Cardiac Rehabilitation

Cardiovascular disorders are the main cause of death in the industrialized world today. It accounts for almost 50% of all deaths yearly. The survivors represent an additional reservoir of cardiovascular disease morbidity. In the US alone, more than 14 million people suffer from some kind of coronary artery disease (CAD) or its complications including congestive heart failure (CHF), angina, and arrhythmias. Of this number, just about one million survivors of acute myocardial infarction (MI), and 309,000 patients who have went under coronary bypass surgery annually, are candidates for cardiac rehabilitation.

Conventionally, cardiac rehabilitation has been provided to fairly lower-risk patients who could exercise without having any complications.

Nonetheless, amazingly rapid evolution in the management of coronary artery disease has now altered the demographics of the patients who can be candidates for cardiac rehabilitation. At present, approximately 400,000 patients who endured coronary angioplasty each year comprise a subgroup that could benefit from cardiac rehabilitation. Additionally, just about 4.7 million patients with congestive heart failure are also eligible for a slightly modified program of cardiac rehabilitation, as are the number of patients receiving heart transplantation is rapidly increasing.

This article sheds some light on the objectives, indications, program components, exercise training, monitoring, benefits, risks, safety issues, outcome measures, and cost effectiveness of cardiac rehabilitation. The objectives of cardiac rehabilitation are to reverse the limitations that have developed after suffering harmful pathophysiologic and psychological consequences of cardiac events.

Identification of the patients at risk for recurrence of such events is essential in formulating a suitable medical, rehabilitative, and surgical strategy to evade recurrences such as this. Patients who are at low or moderate risk will usually undergo early rehabilitation. The major goals of cardiac rehabilitation programs are: to minimize the pathophysiologic and psychosocial effects of heart disease, to limit the risk for reinfarction or sudden death, to relieve cardiac symptoms, retard or reverse the atherosclerosis by instituting programs for exercise training, education, counseling, and risk factors alteration, and to reintegrate heart disease patients into successful functional status in their families as well as the society.

Cardiac rehabilitation programs have been shown to improve objective measures of exercise tolerance and psychosocial well being time and time again, without increasing the risk of significant complications. Today's cardiac care has already curtailed early acute coronary mortality so much so exercise training, as an "isolated" intervention, may not be able to trigger significant reduction in the morbidity and mortality.

Nevertheless, exercise training has the ability to serve as a catalyst for promoting other aspects of cardiac rehabilitation, including risk factor modification through therapeutic lifestyle changes and optimization of psychosocial support. As a result, the effect measures of cardiac rehabilitation now include improvement in quality of life like the patient's insight of physical improvement, satisfaction with risk factor alteration, psychosocial adjustments in interpersonal roles, and potential for advancement at work commensurate with the patient's skills.


Cardiac rehabilitation services are an effective and safe intervention. These services are, unquestionably, a vital factor of the contemporary treatment of patients with multiple presentations of coronary heart disease and heart failure.

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