Cardiac Rehab: A Guide for Patients and Families

Introduction

If you are suffering from chronic heart disease, recovering from heart surgery, or have experienced a major cardiac event, your physician may recommend a cardiac rehab program.

In this comprehensive guide, we’ll take you through everything you need to know about cardiac rehab. We’ll cover the different reasons you might need cardiac rehab, what to expect during treatment, and how you can benefit from the rehab program.

Share This eBook

  

Chapter 1: The Reasons Why You Might Need Cardiac Rehab

why you might need cardiac rehab

Cardiac rehab is aimed at patients suffering from acute or chronic heart conditions. Of these, the most common reason for cardiac rehab is heart disease.

Causes and Symptoms of Heart Disease

Heart disease is a broad term, covering a multitude of conditions and illnesses, which range from mild to severe. It is the leading cause of death for both men and women in the United States. As there are many different types of heart disease, the symptoms and warning signs vary widely. Some of the most common include:

  • Heart Arrhythmia – If you have an arrhythmia, your heart may beat too fast, too slowly, or irregularly. Symptoms include a fluttering feeling in your chest, breathlessness, and fainting.
  • Heart Infection – Caused by an irritant (like a virus or bacteria) reaching the heart, the symptoms include a fever, swollen legs and/or stomach, severe fatigue, and a dry cough.
  • Valvular Heart Disease – If the valves of your heart are damaged by a different heart condition or illness, they may become too narrow to allow blood to pass through or begin to “leak” blood. Symptoms might include chest pain, swollen feet or ankles, breathlessness, and fainting.chest pain heart disease
  • Cardiovascular disease – This term covers all conditions that affect the arteries and blood vessels that carry blood to and from the heart. Symptoms may include chest pain, weakness in the limbs, pain in the neck, jaw, throat, upper abdomen or back, and breathlessness.
  • Congenital Heart Disease – Referring to heart defects developed in the womb, congenital heart disease is usually apparent at birth. However, some less serious conditions may not be diagnosed until adulthood. Signs to watch out for include swollen limbs or extremities, shortness of breath, and tiring quickly when exercising.

Congestive Heart Failure

Congestive heart failure (or CHF) is another common reason why you or your loved one might be referred for cardiac rehab. CHF occurs when the heart becomes less efficient at pumping blood. This means blood moves more slowly through the heart and the rest of the body, which can cause increased pressure on the heart. It may be caused by coronary artery disease, a heart attack, angina, or cardiomyopathy. Other conditions like high blood pressure, obesity, and diabetes can also trigger CHF. At first, CHF may not cause any symptoms, but as the disease progresses, patients frequently experience fatigue, dizziness, heart arrhythmia, lung congestion, and fluid retention in the lower limbs or stomach.

Acute Myocardial Infarction

More commonly known as a heart attack, acute myocardial infarctions occur when one of the arteries supplying blood to the heart become blocked, cutting off blood flow and damaging the heart tissues. This most commonly occurs when a blood clot blocks an artery. People with high blood pressure, high LDL cholesterol, and diabetes are at greater risk of a heart attack. After a heart attack, you may be referred for cardiac rehab to learn how to avoid future incidents and manage your medication.

COPD and the Risk of Heart Disease

There is a clear correlation between COPD (chronic obstructive pulmonary disease) and heart disease. In fact, COPD patients are at least twice as likely to also suffer from heart disease. There are two reasons for this.

Firstly, the damage to the lungs caused by COPD means that the heart has to work harder to meet the body’s need for oxygen. All that extra work can eventually damage the heart, leading to heart disease and even heart failure.

Secondly, the two conditions share a number of overlapping risk factors (including smoking, physical inactivity, and age), making it unsurprising that the same person would develop both conditions.

Anxiety and Heart Disease

Just as COPD may make you more susceptible to heart disease, anxiety and stress are also major contributing factors. The relationship between anxiety and heart issues works in two ways.

On the one hand, anxiety can cause serious heart conditions. Researchers at Harvard University reported that people with anxiety disorders suffered from lower levels of Omega 3s in their bloodstream, which could be a factor in causing heart disease. Anxiety also caused full-body inflammation, which can sometimes increase blood pressure or disturb heart rhythms, causing damage to the heart over time. What’s more, anxiety can cause people to adopt unhealthy habits, such as smoking, drinking, or overeating, all of which have been linked to heart disease.

On the other hand, heart disease itself can be a major source of anxiety and stress. 1 in 4 people suffer from depression and anxiety after a heart attack, and 15% experience severe depression. Cardiac rehabilitation may be recommended if you or your loved one is struggling with the psychological fall-out after a heart attack or other major cardiac event.

