Boulder City Hospital

Posts Tagged ‘Cardiac’

Cardiac Rehabilitation

The most alarming predictions made for the new millennium is that of cardiovascular diseases (CVD) topping the list of death and disability. These accounts for 2, 08,000 deaths, that is 36% of the annual total, every year (coronary heart disease statistics, 2007). CVD rates in urban areas in India are now 4-fold higher than in the USA which were same in 1968 (Enas EA. 2000 ). According to World health organization (WHO) by 2010 CVD’s are estimated to be the leading cause of death in developing countries (World health statistics 2007). Thus, the need of comprehensive program was felt for the patients with heart disease. Cardiac Rehabilitation (CR) was hence recognized as an essential component in the care of patients with CVD. There have been scientific evidences over the past 3 decades of the benefits of CR services (Oldridge, Guyatt , Fischer and Rimm 1988, Witt , Jacobson , Weston et al 2005 ).

The WHO’s (1993) most recent definitions of CR read as follows :

“ The rehabilitation of a cardiac patient is the sum of activities required to influence favorably the underlying cause of the death , as well as the best possible physical , mental , and social condition , so that they may , by their own efforts preserve or resume when lost , as normal a place as possible in the community. Rehabilitation cannot be regarded as an isolated form of therapy but must be integrated with the whole treatment of which it forms only one facet.”

The PHASES OF CARDIAC REHABILITATION are as follows:

·         Phase I : The Acute stage

·         This is the hospital phase which begins with a referral from patient’s physician after he is medically stable to the time of discharge which is usually about 7 to 10 days.

·         It contains educational sessions , correction of cardiac misconceptions and counseling for the patient and their relatives, also the use of hospital anxiety and depression scale(HADS) is also suggested.(Zigmond and Snaith , 1983)

·         This phase is directed to prevent pulmonary complications post surgery also ambulation and self- care evaluation.

·         Phase II : The sub acute stage

·         This varies from 5 to 12 weeks after infarction or surgery.

·         It begins with completion of the low-level treadmill test and ends at the completion of catheterization and the maximal treadmill test.

·         This phase includes aerobic exercise, flexibility exercise and strength training to maintain the cardiovascular endurance.

·         Phase III : Long term follow-up

·         This is a high level phase which includes high level aerobic exercises performed only when formal reevaluations in the form of exercise test shows no inappropriate ventricular function and are medically stable too.

·         This phase ends when the exercise program attains maintenance level of the patient.

·         Educational and psychological support is given to the patient and advices to reduce risk factors also vocational rehabilitation is given to the patient to assist return to work.

·         Phase IV : Lifetime follow through

In this phase patient is expected to carry out his exercise program independently which can be done at any fitness centre, club or at home.

In general cardiac rehabilitation increases the long-term standard of your life. Quite often patients who go through cardiac rehabilitation realize that their overall quality of life has improved.
The moment they understand how to eat properly, and start including exercise into their daily lives, patients realize that they are stronger not only with their hearts but in many other areas. If you are ready to follow the instructions from the cardiac rehabilitation units carefully and accurately, you can enjoy benefits that will remain for a lifetime.
The apparent benefit of cardiac rehabilitation is the heart health advancement that patients go through. Patients will find that their heart has become stronger and more resilient as they go through different rehabilitation stages. With the improvement in heart health, they start to enjoy life again, without the fear that another heart attack may happen.
A cardiac rehab program sometimes results in permanent lifestyle changes. If you understand how to properly control your eating and exercise, you learn that you are enjoying being in control. Quite often, they retain the strategies and practices they learn, even after they have completed the program.
Finally, one of the outstanding benefits of a cardiac rehabilitation program is that your life lasts longer. Patients who are in constant touch with a cardiac rehabilitation specialist will enjoy longer and healthier lives, and are tipped to enjoy these lives well into their old age. Compared to patients who do not undergo the treatment, they are happier and fitter.
Cardiac rehabilitation policies always consist of exercise training. The diseased heart cannot bear high levels of exercise all of a sudden. Because of this, the exercise training program begins slowly and builds towards a suitable level of activity. In the case of patients who are extremely sick, exercise begins with simply sitting up and getting out of bed.
Once they are comfortable with this, they elevate to walking short distances around the room. The walking distance is steadily increased. When patient attains enough strength, long distance walks transform into jogs and runs. After this strength training is put into practice.
While undergoing all this exercise training, the heart is precisely monitored, to make sure that the patient is not suffering from any heart trouble. If such a situation arises, the exercise is brought down a notch so that the heart will recover. If the heart continues to operate normally, the exercise level is increased until the patient can enter a gym to exercise without the close observation of the doctors and nurses.
Learning what to comprehend in the different cardiac rehabilitation phases is the first step towards heart health. If you are suffering from heart disease, don’t waste your time to contact the cardiac rehabilitation unit at your hospital. Your life may hang on it!