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Published on March 12, 2018

Exercising after a heart attack is essential

With two local cardiac rehabilitation programs, people with cardiovascular disease on Cape Cod are more fortunate than those in many parts of the country. The American Association of Cardiovascular and Pulmonary Rehabilitation lists 812 cardiovascular rehabilitation programs in the entire United States, and Cape Cod Healthcare has two of them – one at Falmouth Hospital and another at Cape Cod Hospital.

The benefits of cardiac rehab are well documented. The American Heart Association credits it with a 20 to 30 percent reduction in all-cause mortality. Patients who participate feel better, have decreased symptoms and few hospitalizations, among other benefits.

Yet, the American Heart Association estimates that only 14 to 35 percent of eligible heart attack survivors and 31 percent of patients who have had coronary bypass surgery participate in such a program. The rate for Medicare beneficiaries is even lower at 12 percent.

Cardiac rehabilitation medical director Elissa Thompson, MD, said monitored exercise after a cardiac event and/or procedure can be the difference between a full recovery and a continued decline in health. Providing medical oversight during exercise can give patients the confidence they need.

“The therapeutic thing about monitoring is that if you’ve had a heart attack, bypass surgery, a stent, or a valve surgery, your confidence is blown. It’s a very difficult time in life because people feel fundamentally different about themselves.”

It’s important for cardiologists to be sensitive to the fact that most people who have had a major heart problem suffer from a level of post-traumatic stress disorder that can make them afraid to exercise. It can be terrifying to feel their heart beat fast and they want to avoid it.

“It’s a self-preserving reaction, but in fact it’s the worst thing you can do,” she said. “I don’t want patients doing that. Once they’ve had their revascularization, whether it’s a stent or a bypass, I want them out and exercising. If they are afraid to, then all is lost. Using that muscle and being confident is just as important as what we’ve done in the hospital.”

About The Program

The 12-week program includes an hour and 15 minutes of monitored exercise and 45 minutes of education per session, three times a week. The education includes information about their disease, the importance of a good diet, the importance of exercise and why it helps, managing cholesterol, controlling stress, and quitting smoking.

“We’re trying to help them understand how their heart works so that they don’t get in trouble again,” Dr. Thompson said.

An exercise physiologist and nurse monitor each patient the entire time they are exercising. Each patient wears a telemetry box to record their heart rate. Blood pressure and blood sugar, if applicable, are also regularly checked. The monitoring serves a two-fold mission, according to Dr. Thompson. The first reason is to constantly adjust their exercise regimen so that it is maximally effective.

“What we want to do is make them feel like they are doing moderate intensity exercise, but sneak in more work load,” she said

Insurance programs like Medicare Part B cover cardiac rehabilitation for the following diagnoses:

  • A heart attack within the preceding 12 months
  • Coronary artery bypass surgery
  • Recurrent chest pain from coronary heart disease
  • Heart valve replacement or repair
  • Coronary stenting or coronary angioplasty
  • Heart or heart/lung transplant
  • Stable chronic heart failure
  • Peripheral artery disease

The program is also open to people who wish to pay out of pocket.