How To Choose a Cardiac Rehab Program

Cardiac rehab programs vary in the types of services they offer and
     emphasize. Choose one that makes exercise training a priority.
     Studies show that people who participate in an exercise-based
     program are less likely to have a future heart attack or major heart
     surgery, and are less apt to die of any heart-related cause than those
     who don’t join a program that emphasizes exercise. When choosing
     a cardiac rehab program, also look for one that:

       ¦   Offers a wide range of services, including education and
           counseling.
       ¦   Offers services at a time and place that are convenient for you.
       ¦   Offers services that meet your specific needs and preferences.
           For example, if you’re overweight, look for a plan that provides
           help for weight loss.
       ¦   Is supervised by a team of health care professionals.
       ¦   Is affordable. Your insurance may cover the cost of some
           cardiac rehab services, but not others. Find out what will be
           covered and for how long, so you’ll know from the start what
           your out-of-pocket costs will be.

     What You’ll Do in a Cardiac Rehab Program
     Get moving. E x e rcise training will help you learn to safely participate
     in physical activity, strengthen your muscles, and improve your
     stamina. If you’ve recently gotten out of the hospital, you may be
     worried that exercise will bring on another heart attack or other
     heart crisis. In fact, physical activity can help prevent future heart
     problems. Your rehab team will help you develop a program that is
     safe and effective for you.

     Some programs make use of equipment such as a treadmill for
     walking, stationary bikes, and light weights, and you’ll be shown
     how to use this equipment to get the most benefit. Other programs
     offer low-impact aerobics classes and other group exercise activities.
     In most programs, your heart rate and blood pressure will be moni-
     tored while you move. As your heart and body become stronger,
     you will gradually increase your physical activity. Eventually, after
     you become familiar with the program, you can continue it at a
     fitness center or at home.

Learn new heart healthy habits. In your cardiac rehab program,

you’ll also learn about controlling your personal risk factors for heart

attack and other heart complications, and how to create new, healthier

habits. Controlling risk factors is a very important part of your re c o v-

ery process. Depending on your personal needs, you may learn to:

   ¦   Quit smoking if you’re a smoker.

   ¦   Manage related health conditions such as diabetes and high

       blood pressure.

   ¦   Eat a healthy, low-saturated fat, low-cholesterol diet.

   ¦   Control your weight.

   ¦   Manage stress.

For more information on controlling risk factors, see the sections of

this guidebook on “Major Risk Factors” and “What Else Affects

Heart Disease?” on pages 13 and 31 respectively.

Get counseling and sup-

port. A good cardiac

rehab program will help

you learn to cope with

the challenges of adjust-

ing to a new lifestyle,

as well as address any

concerns you may

have about the future.

You’ll also be offered

help in dealing with the

emotional ups and downs

that many people experi-

ence following a heart

attack or heart surgery.

Many programs offer

classes in stress man-

agement, as well

individual counseling,

group support, or

both.

Getting Tested for Heart Disease

You may be reading this book because you think you might have heart disease but aren’t yet sure. Keep in mind that heart disease doesn’t always announce itself with symptoms. That means you could have heart disease and still feel perfectly fine. The best course is to talk with your doctor about your personal degree of heart disease risk and about whether getting tested is a good idea.

Most screening tests for heart disease are done outside of the body and are painless. After taking a careful medical history and doing a physical examination, your doctor may give you one or more of the following tests:

Electrocardiogram (ECG or EKG) makes a graph of the heart’s electrical activity as it beats. This test can show abnormal heartbeats, heart muscle damage, blood flow problems in the coronary arteries, and heart enlargement.

Stress test (or treadmill test or exercise ECG) re c o rds the heart ’s electrical activity during exercise, usually on a treadmill or exercise bike. If you are unable to exercise due to arthritis or another health condition, a stress test can be done without exercise . Instead, you can take a medicine that increases blood flow to the h e a rt muscle and shows whether there are any problems in that flow.

Nuclear scan (or thallium stress test) shows the working of the heart muscle as blood flows through the heart . A small amount of radioactive material is injected into a vein, usually in the arm, and a camera records how much is taken up by the heart muscle.

Echocardiographic changes sound waves into pictures that show the heart’s size, shape, and movement. The sound waves also can be u s e d to see how much blood is pumped out by the heart when it contracts.

Coronary angiography (or angiogram or arteriography) shows an x ray of blood flow problems and blockages in the coronary arteries. A thin, flexible tube called a catheter is threaded through an artery of an arm or leg up into the heart. A dye is then injected into the tube, allowing the heart and blood vessels to be filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Ventriculogram is frequently a part of the x-ray dye test described before. It is used to get a picture of the heart’s main pumping chamber, typically the left ventricle.

Intracoronary ultrasound uses a catheter that measures blood flow. It creates a picture of the coronary arteries that shows the thickness and other features of the artery wall. This lets the doctor see blood flow and any blockages.

In addition, several new, highly sensitive screening tests have been developed. Ask your doctor about these tests:

Carotid doppler ultrasound uses sound waves to detect blockages and narrowing of the carotid artery in the neck, both of which can signal an increased risk for heart attack or stroke.

