Cardiac rehabilitation in patients with coronary artery disease

Abstract

In 1968, the World health Organization, in association with the International Society of Cardiology, defined cardiac rehabilitation for the fist time in Geneva, Switzerland. Beginning in the 1970s, a number of clinics and cardiac rehabilitation centers were opened, initially in Europe and subsequently in Canada and the United States. Many years later, some countries in Latin America opened their first cardiac rehabilitation centers, including Mexico. The goals of cardiac rehabilitation are to improve functional capacity, alleviate or lessen activity- related symptoms, reduce disability, identify and modify coronary risk factors and to reduce morbidity and mortality due to cardiovascular illnesses. The most important outcome of the cardiac rehabilitation programs is an improvement in the patient´s quality of life. Interventions in these programs emphasize three areas: exercise training and activity prescription, risk factor modification, and psychosocial and vocational evaluation and counseling. Most patients can return to their usual activities within a few months after a heart attack or heart surgery. There are three phases in cardiac rehabilitation; phase I or inpatient program, phase II or outpatient program and phase III or maintenance outpatient program. Cardiac rehabilitation monitors and improves the recovery process, increases physical fitness, and reduces the risk of new coronary events. Doctors, nurses, dieticians, social workers, physical therapists and psychologists participate in these programs. Nurses have an important role in cardiac rehabilitation participating in the assessment, risk stratification, physical rehabilitation activities and education of the patients. They are also responsible for nurse training and coordination of cardiac rehabilitation programs and research.