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Physical activity is important after heart attack

By Kimberly Van Brunt

Post-Bulletin, Rochester MN

Deb Kautz admits that she was overweight and had high cholesterol. The 47-year-old walked more than two miles every morning, went to Curves three to four nights a week and has no family history of heart disease.

So when she began to feel straining in her jaw, neck and shoulder earlier this year, she never dreamed that she might be having a heart attack. Or that one artery was 100 percent blocked.

After being blindsided by a heart attack, having balloon angioplasty and staying in the hospital for four days, Kautz had lots of questions.

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What now?

Doctors know now that physical activity, even within a day or two of heart attack, is beneficial to almost every heart attack patient — but the patients are understandably fearful. "I was scared as heck," says Kautz.

Dr. Randal Thomas, director of Mayo Clinic’s Cardiovascular Health Clinic, has counseled many patients like Kautz. "These patients are really in new territory," he said. "They’ve just had a life-threatening event, and they don’t know what they can do safely."

Enter cardiac rehabilitation. Programs vary throughout the country, but most have phases involving evaluation, an exercise prescription and medically supervised exercise, emotional support and education on lifestyle, nutrition and medications.

"Research shows that people who participate in cardiac rehab have a 25 to 30 percent lower risk of death in the follow-up period, as well as improved exercise capacity, quicker return to work, and better psychological health," said Thomas. "People (in rehab) feel better, do better and live longer."

Last month, new performance measures were released for cardiac rehabilitation, including goals for patient enrollment. Nationally, only about 20 percent of people who have had a cardiac event or cardiac surgery enroll in a cardiac rehabilitation program. At Mayo, it’s 50 percent. According to Thomas, that isn’t good enough.

"Although we have a higher than average referral and enrollment rate, we’re still only getting half the patients into rehab," he said.

The referral process begins in the hospital immediately after an event or surgery; typically, cardiac rehabilitation begins within a week. Health insurance often covers some or all of the cost.

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It’s up to you

Part of cardiac rehabilitation is empowering its participants to take control of their own care and futures with the tools they’re given. While your hospital can encourage you to enroll in the program, the intensive rehabilitation period typically ends about three months later.

"I’ve been given all the tools, and now it’s up to me to make the tools work," said Kautz. "I have a second chance. There’s no guarantee that it won’t happen again, but I have to use the tools that are out there and just go for it."

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