Cardiac rehab, now an inseparable part of heart disease management

The programme is a combination of exercise and diet, apart from psychological counselling and educational components, tailor-made to the requirements of the individual. 

A month after a 64-year-old woman patient was discharged from the hospital, following a bypass procedure, her family members contacted Dr Suresh  Rao, head of department, Critical Care, Fortis Malar Hospital, Chennai. He was surprised to see the woman being confined to the bed and her family members in a state of mental shock. 

He said, “That was one of the occasions, when I realised that treating the condition alone is not enough. We need to aid them sufficiently to get back to their normal lives through proper counselling, diet and exercise regimen, whenever necessary.” 

With a rise in cardiovascular diseases, India like other developing nations are seeing a steep rise in coronary heart diseases and myocardial infarctions. However, there isn’t enough focus on preventive lifestyle, points out Dr Priya Chockalingam, Clinical Director, Cardiac Wellness Institute, in the city. 

“Cardiac rehab is now an integral part of management of heart disease. It covers a broad range of conditions - from those who have already had a cardiac event or have had one of the procedures like angioplasty or bypass, where it is secondary prevention and to those in the high-risk group relying on medication, where it is primary,” she adds. 

The phases of the programme can broadly be categorised into four parts. Dr Priya adds, “First involves counselling of the patient, to make him or her understand the condition to dispel anxiety and educate them about dietary plans. Secondly, get in touch with the patient after the procedure to follow up on the progress, three to four weeks after the procedure. Third phase involves supervision and evaluation and charting out an exercise plan, based on the baseline and functional capacity. If the ejection fraction is low, it is an indication that the heart is not pumping efficiently. This could be improved through the programme. There are 24-36 sessions of rehab, once or twice a week with a combination of education and exercise components, determined based on risk factors. The fourth phase is the maintenance programme, where they come in once a month for a revision, when the body mass index is looked at.” 

Dr Suresh adds that the programme is now being extended to patients post heart transplant. “They would have adopted a more passive lifestyle for almost six months to a year in the hospital, in the event of a transplant. In such cases, they must be trained to understand that they now have a new heart and they can lead a normal life,” he says.