Back to Top

Chapter 2: What to Expect from Cardiac Rehab

what to expect from cardiac rehab

What is Cardiac Rehab?

So, you or your loved one have been referred to cardiac rehab. But what does that even mean? In summary, cardiac rehab (also known as cardiac therapy) is a medically supervised program designed to improve the health and quality of life of patients with a heart-related medical condition. The rehab treatment program may be provided in an outpatient clinic, a specialist inpatient rehab facility, or a hospital-based rehab center. A team of rehab specialists, including doctors, nurses, physical therapists, occupational therapists, nutritionists, and mental health professionals, will work together to put together a customized rehab program. Usually, a cardiac rehab program will include medically supervised exercises and education on heart-healthy living.

Who Can Benefit from Cardiac Rehab?

The short answer is that anyone who is dealing with a cardiac condition can benefit from cardiac rehab. According to the Centers for Disease Control, this includes both patients with mild or moderate heart diseases, patients recovering from major cardiac events, anyone who has undergone heart surgery, and people with serious chronic heart conditions. Specifically, you may benefit from cardiac rehab if your medical history includes any of the following conditions:

  • A heart attack (acute myocardial infarction)
  • Chronic or acute heart failure
  • Coronary or peripheral artery disease
  • Pulmonary hypertension
  • Cardiomyopathy
  • Heart valve surgery or bypass
  • Heart or lung transplant
  • Angioplasty or stents
  • Congenital heart disease

The Four Phases of Cardiac Rehab

Cardiac rehab usually runs through four progressive phases, usually starting when you are still in the hospital. They are as follows:

Phase 1: Acute or Clinical

During the first phase, you may still be in the hospital. For instance, you may have recently experienced a heart attack or be recovering from heart surgery.

In milder heart conditions, Phase 1 might begin after the completion of some kind of medical intervention, such as the introduction of heart medications. During this phase of treatment, you will undergo a careful evaluation by a team of cardiac rehab specialists. They will review your physical and mental state, take a full medical history, and begin to provide you with support and information, in addition to the appropriate medications. You might also receive some acute care physical therapy to help you get back on your feet. In addition, if you are in a hospital, you will receive a discharge plan, also known as a guide for how to safely leave the hospital.

Phase 2: Subacute Care

If you have a serious heart condition or experienced a major cardiac event, you will not be ready to start intensive physical therapy straight away. During this stage of rehab, the focus will be on patient education. You will be guided on how to manage your heart condition and given more information on heart-healthy living. Your health will be closely monitored during this period to make sure that you are making progress toward recovery. Once you are ready to begin exercising, you will move onto the next phase of rehab.

Phase 3: Intensive Cardiac Rehab

Depending on your physical abilities, budget, and the levels of support available to you at home, you may decide to undertake intensive cardiac rehab as an outpatient, or staying in an inpatient rehab facility. This stage typically lasts 3 to 6 weeks. Your rehab team will design a customized cardiac rehab program to help support your recovery. This phase will include a progressive program of supervised physical and occupational therapy to enable you to resume daily activities, care for yourself as much as possible, and gain physical strength, flexibility, and mobility. You will also receive extensive training on how to manage your heart condition, modify your lifestyle, and manage your medications and any necessary medical devices on your own. Many patients will also work with a mental health professional to learn how to manage their stress and anxiety better. The goal of this phase of treatment is to help you feel more independent and better prepared to return home

Phase 4: Post-Rehab Maintenance

Phase 4 will last for the rest of your life! Once you’ve completed cardiac rehab, you should have a clear idea of everything you need to do to keep your heart healthy. The objective now is to keep up changes that you learned during your rehab program once you return to your daily life. You will need to maintain your exercise regime, new diet, and good habits, to avoid experiencing any further coronary incidents. You should also receive regular check-ups with your doctor to keep an eye on your heart health.

What are the Benefits of Cardiac Rehabilitation?

Cardiac rehab has been repeatedly demonstrated to offer major benefits to those suffering from heart conditions, including:

  1. A Longer, Healthier Life

    Of course, the main goal of cardiac rehab is to help you live longer and improve the health of your heart. Researchers have consistently found that “cardiac rehabilitation programs reduce hospital admissions and show a long-term decrease in all-cause mortality.” In other words, cardiac rehab may well keep you out of the hospital and help you live longer despite your heart condition.
  2. Improved Quality of Life

