Cardiac rehabilitation

We offer support, advice and information to patients locally who have had a cardiac event. If they meet the criteria after an assessment they will be offered the Cardiac Rehabilitation Programme.

Contact Us

King George Hospital: 020 8970 8460
Queen’s Hospital: 01708 435 000 ext 3223

E-Mail address for patient contact: bhrut.cardiacrehab.pt@nhs.net
E-Mail address for referrals: bhr-tr.CardiacRehab@nhs.net

Types of treatment

Through the programme, we provide advice and support which includes exercise and education for anyone who has had a heart attack (MI - myocardial infarction), stents, cardiac bypass, valve surgery or Implantable cardioverter defibrillator (ICD) within the past 12 months.

Preparing for your appointment

You will be sent a questionnaire to complete about your lifestyle. You will also need to bring a full list of your medication to the appointment and any correspondence about your procedure/event.

Clinic locations

The programmes which run at Queen’s Hospital are either twice-weekly over four weeks, or once-weekly for eight weeks. At King George Hospital, all programmes are once-weekly for eight weeks.

There are also three separate education sessions to attend. We also offer a home-based programme called the Heart Manual for patients who are assessed as suitable.

External healthcare provider referral

Email: bhr-tr.CardiacRehab@nhs.net. Alternatively please use the key telephone numbers above.

Key staff

  • Lead consultant: Dr Fahad Farooqi
  • Lead AHP: Mari Fantocchi
  • Other key staff:      
  • Senior Sister: Kim Teece
  • Senior Sister: Liana Lekeumo

Useful information for cardiac rehabilitation patients

British Heart Foundation

Heart Helpline: Nurses available to call on: 0300 330 3311, weekdays 9am-5pm and bank holidays and weekends 10am-4pm.

Use these at-home cardiac rehabilitation videos to help you exercise safely while you can't get to cardiac rehab classes.

https://www.bhf.org.uk/informationsupport/support/cardiac-rehabilitation-at-home/cardiac-rehabilitation-exercise-videos

British Heart Foundation leaflets

The links below are for BHF publications which provide useful information on various topics relating to heart disease and risk factor modification. These are the main booklets which we use on the programme.

Medication

Eat better

Taking control of food portions and labels<

Taking control of saturated fats

Understanding Cholesterol

Stress booklet

Understanding physical activity

Reducing your risk: for people of South Asian Origin in the UK

You can also sign up for Heart Matters – a free magazine for anyone living with a heart and circulatory condition or at risk of one (can be received as a digital or paper version). It includes healthy recipes and nutrition features; information on how to keep your heart healthy; support on living with a heart or circulatory condition, from information about tests and treatments to helping your wellbeing; latest research.

Join up on the website or by calling 0300 330 3300.

Cardiac rehabilitation risk factors and lifestyle modification

Introduction

This outlines the risk factors for Coronary Heart Disease (CHD) and ways to help reduce your risk.

Risk factors

Gender: Males are more likely to develop CHD at a younger age and women develop post menopause.

Ethnicity

CHD affects all races but there are marked international differences. People from a South Asian background living in the UK are 50 percent more likely to die from CHD than the rest of the UK population.

Evidence proves the countries which follow a traditional Mediterranean diet have lower cases of CHD.

Age

Mortality from CHD increases with age.

Family History

A significant family history is considered if CHD is diagnosed in a close male relative before the age of 55 years or 65 years for a female. Clusters of risk factors such as high blood pressure, diabetes and obesity are also common family traits.

Lifestyle risk factors

Smoking

People who smoke are twice as likely to have a heart attack compared to those who have never smoked. Smoking a pipe, cigars, roll ups, shish smoking (hubble-bubble or water pipes), chewing paan all have the same effect as smoking a cigarette.

Smoking does not relieve stress. Stop smoking services are available at many GP surgeries or pharmacies. Smoking increases heart rate, blood pressure, reduces amount of oxygen in the blood and makes the blood more ‘sticky’ so increases risk of blood clots.

Stopping smoking after a heart attack reduces the risk of having another attack and improves chances of survival.

Obesity

Obesity contributes to increased blood pressure, cholesterol and an increased risk of developing diabetes. Reduce your portion sizes, develop regular meal patterns and plan you meals. Abdominal fat relates strongly to CHD. Monitor your waist size (measured around your belly button).

Males should aim below 37 inches and females below 32 inches. People from a South Asian background should aim for a lower waist size.

DIET

Modifying your diet will help with cholesterol levels, diabetes, maintaining your weight and blood pressure.

 

Alcohol

Drinking more than the recommended amount of alcohol can have a harmful effect on your heart and general health. It is also high in calories and can lead to weight gain.

There may be some heart health benefits for women over the age of 55 as long as they have no more than five units in a week. However we would not advise you to start drinking if you don’t already as there are safer, healthier ways to protect your heart.

Moderation: national guidelines advise you should have no more than 14 units per week with two alcohol free days. What is a unit?

  • One standard glass of wine (175ml)= two point three units – be aware of glass size
  • Half a pint of beer, lager, cider (300mls) = one unit.
  • One single pub measure of spirits (25mls) = one unit
  • Higher percentage of alcohol will be more units

Physical activity

Physical activity has a very beneficial impact on most cardiac risk factors. If you regularly exercise (30 minutes moderate exercise, five days a week) you are reducing your chances of experiencing an attack.

