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Cardiac Rehabilitation

Getting your health back after a heart attack

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Updated November 13, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

After you have a heart attack (also called a myocardial infarction, or MI), participation in a cardiac rehabilitation program can reduce your risk of having any more MIs, and even of dying.

"Cardiac rehabilitation" is a structured program aimed at helping you develop a heart-friendly lifestyle. Ideally, it will consist of three components: exercise, risk factor modification, and dealing with stress and depression.

Exercise Rehabilitation

Exercise may be the most important component of a cardiac rehabilitation program, because regular exercise not only directly improves your cardiovascular system, but it also helps you with weight control, improves your response to stress, and (many claim) helps you stick to your heart-healthy diet. The benefits of regular exercise after an MI are well documented. Studies show that those who participate in exercise rehabilitation achieve a significantly lower risk of mortality, and of having recurrent MIs.

While almost everyone can safely engage in exercise after an MI, deciding what's "safe" needs to be individualized. Developing a safe exercise program requires taking several factors into account - including your general physical condition, the extent of the heart attack you've had, whether you are still having angina, your weight, and the condition of your limbs and joints. Having you perform a stress test, usually on a treadmill, helps the exercise rehabilitation clinician assess all of these factors, and is normally an important part of creating an appropriate "exercise prescription" for you.

Once the initial assessment is made, your rehab clinician will work with you (and your doctor) to prescribe a safe exercise program. This prescription will include the appropriate type (walking, jogging, swimming, etc.), duration, frequency and intensity of exercise that will safely improve your heart health. Obviously, that prescription will take into account your personal preferences, and your personal constraints.

Most often after a heart attack, the first several exercise sessions will be conducted under medical supervision, possibly with cardiac monitoring. But after a few weeks, as your heart heals and your exercise capacity increases, you will begin following a home-based exercise program that, ideally, will last forever.

Lifestyle "Rehabilitation"

Most cardiac rehabilitation programs today include extensive educational sessions on modifying your cardiac risk factors, such as weight control, smoking cessation, and diet. It is important for you to attend these sessions and absorb as much information as you can. Now that you have survived your heart attack, your health depends on your taking control of those aspects of your life that can be controlled, and that will go a long way toward determining your long-term outcome.

Psychosocial "Rehabilitation"

It is quite common to go through a period of depression or anxiety after an MI. Unfortunately, these problems can not only keep you from engaging in the exercise rehabilitation and lifestyle modifications you need to become healthy, but can also directly worsen your cardiac health.

Many cardiac rehabilitation programs employ individuals who are trained to recognize and help you work through the psychosocial issues that may inhibit your recovery. If you need more intensive therapy, they can help make the appropriate referrals for you.

Summary

While a heart attack is never a good thing, with a little luck and the right attitude, you can turn it into something far less bad than you might think. A cardiac rehabilitation program is very important in achieving this end. By helping you make the changes in your life that you need to make, a good rehabilitation program can help you achieve a level of health that may even be better than it was before your heart attack.

Sources:

Balady, GJ, Williams, MA, Ades, PA, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2007; 115:2675.

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