How Cardiac Rehab Can Help After a Heart Attack

A heart attack can be a wake-up call for anyone.

If you’ve neglected healthy habits such as exercise, you may realize that to live longer, you’ll have to make better choices, and you could use help deciding where to begin. If you’ve always engaged in regular exercise and have a variety of activities you enjoy, you might be nervous about raising your heart rate and need to know that you won’t damage your heart.

Whether you’re a beginner or an experienced exerciser, cardiac rehabilitation can be helpful after a heart attack, heart surgery or other heart-related issue.

“Cardiac rehabilitation is truly for everyone who has experienced a cardiac event,” says Devin Coomer, an exercise physiologist and coordinator of cardiopulmonary rehabilitation at UNC Health Rex. “People may think it’s only for people who have never exercised, but everyone can benefit.”

Coomer explains how cardiac rehabilitation works and what you can expect from it.

What is cardiac rehabilitation?

Cardiac rehabilitation is a medically supervised exercise program that includes educational sessions on nutrition, stress management and healthy lifestyle choices.

To participate, your doctor will provide a referral and you must have a qualifying cardiac condition. Your insurer can give you a list of conditions that are covered, but generally, people who have had heart attacks, bypass surgeries, valve repairs or replacements, angioplasties and transplants are eligible, as are people experiencing heart failure or angina.

Cardiac rehab typically involves three hourlong sessions per week for 12 weeks, though Coomer says that may vary depending on your needs. The bulk of the sessions are spent exercising while wearing monitors that track your heart rate and blood pressure.

Exercise physiologists and cardiac nurses facilitate cardiac rehabilitation, and a cardiologist regularly reviews patients’ treatment plans. Your program may also involve dietitians, physical therapists and mental health professionals. These people write ongoing progress reports that are available to your doctor, who can track your progress.

What are the goals of cardiac rehabilitation?

The general goal of cardiac rehabilitation is to strengthen your heart and reduce the risk of future cardiac events. People who attend a full program of cardiac rehabilitation (typically 36 sessions) have a 47 percent lower risk of death and a 31 percent lower risk of heart attack than people who attend just one session.

Coomer says cardiac rehab also considers individual goals.

“Some people may be experiencing decreased strength and endurance after surgery, and that’s affecting their ability to perform their daily activities or play with grandkids,” she says. “Others may want to return to old routines, like playing tennis three times a week.”

A common goal is exercising without anxiety or worry.

“We may see someone who needs to be introduced to pieces of exercise equipment and shown that exercise is not scary or miserable,” Coomer says. “We also have people who have exercised their entire life and need reassurance that their exercise regimen is still safe. We can help them learn how to monitor their heart rate and change their routine if necessary.”

Cardiac rehabilitation can have positive effects on mental and emotional health as well.

“We see people who are very shaken up by what happened to them,” Coomer says. “They may be frightened or frustrated. They can think they are a burden to others or worry they’ll never feel like themselves again. We can help them regain independence and a sense of strength.”

Because you’ll exercise alongside fellow recovering cardiac patients, you may find others who understand your situation.

“We’ve heard about people who exchange numbers and meet up to talk,” Coomer says. “You meet people who become a part of your support system.”

What is the process of cardiac rehabilitation?

After your physician refers you to cardiac rehabilitation, you’ll have a consultation with a member of the team to review your medical history and the kinds of exercise and daily activities you enjoy. You’ll take a six-minute walk test to evaluate your baseline fitness. An exercise physiologist will use this information to create an individualized treatment plan.

Your exercise sessions may take place in a hospital, wellness center or other specialized facility. Some cardiac rehab programs offer virtual sessions that you can do at home while a specialist supervises you remotely.

In-person sessions usually are completed with others who have experienced cardiac events; Coomer says UNC’s program serves nine to 12 people at a time. Your specific plan may have you walking on a treadmill and lifting dumbbells, while another person’s plan may involve riding a seated elliptical or stationary bike.

As you exercise, staff members will monitor your heart rate and blood pressure and provide guidance on when you can safely increase intensity.

“We’ll make sure you’re tolerating the activity and check for any pain or pressure in the chest,” Coomer says. “We can explain what exercise should feel like after a cardiac event and communicate any issues to the referring physician.”

In addition to workouts, you’ll have the opportunity to meet with a dietitian and attend educational sessions about improving your heart health.

As sessions continue, staff members will check in to ensure that you’re on track to meet your goals and that you’re taking steps to prevent future cardiac events, by making dietary changes, for example.

You’ll also learn how to exercise on your own, without the supervision that cardiac rehabilitation provides. Coomer says that staff members can help you identify appropriate exercises for your needs and create a plan for continuing to exercise after you’re discharged from the program.

“Exercise is for a lifetime,” Coomer says, “so we want the transition from exercising with us to exercising at home to be smooth and confident.”

Have concerns about your heart health? Talk to your doctor. If you need a doctor, find one near you.