title: Rehabilitation in the patient after myocardial infarction with or without surgical management.
abstract: Cardiac rehabilitation has evolved into a composite therapy of exercise training, psychosocial support, and education with major goals of returning patients to normalcy after an acute coronary event such as myocardial infarction or coronary bypass surgery. This process seems especially important in patients with significant levels of deconditioning before entering therapy. Survival is improved with a decrease in cardiovascular mortality after myocardial infarction of as much as 20% to 30%. Cardiac rehabilitation for the surgical patient today is additionally important with shortening length of stay, and with regard to the prevention of recurrent disease. Modification of risk factors in patients with known coronary disease has especially meaningful implications for the bypass patient. The percentage of patients returning for second, and even third coronary bypass operations continues to increase. Recent studies suggest the possibility of slowing, and in some cases actual arrest or regression of coronary atherosclerosis, in addition to the reduction of subsequent acute coronary events and the need for future revascularization. Other issues of potential importance include quality of life, return to work after bypass surgery, and noncardiac complications of surgery.
authors.affiliation: Department of Cardiology, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Pashkow
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome