This helps prevent new heart problems

1. What is that, cardiac rehabilitation?
Cardiac rehabilitation consists of four important parts. The patient receives physical training to condition rebuild; guidance to change an unhealthy lifestyle (such as quitting smoking); psychological help if he or she has become anxious or depressed due to the heart problems; and social support, for example to get back to work quickly or to pick up daily activities.

2. Who is it for?
Rehabilitation is mainly for patients with acute heart problems, i.e. after a heart attack, open heart surgery (such as bypass or heart valve surgery), an angioplasty or stent treatment, or after a pacemaker or internal defibrillator (ICD) has been placed. Cardiac rehabilitation is sometimes also recommended for a chronic heart problem such as angina pectoris, an arrhythmia or heart failure.

3. Does cardiac rehabilitation make sense if the heart attack was a while ago?
It depends on. It is generally accepted that it is useful to start cardiac rehabilitation up to six months after an acute problem. If the heart problems are longer ago, you can discuss with the cardiologist whether you can still benefit from taking part. The cardiologist must refer you. This also applies to patients with chronic heart complaints, for example a heart rhythm disorder.

4. Does it really help you?
Of course. If people with serious heart problems follow a cardiac rehabilitation program after their treatment, they are 50 percent less likely to end up in the hospital again and 30 percent less likely to die from heart problems. Cardiac rehabilitation thus reduces the risk of new problems arising. But the most important thing for many patients is that they regain confidence in their body. They feel more vital and free and can participate in normal life without (many) obstacles. For people with a job, it also means getting back to work faster.

5. Why do so few patients participate?
Cardiac rehabilitation requires a referral from a specialist. Unfortunately, cardiologists often don’t think about it. This may be because they focus on solving the acute problem (such as a blocked coronary artery) and are less concerned with preventing future complaints. And then there’s the money. Due to cutbacks in health care, hospitals often simply do not have enough budget to offer all heart patients who need it a rehabilitation place.

6. It is not always offered, but does it benefit you?
Indeed. It is therefore important that patients request a referral themselves. But because many have a wrong idea of ​​what cardiac rehabilitation means and delivers (“It’s just fitness” or “It doesn’t make sense anymore at my age”), not all of them are doing that now. Another problem is the distance from home to the hospital or to the rehabilitation center. If it is more than ten kilometers, many patients drop out before or during the program.

7. And it differs per hospital whether you receive cardiac rehabilitation?
Precisely. But as a patient you are entitled to it. If the hospital does not offer a program, ask the cardiologist for a referral to an institution where rehabilitation is provided. Or engage the health insurance company’s healthcare mediation service.

8. Where can you go for cardiac rehabilitation?
In the hospital where you were treated, in another clinic or in a rehabilitation center. The program is given in about a hundred hospitals and rehabilitation centers in the Netherlands. You can ask your cardiologist what options are available in the area.

9. Is the rehabilitation equally good for all providers?
New. The Health Care Inspectorate recently conducted research into cardiac rehabilitation and the range and quality appear to differ greatly from one hospital to another. It therefore pays to take a critical look at how a program is composed. It is important that all four aspects of rehabilitation are offered (see point 1).

It is also useful to think about a number of things in advance. What should the rehabilitation bring you? How far do you want to travel for it? Is it important to sit in a group with peers? Would you like your partner to participate? Then you can search for a suitable program and center.

10. Heart trouble is physical. Why is psychological help necessary?
Three quarters of the people who have or have had a serious heart problem experience gloomy or anxious feelings. These psychological complaints can continue to develop for up to a year after the date. In a third, the complaints are so serious that there is a depressive disorder. Psychological problems often only arise after someone has already returned home or at work. Healthcare providers often initially dismiss such complaints as fatigue or as a side effect of medication. Need help? This does not necessarily have to be done through the cardiologist, it can also be done through the general practitioner.

11. Does rehabilitation have to take place in a group?
Research shows that patients benefit more if they rehabilitate together with other patients. You can then exchange experiences and support each other. Moreover, you learn from each other. But if someone prefers individual help or guidance, that is often possible.

12. What if you’re not sure if it’s for you?
In any case, talk to the coordinator of the cardiac rehabilitation program. During the intake you will be told exactly what your personal options are, and you can put any doubts on the table. It can also be nice to hear experiences from others who have already followed such a program. This can be done, for example, by contacting fellow sufferers via the patient association De Hart&Vaatgroep.