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The Mackie Report 

The Heart of the Matter

Heart attacks and other coronary ailments are a huge problem in America. Every year, 1.5 million heart attacks occur, of which roughly 500,000 are fatal. Even more frightening is that 66 percent of these victims showed no prior symptoms of heart problems.

As director of health and fitness for the Ochsner Heart and Vascular Institute, these sobering statistics spurred me to ask a medical colleague about the health of individuals who are lucky enough to survive a major coronary event. What I learned was alarming: many of these events are lifestyle-induced. However, with proper cardiac rehabilitation, a heart attack survivor has a second fighting chance.

Dr. Richard Milani, vice chairman of the Ochsner Heart and Vascular Institute, says that individual behaviors such as obesity, stress, smoking, or lack of proper nutrition and physical exercise, are more responsible for cardiac disorders than genetic factors. Milani also believes that a program of cardiac rehabilitation is essential in recovering from a heart attack, bypass surgery or angioplasty.

A typical cardiac rehab program consists of a 12-week series of therapy sessions. The emphasis, Milani notes, is on "addressing the reasons that caused the heart problem and preventing their repetition." Participants are strongly encouraged to adopt lifestyle changes, whether it is to quit smoking, go on a diet, restrict intake of unhealthy foods or adopt a regular exercise regimen.

A well-staffed cardiac rehab program, Milani explains, consists of two registered nurses, two exercise physiologists and one registered dietician. While a cardiologist is required to be in the facility, it is not necessary that the physician be present in rehab classes.

According to Debbie Strong, a registered dietician in the Ochsner Cardiac Rehabilitation Unit, every cardiac rehab patient is assigned a regular exercise routine as part of his or her treatment. The typical cardiac rehab class consists of a five-minute warm-up, two 15-minute aerobic periods, 15 minutes of resistance training and 15 minutes of stretching/cool-down. Patients use aerobic equipment such as a treadmill, an elliptical, a Nu-Step, an arm ergometer, a Schwinn Airdyne and free weights.

The recovery program also includes a 30-minute educational lecture, taught on a rotating basis by a nurse, an exercise physiologist, and a dietician. Patients are taught how to check their heart rate by measuring their pulse and are encouraged to share their stories and build a support network with other patients.

Patients attend classes three times a week, with an exercise physiologist adjusting the workout intensity on a weekly basis. Every program is customized to the patient's needs, and changes usually are determined by rate of perceived exertion, heart rate and blood pressure. Also, if the patient is diabetic, glucose levels are monitored before and after exercise.

Following discharge from the program, patients are encouraged to pursue healthy lifestyles and schedule regular physical checkups. "It's our job to make sure patients don't have to come back," Milani explains. "So when they come out of rehab, we make sure they are well educated and feeling good."

My sentiments exactly; therefore, I encourage anyone who has survived a major coronary event to seek out this type of program.

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