Who Actually Needs Cardiac Rehab?

When Should I Start Cardiac Rehab After Stent Surgery?

People usually begin cardiac rehab within a few days to a few weeks after surgery, but it depends on the patient and what the doctor advises.


Our heart is amazing. Did you know that it beats 35 million beats per year, pumps approximately 1.5 gallons (5.7 liters) of blood every minute, and has its own electrical system? When all is well, we don’t give it much thought. And when it isn’t, thankfully we have modern medicine that can work wonders when it comes to getting the heart back on track.

Sometimes after we’ve faced a challenging heart condition or had a medical procedure involving the heart, cardiac rehab is suggested. But what is cardiac rehabilitation? Let’s find out!

What Is CaWhat Is Cardiac Rehabilitation?rdiac Rehabilitation?

Cardiac rehabilitation (also known as cardiopulmonary rehabilitation or cardiac rehab) is a comprehensive program designed to help us recover from heart-related issues. It usually involves a number of important components: 

• Physical activity. Exercise is vital for heart health, and cardiac rehab exercises are a crucial part of any cardiac rehabilitation program. And while we’re not talking about running a marathon or climbing a mountain, taking small steps to let our heart build up strength is key. It’s exciting to watch our progress in action: maybe a walk around the track turns into a power walk and, eventually, into a slow jog. We’re making progress!
• Education. A team of specialists will teach us how to keep our heart healthy and strong. It’s all about loading up on the good stuff (antioxidant-rich fruits and veggies and other heart-healthy foods) and staying away from heart health saboteurs (such as alcohol and tobacco).
• Counseling. Heart issues are sometimes caused by stress, but they also contribute to it. Getting a heart procedure is understandably scary, and we might need a bit of help in the emotional department in the weeks and months to come. Having a specialist to talk to can work wonders when it comes to bringing scary thoughts out into the light and clearing our mind. It can also help us avoid turning to unhealthy habits (such as drinking) and help us spot triggers early before we become stuck.

We’ll probably work with a team of specialists including physical therapists, nutritionists, mental health specialists, and physicians. They all have different areas of expertise and will be able to look at our recovery from a holistic perspective.

Who Needs Cardiac Rehab?

But who actually needs a cardiac rehabilitation program? Let’s take a look at who can benefit from this comprehensive recovery plan. Then, we’ll see how alcohol fits into the picture and learn some ways to boost our heart health.

Cardiac Rehab After a Heart Attack


After a heart attack, cardiac rehab helps patients regain strength, reduce the risk of future heart attacks, and improve overall heart health. The goal is to provide rehabilitation and prevent heart problems in the future.

According to the CDC, close to 800,000 people around the U.S. have a heart attack every year. That’s close to a million! And for 1 in every 4 of those in this group, it’s not the first time. Cardiac rehabilitation after a heart attack is all about helping these folks recover and preventing it from happening again.

As the American Heart Association explains, most people go on to recover and live their lives after the first heart attack. However, if it happens again — and for about a quarter of first-timers it does — it usually hits within 90 days of discharge. These vulnerable three months, in turn, make cardiac rehab a good safety measure to maximize our chance of making a full recovery.

Cardiac Rehab After Heart Surgery


Heart problems don’t always require surgery, but occasionally they do. Here are some common types, according to the National Heart, Lung, and Blood Institute:

• Coronary artery bypass grafting (CABG). This one is the most common type of heart surgery. The surgeon swaps a blocked coronary artery for a healthy artery or vein taken from another location in the body. The passage is clear!
• Angioplasty. When an artery in the heart becomes narrowed or blocked due to plaque buildup — a condition known as atherosclerosis — a stent is placed inside the artery to keep it open. This helps restore normal blood flow to the heart muscle.
• Heart valve repair or replacement. Occasionally, a faulty heart valve gets replaced with one that’s constructed artificially or crafted from animal or human heart tissue. The methodology behind this takes some extra deftness: the valve is guided through a blood vessel by a catheter with a small balloon at the tip that allows for the valve to be widened.
• Insertion of a pacemaker or an implantable cardioverter defibrillator (ICD). Pacemakers are the go-to solution for arrhythmias that don’t respond to medication. They use an electric pulse to get the heart beating evenly again.
• Maze surgery. This one’s pretty cool! As the name suggests, the surgeon crafts a “maze” of scar tissue in the upper chambers to direct the electrical signals in the heart along a particular path. The result? No more “stray” signals that contribute to atrial fibrillation (a type of arrhythmia).
• Aneurysm repair. After an aneurysm (during which an artery is weak and bulges, which may rupture or split), part of the bulging artery or heart wall gets patched up or grafted.
• Heart transplant. Finally, one of the most drastic types of surgery that can be a lifesaver in certain circumstances, a heart transplant involves the donation of a healthy heart from a donor who has passed away. Each year, about 3,500 procedures are performed around the world. And since technology has drastically improved, survival rates are high!

Those who have had such procedures as coronary artery bypass surgery, valve repair or replacement, or a heart transplant need rehab to recover properly and enhance heart function. As for the timeline, you might be wondering when to start cardiac rehab after stent procedures or other types of heart surgery. While the answer always depends on individual circumstances, for angioplasty it’s roughly two to four weeks after the procedure.

For more complex procedures, the starting time is usually pushed back further: four to six weeks after heart valve repair, six to eight weeks after CABG, and eight to 12 weeks after a transplant.

Cardiac Rehab After Heart Failure or Coronary Artery Disease (CAD)

Chronic conditions such as heart failure or coronary artery disease (CAD) require ongoing management, which cardiac rehab provides through education, exercise, and lifestyle changes. The goal here is to manage symptoms and improve heart health.

