What is cardiac rehabilitation?

Cardiac rehabilitation (rehab): Overview

Cardiac rehabilitation is a program for people who have a heart problem, such as a heart attack, heart failure, or a heart valve disease. The program includes exercise, education, and emotional support. Cardiac rehab can help you improve the quality of your life through better overall health.

Your cardiac rehab team will include several people, including your doctor, a nurse specialist, a dietitian, and a physical therapist. They will design your cardiac rehab program specifically for you. You will learn how to reduce your risk for heart problems and how to manage stress. You can learn how to stay active, eat healthy, stay at a healthy weight, and manage other health problems. Your rehab team also can help you quit smoking. By the end of the program, you will be ready to maintain a healthy lifestyle on your own.

Cardiac rehabilitation (rehab)

Cardiac rehabilitation (rehab) is a supervised program that uses exercise, education, and support to help people who have a heart problem. Cardiac rehab programs are designed based on a person's needs and overall health.

Cardiac rehab can help you feel better, have a better quality of life, and lower your risk of future heart problems.

What are some types of cardiac rehab programs?

Cardiac rehab programs can be done in a hospital, an outpatient facility, or your home.

Cardiac rehab usually includes:

  • Close supervision. This happens during the early part of your exercise program.
  • Education and counseling for you and your family and friends. This can help you build healthy habits. These habits will lower your risk of having more heart problems.
  • Helping you prepare to get back to work and the activities you enjoyed before your heart problems. You may need to adjust your work or leisure activities.
  • Taking care of your emotional health. You can get help for depression and improve your emotional well-being.
  • Making a plan to help you start a safe exercise program at home.

Who is on your cardiac rehab team?

In cardiac rehabilitation (rehab), you work with a team of health professionals. The team designs a program just for you, based on your health and goals. Then they give you education and support to help you succeed.

The following health professionals may be part of your team:

Doctors and surgeons.

Your family doctor, as well as cardiologists, heart surgeons and other specialists, provide you with general care and care for your heart.

Nurses.

Teach you how to manage your heart condition and other health problems.

Rehab or occupational specialists.

Help you recover from a procedure and return to daily activities, work, and recreation.

Exercise specialists.

Help you plan and maintain your exercise program.

Dietitians.

Help you plan and stay with a heart-healthy diet.

Mental health professionals.

Help you cope with psychological aspects of your condition.

Pharmacists.

Answer your questions about taking your medicines.

How can you care for yourself during cardiac rehab?

  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Weigh yourself every day if your doctor tells you to. Watch for sudden weight gain. Weigh yourself on the same scale with the same amount of clothing at the same time of day.
  • Eat heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that are not so good for your heart, like sodium, alcohol, and sugar.
  • Learn how to take your pulse so that you can track your heart rate during exercise.
  • Always check with your rehab team or your doctor before you begin a new exercise program.
  • Follow instructions from your rehab team about exercising at home. The rehab team can help make a program for you.
  • Stop exercising if you have any unusual discomfort, such as chest pain.
  • Do not smoke. Smoking can make heart problems worse. If you need help quitting, talk to your doctor or rehab team about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Cardiac Rehab: How It Can Help

How well does cardiac rehab work?

Cardiac rehab can help you have better overall health and a better quality of life. It can help reduce your risk of future heart problems, stay out of the hospital, and manage your symptoms. Rehab can also help you recover from a procedure or surgery.

How fast will you get better during cardiac rehab?

How soon you recover depends on your age, your health, and whether you have other health conditions. A younger person without other health problems may improve more quickly than an older person who has other health problems. There is no set length of time that you must stay in cardiac rehab.

Why is cardiac rehab done?

Your doctor may suggest cardiac rehab if you have a certain heart problem, such as a heart attack, stable angina, heart failure, or heart valve disease. Rehab is also done after certain heart procedures or surgeries. Examples include a coronary angioplasty, coronary bypass, heart transplant, or a heart valve repair or replacement.

What tests may be done before you start cardiac rehab?

Before you start a cardiac rehabilitation (rehab) program, your doctor will check your heart health to see what types of exercises you can safely do. Tests may include the following:

Resting electrocardiogram (EKG or ECG).

This test measures the electrical signals that control the rhythm of your heartbeat. A resting ECG will sometimes show if more testing is needed before you start your exercise program.

Exercise electrocardiogram (ECG).

This test records the electrical activity of the heart. It is done during exercise to evaluate how your heart responds to exercise. Your doctor can use the test results to find a safe amount of exercise for you. This test may also be called a stress or treadmill test.

Echocardiogram (echo).

An echo is a type of ultrasound. It uses high-pitched sound waves to make an image of your heart. The sound waves are sent through a device called a transducer. The sound waves are reflected off the various structures of the heart. This test shows how well your heart is pumping blood and how well your heart valves are working. Sometimes it is combined with an exercise stress test.

Cardiac perfusion scan.

This test estimates the amount of blood reaching the heart muscle during rest and exercise. It is typically done to find out the cause of unexplained chest pain or to find out the location and amount of injured heart muscle after a heart attack.

Ambulatory electrocardiogram (Holter monitoring test).

This test monitors the electrical activity of your heart while you go about your daily activities. Many heart problems occur only during certain activities, such as exercise, eating, sex, emotional stress, bowel movements, or even sleeping. A continuous recording is much more likely to find any abnormal heartbeats that occur during these activities.

