Cardiac rehabilitation

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Cardiac rehabilitation is provided within the continuum of cardiac care and consists of integrated and multi-factorial interventions which are intended to enhance and maintain the physical, psychosocial and vocational status of individuals with established heart disease or at high cardiovascular risk for the development of cardiac disease.

The cardiac rehabilitation strategy includes the identification of patient risk factors during the inpatient stay, then follows up with an attempt to modify risk factors. Because of its hollistic nature, cardiac rehabilitation involves smoking cessation, lipid control, exercise training, weight control, and lots more in what we could call the colourful wheel of cardiac rehabilitation. The main components, however, are to stop smoking, add some physical activity, and give antiplatelet agents and beta blockers. Ultimately, smoking cessation is the most important factor in reducing the long-term cardiovascular risk.

There is much data that cardiac rehabilitation can improve patient survival, including data showing that the number of patients that fall into the low-risk category (<1% per year) increases if cardiac rehabilitation is used.

Methodology

Cardiac rehabilitation begins by stratifying the risk of a patient for dying. Short term risk stratification is accomplished by using the Duke treadmill score (DTS), and long-term is assessed by the Canadian association of cardiac rehab scale (CACR scale) by assessing scores assigned to age, lipids, blood pressure, diabetes, psychological distress, and smoking.

The Fitt principle is used to assess how effective exercise is.