As people's living standards improve, they pay more and more attention to health issues. Yangpu District Media Center and Yangpu District Health Commission launched the "People's Health" column. We invite experts from major hospitals in the jurisdiction to interpret and introduce common diseases and health problems in daily life to everyone.
In this issue, Zhao Ya, the department of internal medicine and cardiology director of Yangpu District Guanjiang Hospital, , Yangpu District, and Guanjiang Hospital. will talk to you about the topic of cardiac rehabilitation.
Yangpu District Guanjiang Hospital
Zhao Ya, the Department of Internal Medicine and Director of Cardiology,
"China Cardiovascular Disease Health and Disease Report 2021" pointed out that the prevalence of cardiovascular disease in my country is in a continuous increase stage, and the number of patients is estimated to be about 330 million. Among the proportion of disease deaths among urban and rural residents, cardiovascular disease ranks first. In the treatment of cardiovascular diseases, we all know a little about taking drugs, surgical treatments such as implanting stents, , coronary artery bypass, etc., but we know little about cardiac rehabilitation treatment, but cardiac rehabilitation plays an important role in the occurrence and development of cardiovascular diseases. Today, Zhao Ya, director of the Department of Internal Medicine and Cardiology at Yangpu District Guanjiang Hospital, will introduce to you in detail the relevant content of cardiac rehabilitation.
Point the link to watch the video → https://mp.weixin.qq.com/s/wxfnhNx6q8sBHv8CGJMkMQ
What is cardiac rehabilitation?
cardiac rehabilitation is a comprehensive cardiovascular disease management medical model that takes comprehensive intervention measures to help patients cultivate and maintain healthy behaviors through multidisciplinary cooperation (mainly cardiologists, including rehabilitation, nutrition, psychology, pharmacy, nursing teams), which adopts comprehensive intervention measures to help patients cultivate and maintain healthy behaviors, restore patients' physiological, psychological and social functions to the best state, reduce the incidence and mortality rate of cardiovascular disease, and improve patients' quality of life. Simply put, cardiac rehabilitation is to use a series of comprehensive intervention and treatment measures to allow patients with cardiovascular diseases to maintain their own health, prevent recurrence, improve cardiac function, quality of life, and prolong life. It is a better treatment method for heart disease in the chronic stage.
Why do you need cardiac rehabilitation?
The treatment of cardiovascular diseases in modern medicine is changing with each passing day. Many new technologies have been widely used in clinical practice, and various new drugs are emerging one after another. It saves patients' lives in the acute stage of the disease. However, will the stent be implanted, the bridge is built, and the valves are replaced once and for all?
We can see that most patients will be exposed to many problems during the remission period of the disease, such as mental and psychological problems (often wondering whether the stent will fall off; often feel chest tightness, palpitations, and urgency at night or early morning, and there are no abnormalities when going to the hospital for emergency check-ups many times; they are often afraid of another myocardial infarction and are worried all day long), and their quality of life has dropped significantly (many people think that they cannot "move" completely when they have heart disease, especially during the period after the operation, and they should recuperate at home, mainly rest in peace. This is a wrong view. Long-term single resting can lead to a progressive decline in heart function and body physical fitness, loss of muscles, and asthma after a slight activity), and even make the disease worse, which makes patients unable to resume normal work and life, and at the same time bring additional medical burden. Cardiac rehabilitation can largely solve these objective problems and achieve the organic unity of "preventing, treating and controlling diseases" of cardiovascular diseases.
What are the benefits of cardiac rehabilitation?
A large amount of medical evidence-based data confirms that cardiac rehabilitation can improve heart function and strengthen body physical fitness. Improve the daily life ability of cardiovascular disease patients, enter a relaxed state, improve the quality of life, return to normal life, reduce the number of hospitalizations caused by heart disease, and reduce the incidence of cardiogenic mortality. It can effectively control cardiovascular risk factors such as hypertension , hyperglycemia , lipid metabolism abnormality, obesity, etc. to prevent the recurrence of cardiovascular diseases.
Which people are suitable for cardiac rehabilitation?
patients with clear cardiovascular disease should actively carry out systematic cardiac rehabilitation.
patients with cardiovascular disease: such as patients with stable angina pectoris, myocardial infarction, etc.
After surgery, patients with various heart diseases: such as post-coronary artery bypass surgery, post-coronary intervention stent surgery, and post- heart valve disease, etc.
heart failure patients: such as patients with chronic and stable heart failure.
patients with bi-heart disease: cardiovascular disease and psychological problems.
people with high risk of cardiovascular disease: such as early hypertension, diabetes , dyslipidemia and other patients.
