Cardiac Rehabilitation Programme

Aga Khan University Hospital Cardiac Rehabilitation Programme
If you have already been treated for cardiac disease or have been told that you are at risk, you would be concerned about finding ways to maintain a healthy heart. Cardiac Rehabilitation Programmes are designed to help you reduce the risks of subsequent cardiac disease or disability. In response to your specific needs, a comprehensive Cardiac Rehabilitation Programme would be developed, which would include exercises and cardiac disease education and information. Enrolling in such a programme, will help your heart and improve your general health. Your doctor will advise you about starting on such a programme. You can join either as an in-patient or an out-patient.

A WARNING FROM YOUR HEART

Even though you may not be able to see it or even feel it, coronary artery disease (the common form of cardiac disease) is progressive. If you do not change some habits or lifestyles, chances are that your coronary artery disease will get worse. Even cardiac surgery does not repair the damage done to your heart nor do medications cure the problem. But if you pay attention to the warnings from your heart, there are precautions that you can take towards protecting your heart from further damage.

Learning about coronary artery disease can help you understand why it is important to reduce risk factors. Risk factors are traits or habits that make a person more likely to develop a disease. Some risk factors cannot be changed (like old age or family history) but others can be controlled (like high blood pressure, high cholesterol, etc.).

By talking to people close to you, you can get their support as you start reducing your risk. When you enter a Cardiac Rehabilitation Programme, a specialist can help you set up a personalized exercise programme. You can further reduce your risk by changing your diet and reducing stress. The Cardiac Rehabilitation Programme would help you with appropriate information in these areas.

COMMITTING TO A CHANGE OF HEART

It comes from all directions, and some of us handle it better than others. Since stress makes the heart work harder, try to find ways to relieve the pressure you feel when stressed. One of the best remedies for the tension and stress is doing regular physical exercise. A change in lifestyle with some time for leisure and hobbies also helps fight stress.

Smoking: Causes the heart to beat faster and needs more oxygen. At the same time, it narrows your arteries so that less blood and oxygen get to the heart muscle. The best thing you can do for your heart is not to smoke.

Stress: Stress is defined as any pressure from the outside that makes us feel tense.

Diabetes: People with diabetes are more likely to have heart disease. If you have diabetes, make every effort to keep your blood sugar under control.

Limit your fat and cholesterol: Cholesterol is a part of every human cell. However, when cholesterol sticks to the walls of arteries, it creates a waxy build-up that clogs your arteries. As a result, less blood reaches the heart and increases the risk of adverse cardiac problems. Saturated fats raise the levels of cholesterol in the blood. The higher your blood cholesterol level, the higher your heart disease risks. In order to lower cholesterol levels, set up a goal to avoid foods high in cholesterol and saturated fat, like whole milk products, egg yolks, red meat, coconut, palm oil and "ghee".

Limit Salt: Just as foods rich in saturated fats can be unhealthy, food high in salt content can also create problems for your heart. The culprit is the sodium in the salt. It causes the body to retain water and sodium increases the volume of blood and may raise your blood pressure. If you are using medications for high blood pressure, eating salt can make them less effective. Salt intake can also worsen heart failure with fluid retention in the lungs and body.

Exercise: Getting to the heart of the matter
You have a greater chance of helping your heart work better if you follow an exercise programme. Regular exercise increases your endurance, lowers blood pressure and blood cholesterol, relieves stress and helps control your weight. The higher your blood cholesterol, blood pressure and stress level, the higher your risk for heart disease. A cardiac exercise programme may begin right in the hospital under the supervision of your doctor and a cardiac rehabilitation therapist. As an out-patient, you can continue the programme at Aga Khan University Hospital (AKUH). Later you might want to continue exercising in a different setting such as a fitness centre. Your doctor may prescribe an exercise programme for you to follow at home. Exercise, nutritional counselling, medical counselling and family support; all work together in the Cardiac Rehabilitation Programme to help you regain full confidence in your cardiac health and overall fitness.

WHO CAN BENEFIT?

