After a cardiovascular event, doing exercise and following the recommendations of healthcare specialists are essential to the recovery process.
Medical advisor: Domingo Caraballo – Physiatrist
After experiencing a cardiovascular event, cardiac rehabilitation is a joint effort between medical staff, patients and family. Medical staff are responsible for ensuring clinical tasks are complete, while patients must follow the recommendations of specialists and be willing to change their habits, allowing a quick return to daily activities. With their support and presence, family is responsible for making sure that their loved one follows the doctor’s instructions and also serves as an emotional support for their mental well-being.
According to physiatrist Domingo Caraballo, a specialist in cardiovascular disease prevention, “Among other causes that have become common, people who receive cardiac rehabilitation services and stress tests mostly come as a result of myocardial infarctions, surgeries, heart failure, coronary bypasses, or due to the obstruction of some artery that requires catheterization.” Also included in this list, however, are risk factors such as high blood pressure, physical inactivity, stress, low levels of physical activity and heart transplants.
To address each case, two forms of cardiac rehabilitation have been established. Primary prevention deals with people who have risk factors for cardiovascular disease, but do not yet have the disease. Secondary prevention is for patients who have experienced some type of heart failure and are receiving treatment to prevent a second event from happening.
Education is the answer
The first step for the patient’s recovery starts with giving them a clear and accurate explanation that allows them to understand the causes of the disease, its risks, its treatment options and what can happen again if they do not change some of their lifestyle habits. It is important to emphasize that in order to have a positive emotional response, it is important for this information to be given in an optimistic way.
At this stage, family support is important, as both patients and those close to them often have many fears about the future of their health. The best situation is for everyone to create a support network, be informed and begin to answer any questions about whether the patient will be able to go back to work, if their life is at risk, and what kind of precautions should be taken at home for the patient.
“Some patients return home and their family members do not let them do anything, but the faster they get back to their daily routines, the better,” states Dr. Caraballo.
At appointments, different aspects of the patient’s lifestyle will be examined: their diet, physical activity, whether they are or have been under stress, anxiety or depression, as well as their family history. It is important for accurate information to be provided at these appointments and for all family members to be informed.
Movement is key
Dr. Caraballo’s initial recommendation is to start doing physical activity as soon as possible. After cardiovascular events, the patient can rest for three days after the event occurred. Afterwards, however, it is important to walk, ride a bike, use an elliptical machine or a treadmill, and combine these movements with strengthening, balance and coordination exercises. Developing these routines takes discipline and commitment.
The pace and intensity of the activity depends on the patient’s physical condition and on the medical opinion the healthcare specialist gives at the appointment. This can be done as long as there is no contraindication that arises during the care of the event.
Cardiac rehabilitation involves getting medical care from physical therapists, psychologists and nutritionists. Cardiac events are sometimes caused by stress, anxiety or depression, which is why consulting with other healthcare specialists is part of treatment in order to take a broad-based approach to their care on a case-by-case basis.
“Psychologically, it is important for the person to feel at ease, to not think that the disease is going to happen again, to not think that they are going to die, or that their life will never be the same. In recovery, we help them to relax, and better enjoy every moment,” Caraballo states.
Nutritionists also play a role in teaching patients to eat in a heart healthy way (with foods that are not harmful to their hearts), and to watch their fat, lipid, cholesterol and triglyceride levels. As our physiatrist explains, the goal is to find the pleasure of living again and to live life at the fullest, as every moment counts; but this is a process that requires patience.
Quitting smoking is key, as well as following your medical team’s recommendations. Family support is also essential.