What does cardiac rehabilitation include?
The first thing to emphasize is that before formulating a cardiac rehabilitation treatment plan, we need to conduct a cardiac rehabilitation assessment on the patients. The evaluation includes five aspects: the first is the evaluation of the patient's specialist disease status; the second is the evaluation of the patient's cardiovascular system risk factors; the third is the evaluation of his or her exercise ability; the fourth is the classification of his or her risk; and finally the evaluation of contraindications for rehabilitation treatment. Develop an effective rehabilitation program for patients through comprehensive and scientific assessment.
Specific cardiac rehabilitation includes five aspects, that is, the "five prescriptions" should be kept in mind in the cardiac rehabilitation, which mainly includes the following aspects:
Drug prescription: Effective drug treatment is the cornerstone of cardiovascular disease treatment. Standardization of drug prescriptions has a huge impact on intervening in cardiovascular risk factors, delaying disease progression and improving prognosis. For example, antiplatelet drugs, statins, β-blockers, etc. are used for secondary prevention of coronary heart disease. A few patients think that if they install the stent and build the bridge, they don’t need to take medicine. Some patients think that “the medicine is three parts poisonous” and believe that taking medicine after the operation will cause harm to the body, so they stop taking medicine by themselves. This idea is not correct. Everything is not good after stent surgery. It is very important to prevent the recurrence of the disease. Use medicine. You must use the medicine according to the doctor's instructions. If side effects are found, you must communicate with the doctor in a timely manner and follow the instructions to review it regularly.
Exercise Prescription: Exercise is the core element of cardiac rehabilitation. The occurrence and development of cardiovascular diseases are related to many factors, and the mechanism is very complex. A large amount of evidence from medical research shows that unhealthy lifestyles, especially physical inertia, occupy an important position in cardiovascular diseases, improving physical mobility, and actively participating in exercise and exercising are one of the main means to prevent and treat cardiovascular diseases. exercise prescription includes exercise mode, exercise time, intensity and frequency. First, an individualized exercise prescription should be formulated after a comprehensive assessment of the patient's exercise ability. The evaluation is often performed by cardiopulmonary motor function assay (CPET) and a six-minute walk test. The determination of cardiopulmonary motor function is the gold standard for judging the body's movement endurance. Conventional electrocardiograms, HOLTERs, and cardiac hypertrophy all respond to cardiac function in a resting state. Cardiac exercise tests can accurately reflect cardiopulmonary function in a moving state, reflect individual heart reserve ability, and can detect potential heart diseases in an early stage. For patients with cardiovascular disease, we conduct cardiopulmonary exercise function testing to accurately determine the anaerobic threshold of the patient during exercise, corresponding to the heart rate and heart rate, to ensure that the patient's heart rate does not exceed the anaerobic threshold heart rate during exercise, and to accurately formulate an aerobic exercise prescription that meets his own exercise endurance based on the patient's condition to ensure that the patient's exercise is effective and safe.
Nutritional Prescription: Dietary nutrition is one of the main environmental factors affecting cardiovascular diseases. Scientific and reasonable dietary nutrition can effectively reduce the risk of cardiovascular diseases. First conduct an assessment of the patient's dietary habits, and then provide scientific and reasonable suggestions.
Psychological prescription: Cardiac rehabilitation should pay special attention to the impact of patient psychological factors on rehabilitation. Some patients with cardiovascular disease have different degrees of adverse emotions such as depression and anxiety, which seriously affect the patients' physical and mental health and quality of life. Therefore, on the basis of actively treating cardiovascular disease, they must also conduct screening through the self-assessment scale of depression (SDS) and self-assessment scale of anxiety (SAS). Our Cardiac Rehabilitation Center found that some patients avoided and did not make choices about some problems when filling out the scale, which led to difficulty in evaluation. Our center uses a brain state evaluator to judge the patient's psychological and mental state through electroencephalography and . It is more objective and can accurately understand the patient's mental and psychological state. It can formulate corresponding psychological prescriptions to interfere with the patient's mental and psychological problems in a timely manner.
Smoking cessation prescription: Smoking cessation can reduce the risk of cardiovascular disease and death. The long-term benefits of quitting smoking are at least equivalent to, or even better than the commonly used secondary prevention drugs for coronary heart disease such as aspirin and statins , and are also the most cost-effective and effective intervention to save lives.
2022-10-29 17:41
Source: Shanghai Yangpu
