The research data at home and abroad have unanimously confirmed that cardiac rehabilitation therapy with drug therapy and medical exercise therapy as the core can further reduce the risk of heart events and premature death of patients with atherosclerotic cardiovascular disease on the basis of the original drug therapy. Medical exercise therapy is a part that is easily overlooked and difficult to control in clinic. To carry out safe and effective exercise therapy in clinic, the treatment principles include systematic evaluation, exercise prescription formulation, exercise risk monitoring and intervention of other cardiovascular risk factors.

Author: Ding

SETTING: Peking University People's Hospital

Exercise rehabilitation of patients with acute coronary syndrome and after coronary intervention

The purpose of exercise rehabilitation of acute coronary syndrome is to promote the recovery of the body, control the risk factors of ACS, improve the psychological state, improve the hypoxia tolerance and quality of life, promote the return to society, and prevent the recurrence and sudden death of cardiovascular events. A large number of studies show that exercise rehabilitation therapy not only improves the quality of life of patients, but also helps to improve left ventricular function, delay ventricular remodeling, control or reverse atherosclerotic plaques and reduce the recurrence of cardiovascular events. For patients, if there are no complications, exercise guidance and risk factor treatment can be started the next day; If there are complications or large-scale myocardial infarction, start exercise rehabilitation after the condition is stable, and gradually increase the degree of physical activity according to the symptoms of patients. It is suggested that patients should attend cardiac rehabilitation therapy for 4 weeks under the supervision of the hospital, and then attend cardiac rehabilitation therapy outside the hospital. See table 1 for specific methods.

Table 1 ACS and the core content of sports rehabilitation after PCI

Cardiac rehabilitation in patients with stable coronary heart disease and patients undergoing elective PCI

Secondary preventive measures and exercise-based cardiac rehabilitation are important contents of long-term treatment for patients with coronary heart disease, which further reduces the incidence and mortality related to coronary atherosclerosis. It has been proved that medical exercise therapy, especially target intensity exercise training, has anti-inflammatory, anti-atherosclerosis and anti-thrombosis effects, and delays the progress of atherosclerotic plaques and complications. For patients with stable angina pectoris, medical exercise therapy can not only increase the ischemic threshold (angina threshold), but also reduce the frequency and severity of angina pectoris attacks, and even improve the survival rate. Cardiologists have the responsibility to emphasize the importance of healthy lifestyle and drug therapy to maintain the effect of surgery, and refer patients to receive systematic cardiac rehabilitation treatment. See Table 2 for specific methods.

Table 2 Core contents of stable coronary heart disease and elective PCI exercise rehabilitation

The content is selected from Cardiology Practice 20 18 edited by Professor Zhang Jian and Academician Yihan Chen.

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Editor ┆ Liu Mingyu American Editor Chai Mingxia ┆ Plate Making Liu Mingyu