Cardiac Rehab Flashcards
What is the cardiac rehab triad?
- Exercise
- Behavior modification
- Education
What is the definition of cardiac rehab? (3 components)
Medically supervised program that includes:
- Cardiovascular conditioning (exercise)
- Behavior modification
- Counseling and Education
What is the goal of cardiac rehab?
3 components
- Restore and maintain an individual’s optimal:
- Physiological health
- Psychological health
- Social and vocational functioning
How many deaths in the US are caused by cardiovascular disease?
50 %
How many new diagnoses of coronary artery disease are there each year?
13.5 million.
How many individuals suffer an MI each year in the US?
1.5 million.
On average, of the individuals that eligible, how many receive cardiac rehab?
15 %.
What 3 organizations are trying to change rehab standards to increase enrollment in cardiac rehab?
- ACC
- AHA
- AACVPR
What 2 methods are used to measure a rehab program’s effectiveness?
- % of eligible patients that are referred to rehab.
- Integration of many health care disciplines into cardiac rehab to maximize quality of care for those in the program.
What 6 diagnoses are covered by medicare for enrollment in cardiac rehab?
- Acute MI
- Coronary bypass surgery
- Heart valve repair/ replacement
- Coronary angioplasty/ stenting
- Heart transplant
- Stable angina pectoris
When must the referral be made for the 6 diagnoses?
Within a year.
What are 10 health professionals that are involved in the cardiac rehab setting?
- Referring physician
- Medical director
- Registered nurses
- Exercise physiologists
- Physical therapists
- Dieticians/ nutritionists
- Behavioral therapists
- Social services specialists
- Pharmacists
- Health educator
What are the 4 phases of cardiac rehab?
Phase 1: Hospital phase
Phase 2: Following cardiac even when insurance covers cost
Phase 3: Following discharge from phase 2 (patient pays out of pocket)
Phase 4: Long-term maintenance
What is the physicians role in cardiac rehab?
- Supervision
- Referral
How many sessions are covered by insurance typically for cardiac rehab? How long is each session?
- 36 sessions
- 1 - 2 hour sessions
What are the 3 goals of the exercise portion of cardiac rehab?
- Improve functional capacity
- Reduce disability/ morbidity and mortality
- Lessen activity related symptoms
What are the 3 educational goals of cardiac rehab?
- Identify risk factors
- Educate patient on management and prevention
- Medication usage
What determines the use of telemetry monitoring during rehab?
RIsk stratification.
What factors are considered when determining risk level?
- Ejection fraction
- Arrhythmias
- Depression
- METs
- Angina
- Level of ischemia
- CHF
What are ejection fractions for low, moderate, and high risk patients?
Low: Greater than 50 %
Moderate: 40 - 49 %
High: Less than 40 %
What are the MET values for each risk group during stress tests?
Low: Greater than or equal to 7 METs
Moderate: 5 - 7 METs
High: Less than 5
What 4 factors are exercise prescription in cardiac rehab based upon?
- Functional capacity from stress test
- HR and BP response to exercise
- Functional goals
- Orthopedic restrictions/ limitations
What 3 aspects are addressed in exercise training in cardiac rehab? How much time is spent doing each?
20 - 50 minutes CV conditioning
10 - 15 minutes Resistance Training
5 - 10 minutes Stretching/ Relaxation
What 5 measures can be used to determine the intensity of an exercise?
- HR and BP response
- Target HR calculated using stress test
- RPE
- MET level
- Ischemic/ anginal threshold