Electron-beam computed tomography is a superfast scan that provides a snapshot of the calcium buildup in your coronary arteries.

Heart Disease A Wakeup Call

If you have heart disease, you may understandably hope that it’s only a temporary ailment, one that can be cured with medicine or surgery. But heart disease is a lifelong condition: Once you have it, you’ll always have it. It’s true that procedures such as angioplasty and bypass surgery can help blood and oxygen flow more easily through the coronary arteries that lead to the heart. But the arteries remain damaged, which means that you’re more likely to have a heart attack. It is sobering, yet important, to realize that the condition of your blood vessels will steadily worsen unless you make changes in your daily habits. Many people die of complications from heart disease, or become permanently disabled. That’s why it is so vital to take action to control this serious condition.


The good news is that you can control heart disease. There is much you can do to manage your heart condition, reduce your risk of a first or repeat heart attack, and improve your chances of living a long, rewarding life. The sooner you get started, the better your chances of avoiding further heart problems, feeling better, and staying well. So use this handbook to find out more about your own heart condition and what you can do to improve it. You have the power to make a positive difference in your heart health—and you can start making that difference today.

What Is Heart Disease?

Coronary heart disease is the main form of heart disease. It occurs when the coronary arteries, which supply blood to the heart muscle, become hardened and narrowed due to a buildup of plaque on the arteries’ inner walls. Plaque is the accumulation of cholesterol, fat, and other substances. As plaque continues to build up in the arteries, blood flow to the heart is reduced.

Coronary heart disease—often simply called heart disease—can lead to a heart attack. A heart attack happens when a cholesterol-rich plaque bursts and releases its contents into the bloodstream. This causes a blood clot to form over the plaque, totally blocking blood flow through the artery and preventing vital oxygen and nutrients from getting to the heart. A heart attack can cause permanent damage to the heart muscle.

Heart disease includes a number of other serious conditions, including: 

Angina. More than 6 million Americans live with angina, which is chest pain or discomfort that occurs when the heart muscle is not getting enough blood. The inadequate blood flow is caused by narrowed coronary arteries, due to an accumulation of plaque. A bout of angina is not a heart attack, but it means that you’re more likely to have a heart attack than someone who doesn’t have angina. There are two kinds of angina:

Stable angina has a recognizable pattern. It may feel like pressure or a squeezing pain in your chest. The pain may also occur in your shoulders, arms, neck, jaw, or back. It may also feel like indigestion. Stable angina pain is generally brought on by some kind of exertion or strain (such as climbing stairs or experiencing emotional stress), and it is usually relieved by rest or medicine.

Unstable angina is more serious than stable angina. Occurring at any time, unstable angina often reflects a change in a previously stable pattern of angina. Episodes of unstable angina are usually more f requent, painful, and longer lasting than bouts of stable angina, and a re less often relieved by rest or medicine. Unstable angina is a sign that you may have a heart attack very soon. The symptoms are the same as if you are having a heart attack. (See page 46 for heart attack warning signs.) If you have any of these symptoms, you should call 9–1–1 right away so that you can get immediate treatment.

Congestive heart failure. Congestive heart failure is a life-threatening condition in which the heart cannot pump enough blood to supply the body’s needs. Affecting nearly 5 million Americans, heart failure occurs when excess fluid collects in the body as a result of heart weakness or injury. This condition leads to a buildup of fluid in the lungs, causing swelling of the feet, tiredness, weakness, and breathing difficulties.

High blood pressure is the leading cause of congestive heart failure in the United States. Heart disease and diabetes are also major underlying causes of heart failure. People who have had a heart attack are at high risk of developing this condition.

 Arrhythmias are problems that affect the electrical system of the heart muscle, producing abnormal heart arrhythmias . Many factors can contribute to arrh y t hm i a s , including heart disease, high blood pre s s u re, diabetes , smoking, heavy alcohol use, an electrolyte imbalance, drug abuse, and stress ..

Your Help Can Change A Life.

Your Help Can Change A Life.

Hi, I’m Kevin McGill and this is my story. Not long ago my life was quite normal. I had dreams and ambitions about my future and strived to make them happen. But suddenly everything changed. I was diagnosed with cardiomyopathy and triple cardiovascular disease. My whole world collapsed…

Trying To Overcome The Obstacles.

Since, I haven’t been able to work for a while, money has been short. If that wasn’t enough, my old truck died and I now have no means of transportation. Getting to and from doctor appointments and the drug store has been a real struggle, since there is no public transportation that I can use, and the closest drug store is almost an hour in walking distance.

A Small Donation Can Have A Huge Impact.

Given the chance, I plan on buying a cheap used car that will help me visit my doctor, the drug store and the local grocery store. Due to my condition, I require constant medical attention, but don’t have a way to get there. Your invaluable support and generous donations can fill my life with hope again. If you share my belief that everyone deserves a chance to live with dignity, you can make my dream come true.

Challenges Make Life Difficult, But OvercomingThem Makes Life Meaningful.