Rehabilitation strategies for the complex cardiac patient
Fredric J. Pashkow, MDAddress reprint requests to F.J.P., Medical Director of Cardiac Rehabilitation, Department of Cardiology/Desk F15, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Carefully designed, monitored rehabilitation regimens can benefit patients with significant cardiac disease, such as life-threatening arrhythmias or congestive heart failure, or who have concurrent systemic disease such as diabetes. Patients with heart failure can tolerate minimal workloads but, with conditioning, they can increase their duration of exercise. Heart transplant recipients, who are usually severely deconditioned at the time of surgery, are good candidates for a comprehensive rehabilitation program; some have progressed to competition-level athletic achievements. Rehabilitation is safe for patients with arrhythmias, given appropriate monitoring, and can contribute to enhanced quality of life. Objective measures are needed to distinguish between symptomatic and functional improvement.