    After cardiac rehab, your life may not only be longer but more enjoyable. Patients often experience significant increases in their overall quality of life after rehab. For instance, researchers at James Cook University in Singapore found that patients “reported higher levels of physical and mental quality of life” after completing a cardiac rehab program. As the American Heart Association puts it:
    “Participating in cardiac rehab is one of the best things you can do for your heart. Cardiac rehab helps you regain control of your health.”
    When you complete a cardiac rehab program, you are likely to be physically stronger and mentally more resilient. You will learn how to better manage your heart condition, how to care for yourself, and how to return to your day-to-day routine. You may find that you feel more confident, less anxious, and better able to cope.
    cardiac rehab exam
  3. Increased Physical Fitness

    One of the key benefits of cardiac rehab is that it helps you build up your physical fitness levels in a safe, controlled environment. Your rehab team will put together a progressive program of exercises that will enable you to strengthen your cardiovascular system, build muscle tone and flexibility, and increase your physical resilience, without putting yourself at risk or exacerbating your heart condition. After cardiac rehab, you will know how to exercise on your own safely. This means you can include an exercise regime in your daily routine that will also help you to reduce stress, maintain a healthy weight, and feel better.

  4. More Awareness about Heart-Healthy Living

    Another crucial aspect of cardiac rehab is patient education. During your rehab program, you will receive intensive training on how to manage your heart condition, deal with your medications, and live a more heart-healthy lifestyle. Research has shown that patient education has a significant impact on the long-term well-being of patients. With your new-found expertise on your heart condition, you may identify changes you need to make to your day-to-day routine, such as how to better manage your stress levels or how to prepare nutritious, heart-healthy meals. In many rehab programs, education is also available to your family members and loved ones, to ensure that they can better support you once you return home after your rehab program finishes.
  5. Improved Mood

    Studies show that cardiac rehab reduces the rate of depression in cardiac patients. There are several reasons why cardiac rehab may help improve your mood. Firstly, a regular program of exercise promotes the release of endorphins. Secondly, by providing a supportive environment for recovery, cardiac rehab may help people feel more in control of their health and well-being. Thirdly, cardiac rehab often includes a social aspect; meeting other people with heart conditions may help you feel less alone. And finally, cardiac rehab usually includes training on stress management, which can help reduce feelings of anxiety and depression that frequently occur after cardiac events.
  6. Better Habits

    During rehab, you’ll learn how to change habits that can impact your hearth health. For instance, you may receive guidance on how to stop smoking for good. You’ll work with a nutritionist to develop eating habits that support your heart health. You will learn how to exercise regularly and safely. You might also learn how to use breathing techniques or meditation to manage your stress and anxiety better.

Back to Top

Chapter 3: How to Live a Heart-Healthy Life After Cardiac Rehab

heart healthy habits post-rehab

Once you’ve finished your cardiac rehabilitation program, you’ll be ready to return home. During rehab, you will receive a lot of information on your heart condition, how to manage it, and the habits you need to maintain to keep yourself as healthy as possible. However, all that information is only useful if you put it into practice!

The Secrets of a Heart-Healthy Lifestyle

Depending on the type of heart condition you are dealing with, your rehab team will guide you toward specific medications and treatments that you should continue when you leave. However, almost every heart patient is advised to include the following in their post-rehab routine:  

  1. Regular Exercise

    Regular exercise helps your heart grow stronger, helps reduce stress and anxiety, and helps you reach or maintain a healthy weight. During your cardiac rehab program, you will have learned how to exercise safely. Unless your medical team advises against it, you should include exercise in your daily routine.

  2. A Heart-Healthy Diet

    During rehab, you should receive nutritional guidance as well as a new and improved diet that will help support your long-term heart health. Once you return home, you or your loved one  must follow this new way of eating.

  3. Stress Management

    To keep your heart as healthy as possible, you must manage your levels of stress and anxiety. High levels of stress hormones, such as cortisol and adrenalin, can cause your blood pressure to rise and even make it more likely for you to have a heart attack. In addition to staying active, consider adding meditation, yoga, or tai chi to your routine. You may even want to sign up for a stress management class.
  4. Good Habits

    Make sure that when you head home, you don’t fall back into unhealthy patterns. You must avoid smoking, heavy drinking, or overeating if you want to keep yourself healthy in the long-term.

medicine ball exercise

Conclusion

There’s no doubt that cardiac rehab offers many potential benefits for patients with heart conditions. Researchers at Harvard Medical School report that cardiac rehab reduces heart-related mortality by 20%, hospital readmissions by 28%, and increases the patient’s quality of life, ability to carry out daily activities, and overall mental well-being.

What’s more, patients usually report high levels of satisfaction with cardiac rehab services and link positive lifestyle changes to what they learned during rehab. If you have questions or concerns about cardiac rehab, and whether it would be right for you or your loved one, the team at Rehab Select would be happy to help. Please visit our website here to talk to a rehab specialist or schedule a tour at one of our specialist rehab facilities.

Back to Top