What is cardiac rehab?
Cardiac rehab (cardiac rehabilitation) is a comprehensive therapy combining prescribed exercise training, cardiac risk factor modification, education on heart health, diet and nutrition counseling and psychosocial support that helps you recuperate, build confidence and get stronger after you’ve had surgery or medical treatment for a heart issue, such as a heart attack.
Healthcare providers such as doctors, nurses, clinical exercise physiologists, counselors and dietitians offer expertise and guidance throughout your personalized center-based cardiac rehab program, which typically takes at least three months. Cardiac rehab can help you regardless of your age, gender or whether your heart issue was minor or major.
Three phases of cardiac rehab
Cardiac rehab begins before the hospital discharges you and should continue long-term.
- Phase 1: Inpatient (starting while you’re a hospital patient).
- Phase 2: Outpatient (going to appointments and then going home afterward).
- Phase 3: On your own (keeping up exercises on your own and at your own expense).
Who needs to have cardiac rehab?
Cardiac rehab is important for people who’ve had some kind of problem with their heart, such as:
- Heart attack.
- Heart failure.
- Use of a ventricular assist device.
- Heart or heart-lung transplant.
- Heart valve repair or replacement.
- Coronary artery bypass graft.
- Coronary artery angioplasty with or without stent placement.
Why is cardiac rehab done?
Cardiac rehab helps people who’ve had a heart attack or other heart problem recover by outlining an individualized plan for safely improving physical health and identifying and managing other risk factors. Having a heart attack or other heart issue can also be scary and make you feel depressed. Cardiac rehabilitation emphasizes the importance of psychological health and quality of life. It provides holistic support for every part of rehab so you’re not alone in reaching your goals.
How common is cardiac rehab?
Each year, about 800,000 Americans have a heart attack. For 25% of them, it’s not their first one. Cardiac rehab can help prevent a second heart attack and decrease risk of death over one to three years after participation in the program, but only 20 to 30% of those eligible each year enroll in a cardiac rehab program.
The American Heart Association and the American College of Cardiology provide the strongest level of endorsement for cardiac rehab for people with the heart conditions listed above.
Where is cardiac rehab done?
The initial phase of your cardiac rehab will occur during your hospital stay. For most people, your healthcare provider will recommend that you start cardiac rehab at an outpatient facility shortly after you leave the hospital. In addition to hospitals, rehabilitation centers offer cardiac rehab programs. You may also be able to do cardiac rehab at home but check with your insurance company to see if they cover it.
How to choose a cardiac rehab program
When looking into cardiac rehabilitation programs, ask if they:
- Are in your insurance company’s network, particularly if you have private insurance. (You’ll need a referral from your provider for insurance to cover it.)
- Are in a location that’s convenient for you.
- Will communicate with your provider.
- Have hours that work for your schedule.
- Have the services you need.
- Are a center current and in good standing with their professional certification through the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR).
- Have a staff that’s trained and certified to supervise your cardiac rehab, including an onsite doctor who will approve and provide oversight of your program.
- Require you to perform an exercise stress test as part of the program enrollment process to assess the safety of exercise and help develop the individualized exercise training plan.
- Have a staff who is certified to perform basic and advanced life support if needed.
What happens as part of your enrollment into cardiac rehab?
Before creating an individual program specific to you, staff at the cardiac rehab center will give you a brief physical exam and document your medical history. They may also ask you to undergo basic testing, which may include:
- Cardiac imaging.
- Electrocardiogram (EKG).
- Tests to check your blood sugar and cholesterol.
- Exercise stress test with a treadmill or stationary bike.
Your cardiac rehab staff will work with a doctor to review and assess your risk factors for cardiovascular disease and work with you to develop your individualized treatment plan to guide you through your program. This will include identifying safe and effective target training zones for your exercise training and setting heart-healthy goals for you to reach while in the program and in the long term.
What happens during cardiac rehab?
Working in a group setting, the cardiac rehab staff will provide supervision in the gym as you start out slowly according to your prescribed training zones. As you complete more sessions and gain confidence and endurance, the staff will be there to help you gradually progress by increasing the intensity and/or duration of your exercise according to your fitness level and medical history. They’ll also check your heart rate and blood pressure regularly to make sure you’re safe while exercising.
Cardiac rehab exercises
Exercises you may do in cardiac rehabilitation can vary depending on your incoming fitness level and risk factors, but could include:
- Aerobic exercises, like walking, riding a stationary bike or using an elliptical or step trainer.
- Activities to strengthen your muscles, like lifting free weights or using cable machines and resistance bands.
Other cardiac rehabilitation components
You’ll also get help with:
- Eating healthier.
- Stress management techniques. If requested, the staff can also help you get a referral to speak with a specialist in behavioral health.
- Getting to and staying at a healthy weight.
- Stopping the use of tobacco products and/or other substances.
- Taking and managing your medicines.
- Controlling your blood pressure, cholesterol and blood sugar levels for preventing or managing diabetes.
What happens after cardiac rehab?
After you complete your last cardiac rehab session and as part of finishing out your program, the staff may ask you to perform another exercise stress test in order to:
- Reassess the safety of exercise.
- Quantify how much improvement you made in your cardiorespiratory fitness compared with your initial exercise stress test.
- Update your individualized exercise training recommendations to reflect your improved physical functioning.
Even though you “graduated” from center-based cardiac rehab, you should feel confident in continuing to participate in your cardiac rehab style of exercise, but self-supervised over the long term. You’ll also improve the heart-healthy benefits of regular exercise if you continue to use everything you learned about controlling your cardiovascular risk factors, managing stress, cooking heart-healthy meals and avoiding tobacco products. These can help you for the rest of your life.
Risks / Benefits
What are the advantages of cardiac rehab?
Completing a cardiac rehab program can add up to five years to your life expectancy, according to studies. Cardiac rehab is good for you in many ways. It can:
- Help you recover and get stronger after a heart attack, heart surgery or other heart issue.
- Get your body moving so your everyday activities are easier.
- Improve your daily quality of life.
- Help lower your risk of experiencing another heart attack.
- Decrease your risk of becoming very ill or dying from heart disease in the coming years.
- Help you manage mental health and possible feelings of depression and anxiety after a heart attack.
- Show you ways to fight stress.
- Help you with sustainable weight management strategies.
- Teach you healthier lifestyle habits, such as heart-healthy eating, not using tobacco products, decreasing time spent sitting and exercising more.
- Help with your chest pain and shortness of breath.
What are the risks of cardiac rehab?
In very rare cases, exercise during cardiac rehab can cause an injury or a dangerous heart rhythm. If this happens, the cardiac rehab staff will have you stop exercising so they can treat you right away. If there is a need, the cardiac rehab staff will also communicate with your cardiologist or primary healthcare provider so they can examine you or order additional testing before you return to cardiac rehab.
Recovery and Outlook
What is the recovery time?
Most insurance companies (and Medicare) provide coverage for a 12-week cardiac rehab program with a total of 36 sessions. That works out to three one-hour sessions a week.
When to Call the Doctor
When should I see my primary healthcare provider?
Although you can bring up concerns with the supervising provider in your cardiac rehab program, you may also contact your regular primary healthcare provider if you’re having trouble doing what the program asks. In addition to regularly attending cardiac rehab, be sure to keep all of your follow-up appointments with the other providers in your care team.
A note from Cleveland Clinic
Taking part in a cardiac rehab program puts a whole team of people on your side to help you recover from a heart attack or other heart issue. According to studies, cardiac rehab gives people many benefits, including more years of life and improved quality of life. With medical professionals monitoring you at every step, you can get stronger in just a few months and learn skills to improve your everyday life.
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