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Cardiac rehab: It’s the heart of the matter

You’re in the intensive cardiac care unit when you realize how lucky you are: You’ve survived a heart attack. But soon, your thoughts race to what’s ahead—months out of work, a difficult recuperation, perhaps more heart trouble?

Not necessarily. The fact is, you can sidestep more cardiac trouble and return to a normal life in about six to 12 weeks. How? With cardiac rehabilitation—a program of closely monitored exercises, medications and lifestyle education. There’s no waiting for the program to start; most rehab begins within 48 hours of the attack itself.

Wait a minute … exercise right after a heart attack? Absolutely! Although it may sound counterintuitive, cardiologists know that cardiac rehab significantly reduces a patient’s chance of suffering another heart-related episode.

The treadmill to recovery

The day after a heart attack, cardiovascular experts usually have the patient sitting up, standing and walking the halls. Thus begins the rewarding journey to improved heart health. Within a day or two, while the patient is still in the hospital, his or her heart stress level is measured by an exercise electrocardiogram (ECG) test. The ECG measures blood pressure, pulse and electrical activity in the heart while the patient walks on a treadmill or rides a stationary bike.

Using the ECG results as a guide, specialists then prescribe various exercises for the patient’s recovery. They want the patient to achieve a target heart rate of 50 percent to 80 percent of his or her maximum heart rate through aerobic exercise three times a week—walking or jogging on a treadmill, pedaling a stationary bike or swimming. By repeatedly reaching the target rate for 20 to 30 minutes per session over several months, patients slowly rebuild their stamina, strengthen their heart, lower their blood pressure and control their weight.

Needing a lift

Resistance training, or weight lifting, is another part of the program. Patients begin lifting light weights while working out on circuit-training machines. Their goal is to eventually do three sets of 12 repetitions for 10 different weight-bearing exercises. Weight lifting helps the body burn calories more efficiently and replace fat cells with dense muscle tissue.

By about the fifth week of cardiac rehab, most patients are strong enough to begin working out at home without medical supervision. Although still under a doctor’s care, recovering cardiac patients may begin jogging or brisk walking alone. They’re encouraged to continue at-home weight training, too. By now, most patients need to pay only a weekly visit to the hospital’s physical therapy unit.

New ways of life

Exercise is just one aspect of cardiac rehabilitation. Early on, recovering patients also receive personalized instruction on lifestyle changes; overcoming the stress and anxiety of the heart attack; and eating nutritious, heart-healthy meals.

Of course, every cardiac patient is directed to stop smoking and, at least at first, to avoid alcohol. The hospital dietitian will design an all-new eating plan featuring fruits, vegetables, whole-grain breads, fish, poultry and low-fat dairy products. These foods help scour the blood and arteries of cholesterol and fatty plaque buildup and keep them from coming back.

Medicines that aid recovery

Doctors almost always prescribe medication for use during cardiac rehab. In fact, some patients continue to use prescriptions for many months after their heart attacks. Among the most commonly prescribed drugs are:

  • Aspirin. Taken once a day, its anticlotting properties help reduce the risk of a second heart attack or stroke.
  • Beta blockers. These compounds lower the heart rate and blood pressure to reduce strain on the heart.
  • ACE inhibitors or receptor blockers. These drugs relax the blood vessels, thereby enhancing circulation and lowering blood pressure.
  • Statins. These drugs help lower high levels of low-density lipoprotein (“bad”) cholesterol in the blood right after a heart attack.

The bottom line: Sticking with a supervised cardiac rehab program is the safest and surest way to take back the years that a heart attack tried to take away.