Cardiac Rehabilitation 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

Initial Evaluation

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.

Program Components

Exercise Program

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.

Nutrition Consultation

A nutritionist evaluates each patient and develops a personal and closely monitored dietary plan. Patients may attend an eight-session educational series on heart healthy eating. Topics include label reading, food shopping, eating out, menu planning and weight management.

Educational Seminars

Heart disease prevention and management seminars are available to patients. This eight-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.

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.

Exit Interview

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.

Maintenance Program

After program completion (and space permitting), 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.

Patient Resources

Exercise

• Exercise and Successful Lifestyle Change: Watch the video | Exercise and Successful Lifestyle Change (PDF) | Physical Activity (PDF)
  Exercise is often the best medicine. This video will help you understand components of a safe exercise session, your “exercise prescription,” as well as how to maintain healthy habits for life.
• Strength Training and Stretching: Watch the video | Guidelines for Safe and Effective Strength Training (PDF) | Strength Training Exercises (PDF)
  This video provides the fundamentals of a strength training and stretching program and includes a demonstration of suggested exercises for both strength training and stretching.

Heart Disease

• Cardiac Medications: Watch the video | Download the PDF
  This video highlights and summarizes the medications typically prescribed to treat and manage your heart condition. You’ll learn some tips for taking your medications safely and correctly.
• Coronary Anatomy and Risk Factors: Watch the video | Download the PDF
  An overview of the heart’s anatomy and function and the factors and lifestyles habits that put you at risk for heart disease.
• Symptom Recognition: Watch the video | Symptom Recognition (PDF) | Symptom Log (PDF)
  Understand the difference between angina, a heart attack, and stroke symptoms and learn why it's important to be able to recognize your symptoms.
  

Nutrition

• Dining Out: Watch the video | Download the PDF
  Who doesn’t love to eat out? This short video provides numerous tips to guide you in making healthy choices when eating out.
• Impact of Fats: Watch the video | Fats to Limit (PDF) | Fiber Is Your Friend (PDF) | Healthy Fats (PDF)
  A comprehensive overview of fats, including types of fat, impact on cholesterol levels and sources of fat in your diet.
• Mindful Eating: Watch the video | Download the PDF
  This video provides tips and tricks to help you take control and raise your awareness of healthy eating for life.
• Reading Food Labels: Watch the video | Download the PDF
  Get the information you need to read and understand food labels.
• The Role of Carbohydrates: Watch the video | Download the PDF
  Learn about the variety and types of carbohydrates in your diet and gain a better understanding of healthy carbohydrate choices.
• Supermarket Shopping: Watch the video | Download the PDF
  A primer to prepare for a successful trip to the grocery store and stay on track with your nutrition goals.

Quit Smoking

• SMART About Smoking (PDF)
  Information on how to quit smoking.
• How to Stop Smoking (PDF)
  A personalized plan for quitting smoking, designed by specliaists at Mass General.

Stress, Relaxation and Resilience

• Mind/Body Practice: Meditation: Watch the video | Download the PDF
  Learn a simple meditation practice to relax your body and focus your mind, in order to reduce stress.
• Mini Relaxation (video)
  If you don’t have much time, but are still interested in a quick relaxation session to reduce stress, here's a short practice you can try on your own.
• Stress and Your Heart: Watch the video | Relaxation and Stress (PDF) | Resiliency and Recovery (PDF)
  It's important to understand the effect that stress can have on the heart. In this video, you'll learn why it's important to be mindful of this, along with stress management tips.

Track Your Progress

• Weekly Patient Log (PDF)
  A resource for tracking sleep, exercise, nutrition and mood.