Cardiac rehabilitation

Overview

Cardiac rehabilitation (cardiac rehab) is a personalized program of education and exercise. The supervised program is designed to improve health in those with heart disease. It's often recommended after a heart attack or heart surgery.

Cardiac rehabilitation involves exercise training, emotional support and education about a heart-healthy lifestyle. Healthy lifestyle habits include eating a nutritious diet, managing weight and quitting smoking.

Research shows that cardiac rehabilitation can reduce the risk of future heart problems and death from heart disease. The American Heart Association and American College of Cardiology recommend cardiac rehabilitation.

Why it's done

Cardiac rehabilitation is done to improve health in those with a heart condition or a history of heart surgery. The goals of cardiac rehabilitation are to:

• Get stronger
• Reduce the risk of future heart problems
• Prevent the heart condition from worsening
• Improve quality of life

Cardiac rehabilitation is an option for people with many forms of heart disease. Your provider may recommend cardiac rehab if your medical history includes:

• Angioplasty and stenting
• Cardiomyopathy
• Certain congenital heart diseases
• Chest pain (stable angina)
• Coronary artery bypass surgery
• Coronary artery disease
• Heart attack
• Heart failure
• Heart or lung transplant
• Heart valve repair or replacement
• Peripheral artery disease with pain in the arms or legs during activity (claudication)

Risks

Cardiac rehabilitation isn't right for everyone with heart disease. Before it's recommended, your health care team examines you and reviews your medical history. Tests are done to make sure you're ready to start cardiac rehab.

Rarely, some people get muscle strains or sprains from cardiac rehab exercises. There is also a small risk of heart-related complications. Your health care team carefully checks you while you exercise to lower this risk. They teach you how to avoid injuries when you exercise on your own.

How you prepare

If you've had a heart attack or heart surgery or have a heart condition, ask your health care provider about cardiac rehabilitation. Also check with your insurer to see if it's a covered expense. Insurance and Medicare may cover the costs of cardiac rehabilitation in the United States.

Your treatment team works with you to set goals for your cardiac rehab program. They design a program that meets your needs. Sometimes a case manager tracks your care.

Cardiac rehabilitation can begin while you're still in the hospital. But it's usually done once you're home as outpatient therapy.

It may be difficult to start a cardiac rehabilitation program when you're not feeling well. However, it may be helpful in the long run.

What you can expect

During cardiac rehabilitation

The first stages of most cardiac rehabilitation programs generally last about three months. It takes longer for some people. In special situations, cardiac rehab may be done as an intensive program for several hours a day that can last 1 to 2 weeks.

During cardiac rehabilitation, you'll work with a team of health care providers. Your team may include:

• Heart doctors (cardiologists)
• Nurse educators
• Nutrition specialists
• Exercise trainers
• Mental health providers
• Physical and occupational therapists

During cardiac rehab, continue taking medications you've been prescribed unless your provider tells you not to.

Cardiac rehabilitation includes:

• Medical checkup. Your health care team examines you. They check your physical abilities and medical limitations. The team determines your risk for heart complications, particularly during exercise. This helps create a cardiac rehabilitation program that's safe and effective for you. Frequent checkups help your team keep track of your health and your progress.

• Exercise. Exercise helps keep the heart healthy. Cardiac rehabilitation exercises can improve heart health. Your health care team will likely suggest low impact activities that have a lower risk of injury. These activities include walking, cycling, rowing and jogging. Sometimes yoga is included. Some studies show that yoga is good for heart health.

  During cardiac rehab, you typically exercise at least three times a week. Your health care team teaches you the proper exercise techniques, such as warming up and cooling down.

  You might also do muscle-strengthening exercises, such as lifting weights. Resistance training exercises 2 to 3 times a week can also increase 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. These changes include eating a heart-healthy diet, exercising regularly, maintaining a healthy weight and quitting smoking. You should also aim to get 7 to 9 hours of sleep daily.

  Cardiac rehab also provides guidance about managing conditions such as high blood pressure, diabetes, high cholesterol and obesity.

  During this time, you can ask your provider any questions you have about other types of physical activity, include sex.

• Support. Adjusting to a serious health problem often takes time. You might feel depressed or anxious. You might worry about missing work. Vocational or occupational therapy can teach you skills to help you return to work.

  If you have depression, talk to your health care provider. Depression can make a cardiac rehab program more difficult. It can affect relationships and other areas of life and health.

  Counseling can help you learn healthy ways to manage depression, anxiety or other feelings. Sometimes medications are needed. Ask your health care provider what's best for you.

The more dedicated you are to following your program's recommendations, the more you'll benefit from cardiac rehab.

After cardiac rehabilitation

After cardiac rehab ends, you should know how to do the exercises on your own and maintain a healthier lifestyle. Continue the diet, exercises and lifestyle habits for life to maintain heart-health benefits.

Results

Cardiac rehabilitation can help you rebuild your life, both physically and emotionally. You'll get stronger and learn how to manage your condition.

Over time, cardiac rehabilitation can help you:

• Decrease the risk of coronary artery disease and other heart conditions
• Follow heart-healthy behaviors, such as eating healthy and exercising regularly
• Improve strength
• Learn ways to manage stress and anxiety
• Manage weight
• Quit bad habits, such as smoking

One of the most valuable benefits of cardiac rehabilitation is an improved quality of life. Some people who continue with cardiac rehab end up feeling better than they did before they had heart surgery or a heart condition.