Cardiopulmonary Rehabilitation – A Detailed Guide

What is Cardiac Rehabilitation?

Cardiopulmonary rehabilitation, also known as cardiac rehab, is a medically supervised, customized program that includes education, exercise, counseling, and support. This specialized program aims to help you recover from heart disease, including heart attack or surgery for treating heart disease.

Cardiac rehab typically comprises exercise training, education regarding lifestyle changes to minimize heart disease risk, such as quitting smoking or consuming a heart-healthy diet, and emotional support.

The objectives of cardiac rehab are to create a plan to help you regain your strength, prevent your current condition from worsening, lower your risk of developing heart problems, and enhance your quality of life in the long run.

Benefits of Cardiac Rehab

According to research, a cardiac rehab program can add nearly 5 years to one’s life expectancy. The program of cardiopulmonary rehabilitation can also help in:

• Recovering and growing stronger after heart surgery, heart attack, or other heart issues.
• Getting the body moving to resume everyday activities after a heart problem
• Enhancing the quality of life on a daily basis
• Reducing the risk of a second heart attack
• Reducing the risk of deteriorating heart condition and premature death.
• Managing psychological issues like anxiety and depression after a heart attack.
• Training to reduce stress.
• Aiding with strategies of weight management, including the right diet and exercise.
• Education about heart-healthy lifestyles like quitting smoking, eating right, and doing adequate exercise.
• Helping with breathlessness and chest pain.

Who benefits?

Cardiac rehab may help persons with different kinds of heart disease. It will prove useful for those with symptoms or health history such as-

• • Heart failure
  • Heart attack
  • Peripheral heart disease
  • Coronary heart disease
  • Stents
  • Angioplasty

• Surgery for heart valves
• Bypass grafting of the coronary artery
• Angina or chest pain
• Percutaneous coronary intervention
• Pulmonary hypertension
• Cardiomyopathy
• Congenital heart disease
• Transplant of lung or heart.

What Are the Three Phases of Cardiac Rehab?

There are three main phases of cardiopulmonary rehabilitation. They include –

• Phase #1 – Inpatient (when you start the program while you’re in the hospital)
• Phase #2 – Outpatient (when you go for appointments while staying at home)
• Phase #3 – By Yourself (when you continue to exercise and take responsibility for your health and life)

 Is Cardiac Rehab Common?

Every year, around 800,000 people have heart attacks in the US, which isn’t the first for at least 25 percent of these people. Cardiac rehab aims to help people prevent their second heart attack, decreasing the risk of death by more than 1-3 years.

Research suggests that cardiopulmonary rehabilitation programs have successfully managed to lower the risk of death caused by heart disease and the risk of developing future heart problems by 20 to 30 percent. The American College of Cardiology and American Heart Association actively recommend patients join cardiac rehab programs.

How to Choose the Right Cardiopulmonary Rehabilitation Program?

There are some things you must look at while choosing a cardiac rehab program. Make sure that –

• Your insurance company covers the program.
• The facility is located close to your home.
• Their hours conveniently fit with your schedule.
• They have services that you require.
• They are licensed and have professional certification under the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR).
• They have certified and trained staff.

How Do You Start?

If you’ve recently undergone heart surgery, heart attack, or developed a heart condition, you can request your doctor to join a cardiac rehabilitation program. Medicare and insurance will usually cover your costs in the United States. However, it is best to check with your insurance company to learn whether the costs will be covered.

You will sit with your treatment team to chalk out goals for your cardiopulmonary rehabilitation program to customize it according to your needs. In some instances, you will be assigned a case manager who can track your care.

Your program can begin when you’re in the hospital or when you go home. During a pandemic, a home-based program will work best for some individuals.

What to Expect from the Program?

The initial stages of most cardiopulmonary rehab programs last for around three months, but it may go on longer for some people. In certain cases, people can opt for an intensive program that goes on for a couple of hours a day, lasting for about one to two weeks.

During the program, you will be working with a healthcare team, including cardiologists, exercise specialists, nurse educators, mental health specialists, occupational and physical therapists, and nutrition specialists.

