(File Date: 2026-02-20 10:24:03) الدليل السعودي لبرامج إعادة التأهيل القلبي والو

Setting and practical duration Cardiac rehabilitation typically begins during hospitalization, starting around 48 hours after an acute cardiac event, and continues until the patient is discharged. Phase I of cardiac rehab should commence once the physician confirms the patient's medical stability. In the current healthcare setting, particularly under managed care systems, patients are often discharged within 7 to 10 days following their hospital admission 2.1.1.1 Objectives  Prevent loss of physical capacity.  Avoid effects of prolonged bed rest.  Avoid depression.  Avoid respiratory and thromboembolic complications.  Facilitate early discharge.  Provide suitable information to the patient and family. 2.1.1.2 Inclusion Criteria Medically stable post-myocardial infarction (MI) Post-coronary artery bypass graft (CABG) surgery and others cardiac surgeries Post-angioplasty Post-cardiac transplant surgery Medically stable with other cardiac conditions Patients undergoing cardiac surgery 2.1.1.3 Exclusion criteria Unstable angina Acute Congestive Heart Failure Dysrhythmias Resting BP's >200/100 mm Hg Moderate to Severe Aortic Stenosis Third Degree AV Block Acute Pericarditis Recent Embolic Events Resting ST Segment Depression greater Than 3-4 mm Uncontrolled Diabetes Mellitus Moderate to Severe Cardiomyopathies Orthopedic Problems Left ventricular failure, cardiogenic shock, persistent hypotension (SBP< 90mmHg) Persistent supraventricular tachycardia (SVT). 2.1.1.4 Medical Chart Review A thorough review of the patient's medical records is essential for planning appropriate cardiac rehabilitation interventions. The following key questions should guide the chart review process:  Primary Diagnosis Identify the patient’s main cardiac condition (e.g., myocardial infarction, aortic stenosis, coronary artery bypass grafting [CABG], etc.).  Defibrillation History Determine whether the patient has undergone defibrillation.  Surgical History Confirm if the patient has had a CABG procedure.  Electrocardiogram (ECG) Findings Analyse the latest ECG report for any abnormalities.  Thrombolytic Therapy Check if the patient received thrombolytic agents such as Tissue Plasminogen Activator (tPA) or Streptokinase during the acute phase of myocardial infarction.  Lipid Profile Review laboratory results to assess cholesterol and lipid levels.  Echocardiogram Results Evaluate for structural or functional abnormalities, including hypokinesis of the septum or ventricular wall, wall thickness, and left ventricular ejection fraction (LVEF). An LVEF >60% is normal; values <35% may limit participation in intensive physical activity.  Coronary Angiography If performed, review the catheterization report to identify which coronary vessels are affected and the degree of stenosis.  Pulmonary Function Test (PFT) Determine whether a PFT was conducted and whether it indicates obstructive or restrictive lung disease.  Medication Review Document all current medications the patient is taking, including dosages and indications.  Nursing Notes Examine nursing documentation for additional observations regarding the patient's physical and emotional status, mobility, and response to care. 2.1.1.5 Patient and Family Interview Direct communication with the patient and their family is essential to develop an individualized and effective rehabilitation plan. The interview should address the following components:  Mental Status: Ask the patient to describe why they believe they were admitted. This helps assess their orientation, cognitive function, and understanding of their health condition.  Symptom History: Explore the symptoms experienced prior to hospitalization. Focus on typical cardiac symptoms such as: Chest pain or pressure, pain radiating to the left