Kenneth Shelton, MD, is a critical care physician and cardiothoracic anesthesiologist in the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital and the medical director of the Mass General Corrigan Minehan Heart Center Intensive Care Unit.
Corrigan Minehan Heart Center
Cardiac Rehabilitation Program
Explore This Treatment Program
Overview: Our Approach
The Cardiac Rehabilitation Program in the Cardiovascular Disease Prevention Center at the Massachusetts Hospital Corrigan Minehan Heart Center is designed to treat patients who have heart disease (angina, coronary heart disease or heart attack) or have had a procedure to treat their heart disease (bypass graft surgery or angioplasty). A multidisciplinary team made up of cardiologists, cardiac nurses, a psychiatrist, nutritionist and exercise specialists plan individualized treatments and strategies to prevent cardiac complications and future recurrence of cardiac events (heart attack).
Specialists within this program aim to:
- Increase a patient’s aerobic exercise capacity
- Reduce cholesterol levels through dietary changes
- Reduce or control other heart disease risk factors, such as high blood pressure, cigarette smoking, diabetes, stress and obesity
Patients enrolled in this program will have an initial evaluation conducted by a cardiologist, nurse or exercise physiologist. This comprehensive review and risk assessment includes a physical exam, exercise tolerance test, nutrition evaluation, lab testing and psychosocial assessment. Using this information, the care team designs an effective program to meet each patient’s individual needs and goals.
Nurses within the Cardiac Rehabilitation Program are experienced in cardiac care and exercise physiology. A nurse will oversee each patient’s treatment plan and provide expertise in complex cardiac patient case management including cholesterol and dietary management, smoking cessation and behavior/lifestyle modification.
Following the initial assessment, a personalized exercise regimen is designed for each patient. Patients attend group aerobic exercise sessions one to three times a week at the center’s on site facility. Depending on a patient’s activity level and goals, exercise therapy might include stationary cycling, walking or jogging, arc trainer and strength training. Stretching exercises also are incorporated into each session.
A nutritionist evaluates each patient and develops a personal and closely monitored dietary plan. Patients may attend a five-session educational series on heart healthy eating. Topics include label reading, food shopping, eating out, menu planning and weight management.
Heart disease prevention and management seminars are available to patients. This six-part series addresses coronary artery disease including risk factors and treatment, symptom recognition and management, cardiac medications, principles of safe and effective aerobic exercise and stress management.
Group and individual relaxation sessions are offered several times per week. During these sessions patients learn techniques to help manage stress. Instruction in a variety of relaxation forms including breathing exercises, tai-chi, yoga, visual imagery and meditation is available.
Optional Consultation with a Behavioral Health Expert
In addition to the weekly relaxation sessions, a patient may also choose to see the team’s consulting psychiatrist. The psychiatrist can provide an overall psychological and behavioral assessment to address more complex issues such as anxiety, depression or Type A behavior and prescribe other appropriate treatments.
Weekly Consultation with a Nurse Case Manager
Patients meet with their nurse case managers weekly to review their individual progress toward established heart health goals, including the home exercise plan. The home exercise plan includes safe heart-rate parameters and details the type, duration, frequency and other necessary components of an exercise plan.
At the end of a treatment plan, patients will meet with their nurse for an exit interview to summarize each their participation and goal achievement, and solidify future plans for continued lifestyle change and maintenance. Staff also collects information to examine and measure outcomes in the program. A summary report of this interview is sent to the patient’s physician(s). Patients are also asked to complete an anonymous program evaluation to help with program improvement.
After program completion, patients may choose to continue exercising twice a week at the center through the self-pay maintenance program. At each visit, a staff member checks the patient’s blood pressure, pulse and weight prior to exercise. In collaboration with the staff, the patient adjusts their own exercise workload. Staff is available to field other questions or concerns that may arise. Patients often choose this option to help them stay on track toward achieving personal heart health goals.
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