'Changing Lives, One Heart at a Time'

Heart disease is the number one cause of death in the United States. Yet, according to the American Heart Association (AHA), a medically supervised program of cardiac rehabilitation – also called cardiac rehab – can significantly improve the chances of survival for patients with heart disease. Cardiac rehab includes exercise training, education on heart-healthy living and counseling to reduce stress.

The AHA notes that cardiac rehab could help the roughly 965,000 Americans who suffer a coronary event each year, as well as patients diagnosed with heart failure. AHA research shows, however, that only one-eighth of all eligible Medicare beneficiaries participate in cardiac rehab programs.

“Many people simply aren’t aware of the benefits of cardiac rehabilitation,” says Washington Hospital’s Cardiac Rehabilitation Manager Lani dela Rama, RN, MSN. “Cardiac rehab can help patients improve their general physical condition, strengthen their heart, lose weight, manage their blood pressure and cholesterol, and improve blood sugar control. It also can restore patients’ self confidence while decreasing anxiety and depression.”

To focus national attention on cardiac rehab’s contribution to improved health for people with heart disease, February 14 – 20 has been designated National Cardiac Rehabilitation Week. The theme for this year’s observation of Cardiac Rehabilitation Week is “Changing Lives, One Heart at a Time.”

Started in 1985, the Cardiac Rehabilitation Program at Washington Hospital can be helpful for patients with a variety of heart conditions, such as:

• Recent heart attack
• Cardiomyopathy (enlarged heart)
• Angina (chest pain due to clogged heart arteries)
• Coronary artery bypass surgery
• Heart valve repair or replacement surgery
• Heart transplant
• Balloon angioplasty or coronary stent implants
• Open-heart surgical implantation of a left ventricular assist device (LVAD) to pump blood from the lower left chamber of the heart to the rest of the body

“We celebrated our 30th anniversary in September 2015, and I am so happy that we are able to continue offering this program for people in our community,” dela Rama says. “I have worked in Cardiac Rehab since 2006, and I have seen what this program can do to help patients recover from heart procedures. We strongly promote having patients participate in their recovery. The patients are an integral part of the Cardiac Rehab team that includes nurses, physical and occupational therapists, a case manager, a respiratory therapist, physicians, a cardiothoracic surgeon, a physician assistant, a dietitian, a social worker and a chaplain. I feel so privileged as a registered nurse and educator to make a difference in patients’ lives.”

Many insurance plans, including Medicare, will cover the cost of cardiac rehab for up to 12 weeks (36 sessions) after a recent event such as bypass or heart valve surgery, heart attack, stent placement, angina or heart transplant. Patients who wish to continue in the program once their insurance stops paying have the option of participating on a “private pay” basis for a nominal fee of $8.50 per visit. That same private pay option is available to patients who have cardiac risk factors but have not yet been diagnosed with cardiovascular disease. A physician referral is required to enroll.

Patients are monitored and supervised during exercise sessions by registered nurses and an exercise therapist/physiologist. While exercising, patients are connected to portable electronic equipment to monitor heart rate and blood pressure. In addition to providing each participant with an individualized exercise regimen, the Cardiac Rehabilitation Program counsels patients on lifestyle modifications such as choosing heart-healthy foods and managing blood pressure, cholesterol and diabetes.

“I can see the positive changes our patients go through, from the first day to the 36th day of cardiac rehab,” dela Rama notes. “Our caring Cardiac Rehabilitation team is in constant communication with our patients and their physicians to help patients meet their individual goals. Those goals could range from feeling good and getting stronger to changing their lifestyle and getting back to their normal activities. We emphasize that going through cardiac rehab is not the end of their recovery efforts – it is the beginning, and they need to continue the exercises and lifestyle changes learned in cardiac rehab.”

The program also offers referrals to smoking cessation programs and access to a national support group called Mended Hearts.

“The Mended Hearts members provide education, regular social events and emotional support to patients with heart disease and their families,” says dela Rama, who currently serves as president of the Mended Hearts group at Washington Hospital. “Some members visit patients who are hospitalized after events such as heart surgery, heart attack or stent placement to offer support and encouragement during this stressful time.”

Dr. Shashank Jolly, a cardiothoracic surgeon at Washington Hospital, is a strong supporter of the Cardiac Rehabilitation Program.

“I treat a lot of patients who have coronary artery disease with blockages in the arteries around the heart,” he says. “Coronary artery disease is primarily a disease of aging, but it also can happen in younger people whose ‘biological age’ is older than their chronological age. In addition to chronological age, factors that can contribute to coronary artery disease can include a family history of the disease and lifestyle choices such as poor diet, high blood pressure, high blood pressure, smoking, obesity and diabetes. Symptoms of coronary artery disease might include shortness of breath, syncope (fainting) and angina. Sometimes, though, the first indication of coronary artery disease is a heart attack.”

Dr. Jolly notes that many patients with mild coronary artery disease can be helped by making changes in lifestyle and being treated with medications to adjust blood flow. If medications are not sufficient or the patient has significant blockages, other treatments might be necessary.

“For some patients, inserting stents to open up the blocked arteries might be a good option,” he explains. “For patients with severe blockages, however, bypass surgery may be necessary. Regardless of the treatment required, I generally refer my patients to the Cardiac Rehabilitation Program. The exercise program and education in adopting a heart-healthy lifestyle can help patients get back to their previous everyday activities and lead happier, healthier lives.”

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If you need help finding a physician, visit www.whhs.com and click on the link for “Find Your Physician.”

Learn more

For more information about cardiac rehabilitation, as well as heart disease risks, symptoms and treatments, visit the American Heart Association website at www.heart.org