towards younger population being affected. Though the benefits of exercise in preventing or reducing the severity of cardiac conditions is well known, the emphasis is still very low or under prevalent in India. More emphasis should be given on prevention and rehabilitation. It’s not just about exercise, but also about learning self-monitoring skills, knowing how to push one’s heart to its potential, finding the right exercise balance and getting the whole comprehensive approach through education and counselling. Many of these parameters are lost or overlooked when patients are not provided with proper supervision.