Phase 2 - Center Based Outpatient

Question 1

What is Phase II Cardiac Rehab and its duration?

Answer 1

Phase II Cardiac Rehab is a physician-supervised, multidisciplinary outpatient program focusing on exercise, risk factor modification, and outcomes assessment.

It begins 1-3 weeks post-discharge and can last up to 12 weeks.

Question 2

What diagnoses are accepted into Phase II Cardiac Rehab?

Answer 2

Accepted diagnoses include MI within 12 months, CABG, stable angina, PTCA, heart or lung transplant, heart valve surgery, stable chronic heart failure (EF ≤ 35%, NYHA class II-IV), and symptomatic PAD.

Question 3

What is the purpose of an exercise test with ECG in Phase II?

Answer 3

It evaluates heart rate, rhythm, symptoms, ST-segment changes, exercise capacity, risk stratification, target HR, and initial exercise workload.

Question 4

What are key examination components before starting formal physical activity in Phase II?

Answer 4

Medical history, CVD risk profile, BMI/waist-hip ratio, resting ECG/BP, lung auscultation, extremity palpation, and wound/orthopedic/neuromuscular assessments.

Question 5

What are safety monitoring criteria for discontinuing exercise in Phase II?

Answer 5

Discontinue exercise if

• HR plateaus/decreases with increased work,
• SBP falls or >250 mmHg,
• DBP >115 mmHg,
• arrhythmia,
• ST-segment depression >1mm,
• heart block,
• ventricular dysrhythmias, or
• angina symptoms

Question 6

What are the components of a FITT-VP program for Phase II Cardiac Rehab?

Answer 6

Frequency, Intensity, Time, Type, Volume, and Progression tailored to the individual based on exercise testing, patient history, and response to interventions.

Question 7

What is the initial exercise prescription for Phase II patients?

Answer 7

• start with warm-up,
• low-intensity aerobic training (40-60% HRR or RPE 9-13), and
• gradually increase duration and intensity based on tolerance and symptom monitoring

Question 8

What are progression strategies in Phase II Cardiac Rehab?

Answer 8

Increase duration by 5-10 minutes every 1-2 weeks and add intensity based on patient tolerance and medical clearance.

Question 9

What are the key benefits of aerobic training in Phase II Cardiac Rehab?

Answer 9

Improved insulin sensitivity, lipid profiles, blood pressure, vascular function, autonomic function, and energy balance.

Question 10

What considerations influence exercise prescription adjustments in Phase II?

Answer 10

Adjustments consider patient comorbidities, medications, orthopedic limitations, and subjective feedback on fatigue, pain, and exercise tolerance.