Recovery programme

AFTER a person has had a cardiac event – a heart attack, for example – the next steps after treatment are rehabilitation and recovery.

Cardiac rehabilitation is a process where a patient who is recuperating after a cardiac event goes through a prescribed exercise programme in order to improve heart function and prevent another cardiac event from happening.

“We draw up an individualised exercise programme to help patients improve their heart function.

“The programme can be a simple one or it can be complex, depending on the patient’s condition,” says Dr Lydia Latif, a visiting rehabilitation physician at Ara Damansara Medical Centre.

The programme incorporates two main components – physical exercise and education.

Dr Lydia explains that when the patient comes to the hospital experiencing a cardiac event, they are usually concentrating just on that event and the treatment they are receiving.

During the rehab process, the rehabilitation physician takes things slower to create a calm and reassuring atmosphere.

“We provide education on the risk factors that caused the cardiac event in the first place and advise the patient on secondary prevention measures, which usually involve lifestyle changes,” she says.

The patient will be given advice about dietary modification, quitting smoking and stress management, among other recovery and rehabilitation measures.

In devising a programme for a patient, the doctors will put the patient through an exercise stress test to determine current heart function as well as assess the risk of another cardiac event occurring.

The patient will then be prescribed an appropriate set of exercises.

He will be advised as to the intensity and frequency of the physical activity he can carry out.

There are two types of exercises:

Endurance – after a cardiac event, the heart’s endurance will be poor. In other words, the patient will have very little stamina and is easily fatigued. Endurance exercises are aerobic exercises such as swimming or cycling that challenge the heart to pump harder. As with any other muscle, the heart needs to be exercised in order to reach optimal function.

Resistance – exercises such as lifting weights not just exercises arm and leg muscles, they also help the heart pump better.

At the start of the rehabilitation process, the patient will come to the rehab centre for about six to eight weeks where he will go through the physical exercises in a controlled environment under supervision.

Eventually, the patient will have to incorporate these exercises into his daily life.

“Cardiac rehab is part of longterm cardiac management and care. It’s not sufficient to just prescribe medication; we need to take management to the next level.

“Medicines restore primary heart function, but the rehab process and lifestyle changes the patient makes are to prevent another cardiac event,” explains Dr Lydia.

When it comes to heart health, each patient’s level of knowledge of what caused the event and how to prevent another one is different.

“The physician assesses the patient’s level of knowledge, his or her daily practices and attitude towards heart health and making changes. From there, we will be able to streamline the rehab needs to the patient,” says Dr Lydia.

It can take as few as two or three sessions for the patient to receive all the knowledge he needs, and change his attitude and lifestyle, so the rehabilitation process is not one that has to go on for the rest of the person’s life.

However, the lifestyle changes and taking care of one’s health have to go on forever.