Physicians recommend and prescribe the Cardiac Rehabilitation Programme for people with:

• A recent heart attack;
• Recent coronary bypass surgery;
• Angioplasty (balloon dilation);
• High cholesterol of arteries;
• High blood pressure;
• Obesity (overweight);
• Chest pain/Angina (heart pain);
• Diabetes;
• Family history of heart disease;
• Pulmonary disease (chronic lung diseases);
• Pacemaker implantation;
• Heart transplant;
• Peripheral Vascular disease (blocked arteries in the legs).

While most of the people in the Cardiac Rehabilitation Programme are recovering from heart conditions, others can also participate to improve fitness levels and prevent heart problems in the first place.

CARDIAC REHABILITATION PROGRAMME

AKUH offers a comprehensive, multidisciplinary team approach to Cardiac Rehabilitation Programme for both men and women who need careful monitoring and supervision.

Highly trained physiotherapists, nurses and exercise physiologists at AKUH help convalescent patients through their professional expertise. Patients are guided to improve their total physical fitness by following a practical supervised exercise programme. The programme is designed around the specific goals recommended by the patient's doctor.

On entering the programme, the participants undergo a thorough assessment. Each patient is then started on an exercise Programme approved by his/her doctor. The Programme is designed to begin at each patient's current level of fitness. From warm-up, through exercise to relaxation, qualified personnel ensure that your heart rate and rhythm responds safely to the demands of the exercise.

The Cardiac Rehabilitation team at AKUH is a diverse group of medical professionals. The multidisciplinary approach to cardiac recovery includes the following:

IN-PATIENTS

Those patients hospitalised for cardiac disease (heart attack, angina, heart failure), angioplasty or open heart surgery, AKUH's Cardiac Rehabilitation Programme can help begin the recovery process by:

• Answering Questions : Any questions regarding the cardiac condition or medications the patient and his/her family members have, are addressed.
• Monitored Exercise : Gaining strength begins with sitting up in bed and progressing to a walking regimen under the guidance of a physiotherapist. Further, exercise is conducted in the Physiotherapy Department.
• Nutrition : Patients learn principles of nutrition and methods of achieving their ideal body weight as well as controlling cholesterol levels, diabetes and hypertension through diet changes.
• Assisting : Patients and families are assisted as they deal with pain, fear and depression to help regain a positive outlook towards the future. Realistic reassurance and hope in future are instilled.
• Education : Individually and in groups, participants learn more about their health and cardiac disease. The changes needed in their lifestyles to speed up their recovery process, are communicated to them with supportive guidance.
• Recuperation : The discharge planning team and the Cardiac Rehabilitation team ensure that before leaving the Hospital, patients know what they should eat, how much they should exercise and what they can expect over the following weeks; when and where to report in case of an emergency, for follow-ups as well as for future healthy heart management programmes.

OUT-PATIENTS

AKUH's out-patient Cardiac Rehabilitation Programme, ensures continuous recovery through helping patients gain optimum strength, fitness and confidence. It is an important phase of a well-supervised Cardiac Rehabilitation Programme.

Add aerobics: Any exercise that increases your body's use of oxygen is considered an aerobic exercise. The normal aerobic exercise period lasts between 2O-3O minutes and should be done 3-5 times a week. Brisk walking, running, jogging are a few examples. Before staring any aerobic activity, please consult your doctor.

AT HOME

If you have completed our in-patient or out-patient programme, you may choose to continue exercising either at a medical facility or at a fitness centre or at home. Your family members may join you in exercising, help you monitor your heart rate by checking your pulse or chart your general progress on an exercise log.

By maintaining a regular exercise programme for life, you will be able to participate more fully in the recreational activities you enjoy and be as active as possible within the limits of your fitness level. More importantly, you will decrease the risk of subsequent cardiac events.

In the end, please remember that no rehabilitation Programme can be effective without your personal commitment and will-power. Help us to help you live a happier and healthier life. You owe it to your heart.

Aga Khan University Hospital, Karachi
P.O Box 3500, Stadium Road, Karachi-74800, Pakistan.
Email: marketing@aku.edu