Jered Cook, MD, FACC, RPVI Profile picture
Aug 21, 2018 10 tweets 6 min read Read on X
1/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

1⃣Key Components
2⃣Benefits
3⃣Patients
4⃣Starting
5⃣Objective data
6⃣Patient limitations
7⃣Phase 1
8⃣Phase 2
9⃣Phase 3
2/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

1⃣Key Components

🚬 cessation, lipid mgmt, 🍄🍒🥥🥦🥬 counseling, ⬇️weight, 🆗blood pressure, psychosocial 🛋️, 🏋️‍♀️🏋️‍♂️⛹️‍♀️🏊‍♂️🏌️‍♀️🚣‍♂️⚽️, Diabetes mgmt
3/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

2⃣Benefits

Why? 25% mortality ⬇️, Benefit for >5yrs post-participation, ⬇️ symptoms, ⬇️ non-fatal MI for 1 year, ⬆️ 💊adherence, ⬆️ health factors, ⬇️ healthcare 💰💰.
4/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

3⃣Patients

Who? S/p MI, CABG, PCI, valve surgery, cardiac tx. Also, HF, stable angina and PAD
5/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

4⃣Starting

How? CPX testing pre and post program ( Naughton or Mod Bruce with treadmill, bike, upper body ergometer or NuStep) with PFTs

Can be done for all activity levels
6/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

5⃣Objective data

Determine VO2 max – 60-75% is the anaerobic or lactate threshold
METs level - activity level
VE/VCO2 - Ventilatory efficiency
7/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

6⃣Patient limitations

Factors limiting exercise capacity – Dec CO, Dec skeletal muscle flow, Dec skeletal muscle oxidative metabolism and fiber shift Dec T1, Inc T2, Dec respiratory muscle function
8 /10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

7⃣Phase 1 - inpt rehab, usually around 1 week. Starts the process to strengthen for everyday tasks and set a base for outpatient rehab.
9/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

8⃣Phase 2

Monitored exercise program - 12 weeks 3x/week for 60min. Certified exercise physiologists to maximize each individual’s program.
10/10 Cardiac Rehab – Secondary prevention #FITSurvivalGuide

9⃣Phase 3

Maintenance phase. Sustained activities to decrease occurrences. Can be supervised or not.

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