The four pillars of any cardiac rehabilitation program consist of –

Medical Evaluation –

An initial medical assessment will be conducted to check your medical limitations, physical abilities, and other issues that you may have. Your health and stats will be monitored regularly to keep tabs on your progress throughout the program. Some of the tests you may have to undergo include –

• Electrocardiogram (EKG)
• Cardiac Imaging
• Cholesterol and Blood Sugar tests
• Exercise Stress Tests

Your healthcare team may also look closely at risk factors that could contribute to heart complications, specifically during exercise. It will further help in tailoring the program to best suit your needs, keeping the program effective and safe for you.

Lifestyle Education –

Your team will educate you about healthy lifestyle changes, such as exercising regularly, having heart-healthy meals, quitting smoking, and maintaining an optimal weight.

Professionals will also guide you to help manage conditions such as diabetes, obesity, high cholesterol, and high blood pressure.

You will get the opportunity to raise questions regarding issues related to your sexual health. You may have to take medications as prescribed by your healthcare professional.

Physical Fitness –

Cardiopulmonary rehab will aim to keep you fit with the help of physical activities. You will likely engage in low-impact activities with a low risk of injuries, such as jogging, rowing, cycling, and walking. Your program may also include yoga, especially because several studies have shown that it benefits cardiac health.

You’ll be expected to exercise three times a week at least. Your healthcare team will guide you through the proper exercise techniques, including warm-up and cool-down.

The program may also include muscle-strengthening exercises, such as weight lifting or other resistance training workouts, which you have to do at least two or three times a week for better muscular fitness.

People who have never exercised before will be guided accordingly to make sure you move at a safe and comfortable pace.

Support –

People often struggle to adjust their lifestyle around a serious health issue. You may feel anxious or depressed, which can affect how you socialize with people around you. Having to stop working can also take a toll on your mental health.

It is essential to take note of signs of depression because it can further deteriorate your progress in the cardiac rehab program and negatively impact other areas of your life, such as relationships and health.

Counseling services will be part of your rehab program to help you learn the right ways to deal with anxiety and depression. You may be prescribed antidepressants or other medications by your doctor. Occupational or vocational therapy will aim toward teaching skills that can help you go back to work after the program.

It is not easy to take the first step, but if you’re not feeling well, joining a cardiopulmonary rehabilitation program can significantly benefit you. Not only will it help guide your anxieties and fear around your illness, but it will also help you return to a lifestyle that you can enjoy with more energy and motivation.

Cardiac rehab is meant to reconstruct your life, emotionally and physically. Gradually, you will get stronger and will be able to manage your health condition better. However, the success of your cardiac rehab program will depend majorly on you. If you’re dedicated enough, you’ll see great results.

What Are Some of the Risks?

Cardiopulmonary rehabilitation may not be appropriate for every person with heart disease. Therefore, a team of doctors will assess your health by going through your medical history – performing tests and physical examinations to check whether you’re a suitable candidate for the program.

In rare cases, people can incur injuries, such as sprains or strained muscles, while performing the exercises that are part of the program. However, the risks are mitigated by carefully monitoring your activity during exercise, lowering the risk even further.

What Happens After the Program Ends?

Even when your program ends, you need to stick to your new diet, exercise routine, and other changes introduced to your lifestyle to stay healthy. The program’s goal is to equip you with the knowledge and skills necessary to take charge of your lifestyle after your heart-related health issue.

When you follow the program judiciously, you will be able to see the following benefits in the long run –

• Better Strength
• Reduced Bat Habits, including drinking and smoking
• Better Adjustment with Heart-Health Behaviors, including diet and exercise
• Healthy Ways to Manage Stress
• Better Management of Weight
• Decrease in Risk of Developing Heart Conditions in the Future

After your cardiopulmonary rehabilitation program is over, you will witness a significant improvement in your quality of life. If you stick to the program, you may even end up feeling much better than you used to before your heart surgery or heart condition.