The term cardiac refers to something related to the heart and the term rehabilitation refers to restoring someone to normal life or normal health through specific interventions.

Cardiac rehabilitation is a set of programs that are designed to restore both the physiological and psychological wellbeing of a person following a cardiac event such as a heart attack. Cardiac issues and treatments such as heart attack and the consequent heart surgery can have a varying degree of negative impact on the patients’ physiological and psychological wellbeing.

Cardiac issues are generally caused by unhealthy behaviour of an individual such as intake of unhealthy diet for a long time, smoking, excessive consumption of alcohol, and static lifestyle or lack of physical activity. This means that these causes must be addressed in the first place to avoid having cardiac issues. It is important because these factors are generally underestimated, and health problems are believed to happen by chance. Therefore, people should generally adopt a healthy lifestyle to reduce cardiac risk in the long run.   

However, when a patient undergoes a cardiac event, it is generally a medical emergency and should thus be consulted with a certified medical doctor immediately. It is important to get medical advice and treatment from a certified doctor who specializes in heart issues. Since cardiac events are seen as a life-threatening medical complication, it also accompanies a sense of fear. Therefore, cardiac events and the consequent treatment can have a negative effect on both the physiological and psychological wellbeing of the person. Thus, after the treatment, the patient should be rehabilitated to restore him to a normal life. For this, cardiac rehabilitation is a set of programs designed to rehabilitate patients following a cardiac event.

It is important to note that this page does not provide any medical advice on the treatment of cardiac issues which should only be done by a certified doctor. This page only explains cardiac rehabilitation as a process of rehabilitating the patients following a cardiac event and/or treatment. This rehabilitation is aimed at improving the psychological well-being of the patient who undergoes or have undergone fear of a cardiac issue.

The goals of cardiac rehabilitation are as follows:

1. To improve the physiological, psychological, and social wellbeing of the patient. To enable them to live a happy life.
2. To help the person adopt behaviour that reduces the risk of cardiac events.
3. To shorten the time of recovery for the patient.
4. To reduce excessive use of medication by replacing them with healthy behaviors.
5. To help the person to return to work instead of staying in bed for long.
6. To help the person quit addictive behaviour that causes health issues.

Many specialists from different fields are involved in this program. They work together to help the patient in various domains, such as social, mental, and physiological areas of health. The cardiac rehabilitation team comprises of the following:

• Cardiac specialist
• Psychologist
• Social worker
• Nurse 
• Physiotherapist.

There are four phases of cardiac rehabilitation.

This is the first phase of cardiac rehabilitation directly following the cardiac event. Soon after the cardiac event occurs the person is hospitalized where he or she is under the supervision of the cardiologist, nurses and other rehabilitation team members. Since the patient’s condition is severe, he is in the intensive care unit where proper care is provided to save the life of the person.

At this stage, the main concern of the rehabilitation team is to save the life of the person and to help him regain mobility. As the condition of the patient gets better, he may be shifted cardiac unit. At this stage, exercises and behavioral therapies are not provided to the patient because the patient is not in a condition to move properly. The therapist along with other team members only plan when to discharge the patient and what type of exercises will be recommended to the patient.

At this stage, only plans about the better health and cardiac fitness of the patient are made. These plans are implemented in the later stages depending upon the condition of the patient. To understand this, take the example of a patient who undergoes open-heart surgery. In the initial days, the patient is not able to move properly and is not in a condition to be advised for any physical exercise. Therefore, the team may make a plan for his exercise and other therapies and wait for some time so that the patient becomes able to take exercise. These plans are made in consultation with medical doctors (cardiac specialists).

This is the second phase that starts after the patient is discharged from the hospital. This phase lasts for approximately 3 to 6 weeks. At this stage, mild exercises are advised to the patient which he does under the supervision of the medical physiotherapist. Moreover, the major focus is on educating the patient to adopt healthy habits to reduce the risk of future cardiac events. The patient is helped to quit smoking and alcohol consumption in a manner allowing his recovery. The patient is advised to eat heart-healthy foods. The patient is educated on how to monitor his heart rate and exertion level during exercise.

In this phase, the patient becomes more independent as compared to the second phase. The patient does more independent exercises on his own, though a therapist may be present to monitor the activities of the patient and to help him avoid having any complications. Aerobic and more flexible exercises are designed by the therapist for the patient.  Psychological education and awareness about the risk factors are provided to the patient. The exercise program is not the same for all patients and is tailored according to the need and situations of the patient. 

This is the final stage of cardiac rehabilitation. In this stage, the patient is able to carry on his exercises without the presence and guidance of the therapist. The success of this stage depends on how well the previous two stages were conducted. It depends on the performance of the rehabilitation team in the previous stages but also on the patient - whether or not he has followed the advice of the team seriously in previous stages.

The important part of the rehabilitation program is psychological care which should be provided to the patient throughout the four stages of rehabilitation.

A cardiac event such as a heart attack or an open-heart surgery is a threatening and life-altering experience. The person who goes through the traumatic event of heart problems may become stressed and develop PTSD. This means that proper psychological care must be provided to the patient to minimize his stress and fears to a possible extent by 1) counselling, 2) encouraging, 3) helping the patient to adopt an optimistic approach to life, and so on.

A person who goes through a cardiac event may have problems adjusting in his job, neighbourhood or with the boss. People may expect them to function as a normal person which they may not. Thus, in order to cope with the problems and adapt to the situational demands counselling is done. CBT, breathing exercises and anger management techniques are also carried out. 

Apart from reducing stress (as a consequence of the traumatic experience of the cardiac event) for normalizing the life of the patient, stress management is also important because there is a relationship between stress and cardiac issue. If the stress is not handled properly, this can aggravate the existing cardiac issue or result in cardiac issues in future.

As noted, there is a direct relationship between stress and cardiac problem. Thus, to reduce the risk for developing cardiac problems, the stress should be minimized. It means that a lot of psychological work needs to be done to reduce both the problems that arise due to cardiac events as well to reduce the risk associated with further cardiac attacks.