The term cardiac rehabilitation, as defined by the World Health Organization (WHO), refers to coordinated, multifaceted interventions designed to optimize the physical, psychological, and social functioning of the person who suffered a cardiac arrest, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic processes, thereby reducing the risk of further disease.
In simple words, cardiac rehabilitation is a comprehensive programme that helps an individual recover from heart disease and prevents the recurrence of the disease.
The main goals of the programme are:
- To get a person back to normalcy as quickly and safely as possible after a heart attack, angioplasty or bypass surgery,
- To institute lifestyle changes and regular monitoring to reduce future risk of cardiac events, and
- To improve the psychological well-being of the person suffering from cardiac disease.
After any heart event, post-care and rehabilitation are a vital part of the treatment. A structured cardiac rehabilitation programme is crucial to get that person on the path to recovery and prevent further illness.
Extensive research has revealed that, when compared with usual medical care, individuals who undergo cardiac rehabilitation show a reduction of 20 per cent in total death and 26 per cent in cardiac deaths.
When does cardiac rehabilitation begin?
The sooner, the better. The programme should start the moment the person is discharged from the hospital. The process begins within 10-14 days post-bypass surgery if there are no complications.
Similarly, after an angioplasty, cardiac rehabilitation can begin within a few days if there are no complications. In fact, for some people who are clinically stable, it can even begin while they are in the hospital.
What happens during the programme?
Often some people walk into a cardiac rehabilitation centre and get the impression that they are in a gym. This is because they see several people exercising at the same time. Exercise forms only one component of the programme, but it’s the most visible one.
In reality, cardiac rehabilitation looks at every aspect of the risk profile and works at keeping it to a minimum.
Initially, the individual is thoroughly evaluated from a medical, physical and emotional standpoint. Following the evaluation, an individualized programme of exercise, nutrition, and stress reduction is planned. The individual visits the centre thrice a week and exercises using portable heart monitoring equipment known as telemetry.
With the help of this special equipment, the electrocardiogram or ECG is continuously transmitted to the monitoring station wirelessly while the person is exercising. This ensures that the optimal amount of exercise is performed in the safest manner possible.
In addition to exercise, the individual’s risk factors are charted out and goals are set for each of them and evaluated at regular intervals to ensure optimum risk factor management. The individual visits the programme frequently and the team is able to fine-tune his or her medications to achieve perfect control over most cardiac parameters.
For instance, the individual visits the rehab centre thrice a week and their blood pressure is charted several times at each visit. This allows ‘titration’ of medications to achieve aggressive risk factor control—not just ordinary control.
Besides exercise and risk factor reduction, diet and stress management form an integral component of the process. Again, the frequency of visits allows the dietician to tailor a meal plan that suits the person’s health and cultural needs and modifications can be made as needed. Stress management is done through a variety of methods, which often include yoga, meditation, and group support.
Mental confidence gets a boost
Mental confidence is one of the greatest benefits of good cardiac rehabilitation and helps a person to get back to a ‘better than before’ state. When individuals are able to greatly improve their physical capacity, they also feel more confident about their future.
Who can benefit from cardiac rehabilitation?
Anyone who has suffered from heart disease, or is at risk for heart disease, can benefit from a structured cardiac rehabilitation programme. This includes those who have undergone:
- Heart attack
- Bypass surgery
- Angioplasty
- Angiography showing blockages
- Heart failure
- Heart valve replacement
- Angina
Cure the disease, don’t just repair it
The cardiac rehabilitation process is a cure for the problem. It gets to the root of why one had heart disease in the first place, and works out solutions to reduce future risk.
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Take-home messages
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Recap of medical terms in this article:
- Angina: Squeezing of the chest due to lack of adequate blood supply to the heart muscle. Pain may occur anywhere in the chest region (left or right) and may radiate to either arm, or even the shoulders, back, and jaw.
- Angiography: A test that looks at the inside of the coronary arteries to detect blockages and their location
- Angioplasty: A procedure in which a balloon is used to widen blocked arteries
- Atherosclerosis: The hardening of arteries caused by plaque accumulating over time
- Cardiac rehabilitation: A set of coordinated interventions that helps optimize the physical, psychological, and social functioning of someone who suffered a cardiac arrest.