Stress

Stress is very difficult to define. Things that may be stressful for one person may be a positive challenge for another. Stress encourages less healthy behaviours.

Coming to terms with having a cardiac event may help to reduce your anxiety. Cardiac Support Groups / Psychology service, more information is available from the Cardiac Rehabilitation team.

Diabetes

Diabetes increases the risk of CHD and also increased the severity of other risk factors.

It is a strong risk factor for women as it diminishes relative protection from female hormones.

It affects the walls of the artery making them more likely to develop atheroma (narrowing). It also affects the efficiency of the heart muscle as well as the nerves to the heart so that symptoms of angina may not be felt in the usual way. Addressing and maintaining risk factors will improve glucose control reducing long term complications of diabetes.

Hypertension/high blood pressure

High blood pressure can lead to strokes, heart attacks, peripheral vascular disease and an enlarged heart. There is a higher risk of developing high blood pressure if you smoke and have high cholesterol.

There is a link between too much salt in your diet and high blood pressure. You should take no more than six grams per day (one teaspoon). Recommended blood pressure 130/80 or below. Excess weight, excess salt intake and excess alcohol intake will raise blood pressure.

Hypercholesterolemia/High cholesterol

Cholesterol is made mainly in the body. Some cholesterol is needed, however too much can lead to health issues. The liver makes some cholesterol from saturated fats in our diet, hence recommendation to reduce saturated fat. A normal range is four mmol/L

References

British Heart Foundation www.bhf.org.uk.

Cardiac rehabilitation exercise

This information outlines the benefits of exercise and give guidelines regarding safe exercise.

Benefits of cardiovascular exercise

Reduce

  • Stress
  • Cholesterol
  • blood pressure
  • angina symptoms
  • build-up of plaque in arteries
  • risk of falls and fractures.

Improve

  • Confidence
  • Energy
  • Sleep
  • Wellbeing
  • Balance
  • Strength
  • Mobility.
  • Burn calories to help with weight control.
  • Help the heart to work more efficiently.
  • Help with control of diabetes.

Chest pain

If you have any chest pain during exercise stop what you are doing and sit down if possible. Wait a few minutes – if you have glyceryl trinitrate (GTN) consider using it. If at any point you feel very unwell, the pain is getting worse or if you are unsure what to do then phone 999. If your chest pain does ease with rest or with use of your GTN make a note of what you were doing? Were you over doing it? You may need to see your GP for a review.

Considerations

  • Weather – remember to wrap up well in the cold, a scarf around your nose and mouth can help to prevent increased breathlessness and occasional angina
  • Terrain – if you are walking up a hill reduce your pace, don’t expect to go at the same speed.

Guidelines

  • Aim towards doing thirty minutes of moderate intensity (feeling your heart rate increased but comfortable) exercise five days a week.
  • Build up towards this gradually and increase or decrease the time as required.
  • Warm up and cool down are very important parts of exercise and should not be missed.

Timings

  • Five minutes warm up, start slow then gradually increase the pace.
  • 20 minutes exercise section - at a moderate pace – increased heart rate but comfortable – this section can be made shorter or longer to suit your individual needs.
  • Five minutes cool down, gradually reducing the pace.

What counts?

Any exercise where you are working at a level where you are feeling a little warm, heart rate increased, sweaty but comfortable. You should know you are exercising but should feel comfortable.

Sports

If you previously played sports such as football, cricket, tennis it is advisable to speak to the Cardiac Rehabilitation team prior to resuming playing.

Walking

• Walking is a very good form of exercise as long as for the middle section of your walk you are walking briskly so that your heart rate is increased but comfortable then walking is a very good form of exercise

• Don’t be concerned if your walking pace is now slower than it used to be, as your fitness returns your walking pace will increase. There are local walking groups, these can help with confidence and are more social.

They usually have a variety of difficulty levels.

Swimming

  • Prior to resuming swimming you should build up your fitness on land
  • It is difficult to judge how hard you are working when in the pool therefore start at a lower level
  • As you are using arms and legs together it is harder so you need to adjust your pace for that
  • Avoid the water if the water is very cold.

Exercise classess

  • These can be a fun, social form of exercising.
  • A warm up and cool down should be included in the class.
  • Remember to keep at your comfortable pace.

Attending a gym

If you are going to a gym, remember to focus on cardiovascular exercise. You could use the treadmill, bike, rowing machine, cross-trainer or stepper.

If using weights:

  • Use lighter weights and do more repetitions
  • Do not use weights where you have to hold your breath.

Home exercise

It is easy to modify exercise classes to be able to do them in your own home with no need for expensive equipment.

After you have attended the Cardiac Rehabilitation Programme we can give you a home exercise circuit to follow and also a British Heart Foundation DVD.

British Association of Cardiac Prevention And Rehabilitation (BACPR) Phase Iv

These are exercise classes designed specifically for cardiac patients run by exercise instructors who have completed extra training regarding cardiac conditions and are BACPR qualified. There is  a cost for these classes.

After you have completed your Cardiac Rehabilitation Programme the team can refer you to these classes.

References

British Heart Foundation – www.bhf.org.uk.

Association of Chartered Physiotherapists In Cardiac Rehabilitation – www.acpicr.com.

British Association for Cardiac Prevention and Rehabilitation – www.bacpr.com.

Walk for health – www.wfh.naturalengland.org.uk