Cardiac Rehab as a Preventative Measure

People with multiple risk factors for heart disease, such as high blood pressure, diabetes, or a family history of heart disease, can use cardiac rehab as a preventive measure. We’ve heard it before, and it’s true: prevention is the best medicine!

Are There Disadvantages of Cardiac Rehabilitation?

It all sounds great, but are there any downsides to cardiac rehab? The reality is, the advantages probably outweigh any perceived disadvantages. That said, we might face a few challenges.

• It takes time. For the program to work, we need true commitment. And that means clearing time in our schedule for meetings with our treatment team, doing our exercise routine, and learning more about our heart.
• It might be costly. Many insurance plans will cover cardiac rehab, but that’s not always the case across the board. Always check with the insurance provider to find affordable options.
• It might be challenging. Challenges may arise at different levels. The most obvious one is initial physical discomfort that might come with a new exercise routine. Plus, processing our emotions with a mental health professional isn’t always smooth sailing either, especially at the beginning.

However, when considering the difficulties, it’s important to keep in mind that it’ll be worth it at the end. Our heart health is too important, and shortcuts aren’t worth the risk.

“Do It Yourself” Cardiac Rehab

Some of us might be wondering, wait a second, this sounds pretty easy. These days, information about nutrition and heart-healthy habits is at the tip of our fingertips. And finding an exercise program is as easy as getting on the Peloton bike at the gym downstairs or checking out one of the myriad gentle cardio videos on YouTube. Can I do this myself?

When it comes to “DIY” cardiac rehab, there are some important considerations to keep in mind:

• We may need a medical evaluation. In addition to creating a treatment plan tailored to our needs, medical supervision might be necessary. It’s a vulnerable time, and we want to give our heart the best chance to recover.
• A trained team will give us tailored advice. Professional programs offer comprehensive care, including nutritional advice, psychological support, and medical monitoring, which can be hard to replicate on our own.

All in all, while we can certainly take steps to improve our heart health on our own (more on that later!), nothing replaces a team of pros.

How Alcohol Fits Into the Picture

One important component of heart health that plays a role in cardiac rehab and prevention of heart problems in the future has to do with our drinking habits. Science shows that alcohol (yes, even wine) is not as heart-healthy as we once thought. That glass of wine at dinner isn’t doing more good than some grape or cranberry juice, which are rich in antioxidants. And if one glass turns into several (or even a whole bottle), it’s likely doing our heart more harm than good. For a deep dive, check out “How Does Alcohol Affect the Heart?” For now, here’s a brief overview of alcohol and our heart:

• It causes fluctuations in our blood pressure. As a vasodilator, alcohol widens our blood vessels, causing an initial drop in blood pressure. However, there’s a rebound effect — a spike several hours later. Plus, alcohol misuse causes hypertension to become more chronic over time, increasing our risk of heart disease.
• It causes our heart to race and beat unevenly. Booze is also responsible for speeding up our heart rate and causing arrhythmias — glitches in the heart rhythm. These are often benign but can sometimes be dangerous.
• It messes with our cholesterol levels. Another pervasive myth about alcohol is that it “helps” our cholesterol levels by increasing “good” HDL cholesterol. Unfortunately, the media often leaves out a key piece of information: while alcohol can, indeed, raise HDL levels, it also increases its counterpart — the “bad” LDL cholesterol that builds up in our arteries.
• It can cause heart muscle damage. Heavy drinking can cause cardiomyopathy, a condition in which the heart muscle weakens and struggles to pump blood efficiently.
• It can pack on the pounds. Alcoholic beverages are a calorie disaster, which can contribute to obesity — a risk factor for heart disease.
• It disrupts our sleep. Alcohol messes with our REM sleep, and lack of sleep is hard on the heart and is even a risk factor for heart disease.

Clearly, alcohol and the heart aren’t the best of friends, and being aware of our drinking patterns is key to keeping our heart safe!

Keep Your Heart Healthy

Finally, here are some tips for a healthy heart. Whether or not you’re considering cardiac rehab, taking care of the heart is key for all of us!

• Get moving. Remember what we said about exercise? It’s crucial — and not just as a part of cardiac rehab. The best strategy is to pick an activity you enjoy and stick with it: walking, pickleball, hiking, cardio kickboxing, even dancing in your living room! Anything that gets your heart rate up and makes you break a sweat counts.
• Nourish your body. A heart-healthy diet is another crucial piece of the puzzle. The National Institutes of Health recommends the Dietary Approaches to Stop Hypertension (“DASH”), which is all about eating foods that are low in sodium and saturated fats. The DASH diet suggests loading up on veggies, fruits, and whole grains while limiting sugar and sweeteners.
• Lower stress. An article by Johns Hopkins Medicine explores the connection between stress and heart disease, discussing a recent study that tracked participant stress levels over a period of 18 years. As it turned out, women who went through two or more divorces had a higher risk of heart attacks — one that’s on par with that of smokers or diabetics. Unlike men, who experienced similar effects but bounced back after remarriage, the risk for women in the same situation didn’t drop even after finding “the one” once again.
• Get quality sleep. Finally, rest is crucial for our overall health, and heart health is no exception. This is the time for our body to repair itself, and sleep deprivation is a known risk factor for heart disease.

With these steps, you can keep your heart healthy as you recover and build up your strength. Carry the healthy heart habits into your future — your heart will thank you! And remember, if alcohol has become a problem and you’re ready to change your relationship with it, Reframe is here to help!