You may also have other tests during cardiac rehab. These tests help your doctor see how you are doing. The tests may include checking your blood pressure and weight. You may also have your blood sugar and cholesterol checked.

Cardiac rehab: Staying with the program

Cardiac rehabilitation (rehab) takes a lot of time, energy, and commitment. Sometimes, it can be hard to keep showing up.

But if you decide to keep doing rehab, it may give you some things that could really add to your life. And you get to choose what those things are.

Here are some ideas about how to make rehab work for you.

  • Write down how you feel about rehab.

    You've got your own reasons why it's not always easy to get to rehab. Maybe you've had some thoughts like these that get in the way.

    • "It just doesn't feel worth it."
    • "I don't have the energy."
    • "It's too hard to get there."

    You may want to take a little time to explore your thoughts about rehab. Then you'll have a better chance of finding out what rehab might do for you, just like these people.

    • "I thought my lack of energy was because of all the heart stuff. But it turns out it was also because I was depressed. Rehab gave me the support I needed to feel better."
    • "Getting to rehab was tough. But then I spoke up about my transportation issues and I found out about ride sharing and taxi vouchers."
    • "The stress management part of rehab helped me prioritize. And that gave me more time for the important things—like my mental and physical health."
  • Set some goals.

    Having goals—big and small—can give you proof that rehab is working. Plus, it just feels good to experience the satisfaction and the benefits of meeting your goals.

    Think about what you'd really like to be able to do in the future. Maybe it's something small like taking a walk in the neighborhood. Or maybe it's something bigger like feeling good enough to go out to breakfast with your friends or babysit your grandchildren.

    What kind of goal could you set that might bring you more joy or make you feel better overall? If you want, use the following questions to think a bit more about your goals and how rehab might help you meet them.

    • What's an important goal to you?
    • How can rehab help you meet that goal?
    • What's getting in your way of getting to rehab?
    • What could help you get around the things that are getting in your way?
  • Know that you don't have to do rehab alone.

    You'll work with a whole team of experts whose focus is on you and your goals.

    The members of your team want to do everything they can to make your life better. That's their job. And you may be more likely to meet your goals if you have a lot of support along the way.

What is a cardiac rehab hospital program?

Cardiac rehabilitation (rehab) may start while you are in the hospital. The hospital (inpatient) program is one part, or phase, of your cardiac rehab. This phase emphasizes exercise and education.

A hospital program may include:

  • A customized exercise program, based on your medical history, clinical condition, and symptoms.
  • Discharge instructions about recovery activities.
  • Education on a heart-healthy lifestyle and how to lower your risk of future heart problems.
  • Ways to help your body recover and:
    • Increase appetite and strength.
    • Increase aerobic capacity.
    • Increase lung capacity.
    • If you had a heart transplant, avoid rejection of your new heart.

Your hospital rehab staff can provide you with information and resources for making the transition from hospital to home. They can also refer you to a cardiac rehab program in your community.

Exercise program

The following exercises are examples. Your exercise program depends on your medical history, clinical status, and symptoms.

Discuss with your doctor any additional physical limitations or medical issues before you begin any exercise program.

An exercise program in the hospital progresses from initial supportive and self-care activities to regular daily walking.

  • You will start with easy activities, such as sitting up in a chair and walking, as soon as you are able. Early activity is important, because you lose muscle strength very quickly when you stay in bed.
  • As you become stronger, you might be active a couple of times a day for several minutes each time, depending on your condition. A member of the rehab staff will monitor your heart rate to be sure it doesn't get too high while you walk or slowly climb stairs.
  • How long you stay in the hospital depends on what problem, procedure, or surgery you had.

Here are some examples of initial activity:

Step 1.
  • Rest in bed until stable.
  • Sit up in bed with assistance.
  • Stand at bedside with assistance.
  • Perform self-care activities while seated.
Step 2.
  • Sit up in bed independently.
  • Walk in room and to bathroom.
  • Perform self-care activities in bathroom.
Step 3.
  • Sit and stand independently.
  • Walk in hall with assistance: 3 to 5 minutes, 2 to 4 times a day.
Step 4.
  • Walk in hall: 10 to 15 minutes, 2 to 4 times a day.
  • Walk up and down stairs with assistance.

What tests may be done before you start cardiac rehab?

Before you start a cardiac rehab program, your doctor will check your heart health to see what types of exercises you can safely do. Tests may include the following:

  • Resting electrocardiogram (EKG or ECG)
  • Exercise electrocardiogram (ECG)
  • Echocardiogram (echo)
  • Cardiac perfusion scan
  • Ambulatory electrocardiogram (Holter monitoring test)

You may also have other tests during cardiac rehab. These tests help your doctor see how you are doing. The tests may include checking your blood pressure and weight. You may also have your blood sugar and cholesterol checked.

Cardiac rehabilitation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.
  • You cough up pink, foamy mucus and you have trouble breathing.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have angina symptoms (such as chest pain or pressure) that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or increased shortness of breath.
  • You are dizzy or lightheaded, or you feel like you may faint.
  • You gain weight suddenly, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
  • You have increased swelling in your legs, ankles, or feet.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

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