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

Phase II- Out Patient Cardiac Rehabilitation 2.2.1 Objectives The goals of Phase II cardiac rehabilitation focus on improving physical, mental, and cardiovascular health outcomes. Key objectives include: 1. Enhance exercise tolerance and functional capacity. 2. Improve lipid profile and blood pressure control. 3. Support optimal blood glucose management. 4. Reduce anxiety, depression, and emotional distress. 5. Promote independence in activities of daily living (ADLs). 6. Restore confidence and overall well-being. 7. Facilitate return to work and recreational activities. 8. Decrease hospital readmissions and medical visits. 9. Minimize reliance on medications through lifestyle change. 2.2.2 Referral system Patients are referred to cardiac rehabilitation by a cardiologist or cardiac surgeon. Upon referral, the cardiac rehabilitation physician will assess the patient’s eligibility. Participation should be offered to all eligible cardiac patients, with inclusion and exclusion criteria applied to ensure safety. 2.2.3 Inclusion Criteria Post-myocardial infarction (MI). Stable angina. Coronary artery disease (CAD). Heart failure (stable). Congenital heart disease. Coronary artery bypass grafting (CABG). Percutaneous coronary intervention (PCI). Valve repair or replacement. Cardiomyopathy. Cardiac pacemaker or implantable cardioverter defibrillator (ICD). Cardiac transplantation. Peripheral arterial disease (PAD). Atrial fibrillation (controlled). Individuals at high risk of CAD (e.g., with diabetes, dyslipidaemia, or hypertension). Other cardiac surgical procedures, as clinically indicated. 2.2.4 Exclusion Criteria Unstable angina. Ischemic changes observed on resting ECG. Resting systolic blood pressure ≥200 mmHg or diastolic BP ≥110 mmHg. Symptomatic orthostatic hypotension (drop in BP >10 mmHg with symptoms). Critical aortic stenosis. Active or uncontrolled inflammatory or infectious cardiac conditions. Severe obstructive cardiomyopathy. Acute systemic illness or active fever. Pulmonary arterial hypertension >60 mmHg. Uncontrolled atrial or ventricular arrhythmias. Uncontrolled sinus tachycardia (>120 bpm). Decompensated (uncompensated) congestive heart failure (CHF). Third-degree atrioventricular (AV) block without pacemaker. Active pericarditis or myocarditis. Thrombophlebitis. Uncontrolled diabetes (resting blood glucose >400 mg/dL). Severe orthopaedic limitations preventing safe participation in exercise. Significant metabolic disorders (e.g., acute thyroid dysfunction, severe electrolyte imbalances such as hypo/hyperkalaemia). History of cardiac arrest without subsequent revascularization. Resting ST-segment displacement >3 mm. Significant cognitive impairment or mental health issues impacting participation. Educational or communication barriers that prevent engagement with the rehabilitation process.