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Title:

Cardiac Rehabilitation

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Post MI we can see a predictable pattern of peaks & troughs of anxiety, CABG and ... climb two flights of stairs without getting chest pain or becoming breathless ... – PowerPoint PPT presentation

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Provided by: alisona
Learn more at: http://www.glospccag.nhs.uk
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Title: Cardiac Rehabilitation


1
Cardiac Rehabilitation
  • Alison Anderson
  • Specialist Nurse
  • Gail Bohin
  • Psychologist

2
Making Sense of Symptoms
What has caused this?
What do these symptoms mean?
  • What does the future hold?
  • What has happened to me?
  • How long will it take to get better?

3
Thoughts, feelings, behaviour recovery
  • Cardiac misconceptions
  • Hypervigilance for symptoms
  • Fear avoidance of exertion/activity
  • Mood disturbance
  • Low motivation for lifestyle changes
  • Denial

4
The Psychological Recovery
  • Can often feel harder than the physical one
  • Post MI we can see a predictable pattern of peaks
    troughs of anxiety, CABG and PCI require more
    research
  • A patients psychological response to their
    cardiac event will have a huge impact upon their
    physical recovery, rehabilitation potential,
    quality of life and survival

5
When Can I?
6
Goal Setting and Pacing
  • Goal -------------
  • Baseline----------

7
Warm Up and Cool Down
8
I am on the go all day at work, why do I need to
exercise?
9
Multi-disciplinary Management of Angina Symptoms
  • Medication / investigations
  • Education Risk factor and symptom management
  • Psychology - Awareness of vicious circles,
    reducing anxiety, stress triggers, relaxation
    techniques
  • Exercise - Pacing, exercising appropriately to
    increase functional capacity and lower angina
    threshold

10
Angina is damaging my heart

? fatigue, angina at lower workload
Increasingly restricted life Increasing anxiety
depression symptoms Seeking further treatment
Patient reduces activity to avoid angina
Physical de-conditioning lowers angina threshold
11
Work
  • Influencing factors
  • Type of job
  • Attitude to job
  • Capacity / support of employers to phase return
  • Environmental conditions
  • Travelling
  • Cardiac condition awaiting tests / treatment
  • Other medical conditions

12
Sex After A Cardiac Event
  • 54 of people do not resume their previous
    level of sexual activity following a cardiac
    event.
  • Partners can also be anxious about resuming sex
    due to fears of over exertion.

13
Sex After a Cardiac event
  • You can have sex when
  • You can walk 300 yards on the level comfortably
    or
  • You can climb two flights of stairs without
    getting chest pain or becoming breathless
  • 2-3 weeks post MI (BHF)

14
Driving
  • DVLA guidelines Group 1
  • MI/ CABG 4 weeks
  • Angioplasty 1 week
  • Valve No restrictions!

15
Driving and Acute Coronary Syndromes (ACS)
  • For Group 1 ACS defined as All
  • Persistant or recurrent cardiac pain
  • Cardiac troponin release positive
  • Electrocardiographic changes
  • (NSTEMI successful angioplasty 1 week)

16
Driving (Group 2)
  • LGV / PCV
  • Angina 6 weeks
  • MI 6 weeks
  • ACS 6 weeks
  • Angioplasty 6 weeks
  • CABG 3 months

17
Holidays
  • Insurance
  • Altitude
  • Temperatures
  • Flying

18
Summary
  • A multi disciplinary team approach is needed to
    address the complex issues that patients have
    about their recovery.
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