Cardiovascular disease (CVD) and acute coronary syndrome (ACS) constitute the leading cause of morbidity and mortality in the United States. Of the one million ACS cases per year, nearly half are repeat events. Most of the risk factors for CVD can be modified with life style changes and medications. Secondary prevention of CVD involves healthy diet, regular exercise, smoking cessation, and adherence to blood pressure and lipid-lowering medications. A strong secondary prevention has been proven to reduce cardiovascular morbidity and mortality.
Cardiac rehabilitation (CR) is a comprehensive secondary prevention program. The American College of Cardiology and American Heart Association give cardiac rehabilitation a class 1a indication after heart surgery, myocardial infarction, or coronary intervention; and for stable angina or peripheral artery disease; and a class 2a indication for stable systolic heart failure.
Cardiac rehabilitation at Rancho Los Amigos is part of a state-of-the-art atherosclerotic cardiovascular disease prevention program that includes an inpatient phase (phase 1), an outpatient phase (phase 2), and a long-term maintenance phase (phase 3). This multidisciplinary program includes nutritional counseling, weight management, blood pressure management, lipid management, tobacco cessation, psychosocial management, and physical exercise training.
Referrals are screened for appropriateness and readiness. Candidates participate in pre-CR stress testing. Each approved participants receives an individualized treatment plan, which is updated and optimized every 30 days by regular, on-going communication with the patient’s referring cardiologist and the cardiac rehabilitation staff.
Board-certified cardiologists serve as the medical director and supervising physicians for the program. They oversee operational and clinical aspects of the program and ensure the achievement and maintenance of quality standards of medical care.
A nurse practitioner (NP) works closely with the cardiac rehabilitation team to coordinate care. The NP monitors patient symptoms and EKG telemetry and provides support for physical therapists during exercise sessions. The NP provides education on disease process, medication adjustments, and life style modifications. The NP schedules cardiac testing and educational activities for the participants. After completion of phase 2, patients in CR transition to long-term monitoring with home monitoring devices and life-style coaching via telehealth by the NP in phase 3 or maintenance phase.
Exercise training sessions are individualized and conducted over 12 weeks under the supervision of a physical therapist. These sessions are vital to promoting cardiac recovery. Each session includes telemetry monitoring to ensure safe and effective progress through the program. Participant will learn exercise regimen, goal setting, and symptom monitoring to optimize their return to life activities.
Patients examine the role of lifestyle modifications in partnership with occupational therapists to achieve heart-healthy nutrition, energy conservation, work simplification, and stress reduction. Sessions may also include discussions about self-care, home chores, and leisure activities. Return-to-work discussions include considerations for cardiac safety and modifications needed to the work environment.
A clinical psychologist conducts regular, ongoing group classes for cardiac rehabilitation patients on topics such as stress reduction, coping skills, and medication adherence. The psychologist assists CR staff in monitoring patient progress towards psychosocial goals
Patients and their families have access to nutritional counseling with a dietitian who also assists CR staff in monitoring progress towards nutritional goals.
For more information about the cardiac rehabilitation program at Rancho Los Amigos, please contact the Rancho Los Amigos Cardiology Division.
Rancho Los Amigos National Rehabilitation Center
7601 Imperial Highway
Downey, CA 90242
Tel: (562) 385-7611