Cardiac Rehabilitation in Ischemic Heart Disease

Introduction

Cardiac rehabilitation is a multidisciplinary program aimed at improving the quality of life and prognosis of patients with ischemic heart disease. It includes supervised physical exercise, health education, psychological support, and optimization of pharmacological therapy.

The main goals of cardiac rehabilitation are:

Reduction of mortality and risk of ischemic recurrence.
Improvement of functional capacity and quality of life.
Control of cardiovascular risk factors.
Promotion of therapeutic adherence and a healthy lifestyle.

Phases of Cardiac Rehabilitation

The rehabilitation process is divided into three phases:

Phase I: In-Hospital Rehabilitation

Begins during hospitalization after an acute ischemic event or revascularization procedure.
Includes early mobilization, patient education, and risk stratification.
A post-discharge rehabilitation plan is established.

Phase II: Outpatient or Residential Rehabilitation

A structured program lasting 6-12 weeks.
Includes personalized physical exercise, nutritional therapy, psychological counseling, and pharmacological management.
ECG monitoring during physical activity for high-risk patients.

Phase III: Long-Term Maintenance

Continuation of healthy lifestyle habits.
Regular physical activity and periodic cardiovascular monitoring.
Cardiology follow-up to monitor disease progression.

Physical Activity and Rehabilitation

Physical exercise is the cornerstone of cardiac rehabilitation. Training programs are tailored to the patient’s condition.

Types of Exercise

Aerobic exercise: Walking, cycling, swimming at moderate intensity (30-45 minutes, at least 5 days a week).
Resistance training: Light weight training to improve strength without overloading the heart.
High-intensity interval training (HIIT): Recommended for selected patients to enhance cardiorespiratory capacity.

Benefits of Physical Activity

Improves endothelial function and exercise capacity.
Reduces the risk of new cardiovascular events.
Helps control hypertension, dyslipidemia, and diabetes.

Health Education and Psychological Support

Managing cardiac patients extends beyond physical aspects, including psychological and educational support.

Stress Management and Psychological Support

Cognitive-behavioral therapy to reduce anxiety and post-infarction depression.
Mindfulness and relaxation techniques to improve mental well-being.
Support groups for patients and families.

Therapeutic Education

Importance of adherence to pharmacological therapy.
Nutritional advice for a heart-protective diet.
Monitoring of symptoms and early recognition of ischemic recurrences.

Conclusion

Cardiac rehabilitation is an essential intervention to improve prognosis and quality of life in patients with ischemic heart disease. A multidisciplinary approach incorporating physical activity, health education, and psychological support is fundamental in preventing recurrences and optimizing recovery.

References

Anderson L, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2022;7:CD001800.
Giannuzzi P, et al. Cardiac rehabilitation programs: key components and outcomes. European Heart Journal. 2021;42(11):1023-1036.
Lavie CJ, et al. Impact of cardiac rehabilitation and exercise training in coronary heart disease. Progress in Cardiovascular Diseases. 2020;63(1):10-20.
Ruiz-Canela M, et al. Dietary patterns and cardiovascular risk reduction. Journal of the American College of Cardiology. 2019;74(11):1397-1410.
Gielen S, et al. The role of exercise in cardiovascular prevention. European Journal of Preventive Cardiology. 2018;25(2):107-115.