For Your Patients: What to Expect From Cardiac Rehabilitation

Cardiac rehabilitation, or cardiac rehab as it is often called, is recommended for most patients with heart failure, but just what is it?

A major component is exercise training. Physical activity is not only safe in heart failure but has direct benefits for symptoms and outcomes. In one major trial, exercise training reduced the risk of death or hospitalization by about 10% over 1 year after factoring in preexisting risk characteristics.

Other components of cardiac rehabilitation programs for patients with heart failure are medical evaluation to determine your needs and limitations as well as stress management and support for the emotional aspects of dealing with heart failure and in understanding and sticking to your medication regimen and recommended diet.

Programs are usually broken into three phases, with phase 1 starting in the hospital after a heart failure event, phase 2 with visits to the cardiac rehab program after you leave the hospital, and phase 3 continuing exercises on your own. Visits to a program usually last at least 3 months.

It takes time and effort to do cardiac rehab, but it's well worthwhile. In addition to better health outcomes, studies have shown that cardiac rehab overall improves a person's capacity to perform the daily activities that require physical exertion and health-related quality of life.

Unfortunately, insurance does not always cover cardiac rehab for heart failure, particularly for cases with preserved ejection fraction. If that's the case for you, ask your healthcare team about alternatives that might be available.

Structured exercise programs have been shown to be more effective in heart failure than general guidance. A local gym or outpatient medical center might have phase 3 programs available; or your healthcare provider may recommend a walking program. Moderate intensity training, like brisk walking, appears to be as good for people with heart failure as more intense activity.

A common goal is walking 30 to 45 minutes a day, for most days of the week. However, talk with your medical team about what level of physical activity is right for you, especially before lifting weights.

Generally, your physician will recommend that you start slowly and gradually work up to walking at a pace where you're breathing heavier but could still talk with someone. Each day you might try to add a few minutes to how long you can keep up that pace.

Slow down if you feel too short of breath. Stop if you are excessively short of breath, if your heart rate doesn't return to normal after 15 minutes of rest, or if you feel dizzy or have chest discomfort or weakness. Notify your doctor if those symptoms occur with physical activity.

Read previous installments in this series:

For Your Patients: What is Heart Failure?

For Your Patients: How Is Heart Failure Diagnosed?

For Your Patients: Getting the Most From Heart Failure Visits

For Your Patients: Self-Care for Heart Failure

"Medical Journeys" is a set of clinical resources reviewed by doctors, meant for physicians and other healthcare professionals as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.