Heart attack

Cardiac rehabilitation & support

Cardiac rehabilitation programme (also called Cardiac Rehab) usually includes the following basic areas: supervised exercise sessions, education and relaxation and emotional support. The goals of cardiac rehabilitation are to help you regain strength, to prevent your condition from worsening and to reduce your risk of future heart problems.

Cardiac rehabilitation begins in hospital. A member of the cardiac rehabilitation team will visit and provide detailed information about:

  • your state of health and how the heart attack may have affected it
  • the type of treatment that you received
  • what medications you will need to take when you leave hospital
  • what specific risk factors are thought to have contributed to your heart attack
  • what lifestyle changes you can make to address those risk factors
Some of the people we talked to sometimes found it difficult to take in all the information and advice given while in hospital. And a few people pointed out that they hadn’t been given enough information on what to expect or do if they had health concerns at home.
Cardiac rehabilitation programmes can vary throughout the UK but it is usually a service which is ‘menu based’ meaning that the person can access from the list of what it is on offer the service(s) he or she needs. The ‘menu list’ provides:
  • advice on how to stop smoking
  • a copy of the BMA Cardiac rehabilitation – information booklet and personal plan
  • telephone follow-up and Primary PCI (percutaneous coronary intervention) clinics
  • locally based pre-exercise assessments clinics
  • group education sessions for patients and their carers
  • supervised exercise sessions
  • relaxation and psychological support
  • advice on the long term management of their cardiac condition

It is usually recommended, once at home, that people get plenty of rest and only do light activities, such as climbing up and down the stairs or short walks, which can be increased gradually over several weeks with advice from the care team.

Following a heart attack people were keen to get fit and resume their everyday lives. This initial period can be frustrated as people think they are able to do more activities than advised by the cardiac care team. Neil tried to attend exercise sessions two weeks after his heart attack only to be turned back by the physiotherapist because it was too soon for him to start.
Some people attended pre-exercise assessment clinics were their overall fitness and cardiovascular function was evaluated to help planned their personal exercise programme.

Cardiac rehabilitation programmes for people who have had a heart attack, are run either at the local hospital or at a nearby centre and starts about 4 -8 weeks after leaving hospital. People usually go once or twice a week for between 6 and 12 weeks, sometimes longer. The cardiac rehabilitation nurse will explain the local programmes.

There is also a Heart Manual, which people can use to follow a rehabilitation programme at home*. One man who lived in a rural area and who needed a programme that would fit in with his job, explains the benefits he got from the Manual.
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Many people said cardiac rehabilitation had been a fundamental part of their emotional and physical recovery. At these programmes - they built up their fitness through exercise sessions, they learnt what they could and could not do and there were talks and advice on lifestyle, such as diet and relaxation techniques. Topics that people might not want to talk to their doctor about, such as sex, are also discussed.

The cardiac rehabilitation programme has helped people to make the necessary changes to improve their quality of life and minimise the risks of having another heart attack including losing weight, giving up smoking and taking up regular exercise (see also 'Preventing another heart attack').

In many cases, cardiac rehabilitation helped to restore people's confidence. Many said that meeting and talking to other people who had had a similar experience, and support from the cardiac rehabilitation staff, had helped them to recover. People were surprised to find that a heart attack can affect different types of people including those who are not overweight and that men are more likely to have a heart attack than women.

Partners or carers of heart attack patients are encouraged to attend these classes. Many valued this because their partners or carers got a better understanding of how much they could do, and showed them that they didn't have to worry.

Some younger people found it difficult to take part in an organised cardiac rehabilitation programme with much older people. A few said they would have liked to have done more strenuous exercises. Cardiac rehabilitation classes should be tailored to the individual's needs: if they seem not to be, it is worth discussing this with the cardiac rehabilitation nurses.

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Support Groups
Support groups also offer help with rehabilitation. There are many national and local heart support groups in the UK. Some of the people we interviewed had joined one and valued the opportunity to talk to others in a similar situation. There were also exercise classes, talks and advice from health professionals, information and social events.
 
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Some people did not feel a need to join a support group; some younger people would have liked to be in one but felt uncomfortable that they were younger than the other people there. But many more felt that the benefits had greatly exceeded their expectations.

A few people who had not known of a support group, said they found it hard to get information and they felt this had made it harder to recover from their heart attack. Others felt that once the initial rehabilitation programmes had finished, people who had had a heart attack did not get enough support.

Other sources of support during rehabilitation were the cardiac rehabilitation nurses, family and friends and a religious faith.

*Heart Manual

If you have recently had a heart attack, you may be given a Heart Manual. This includes a six-week recovery plan as well as relaxation and information CDs for you and your family. The Heart Manual enables you to make progress at home, with telephone contact and/or visits from a member of the cardiac rehabilitation team. Before you are discharged from hospital, a rehabilitation nurse may have assessed your exercise ability, anxieties and risk factors so that your rehabilitation can be tailored to meet your needs. It can be used as a stand-alone programme or in combination with hospital based programmes. For more information on the Heart Manual see the Heart Manual website.     

Last reviewed June 2017.

Last updated June 2017.

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