Rehabilitation after a heart attack is carried out in 3 phases:
- Acute hospitalThe patient is monitored around the clock in the intensive care unit and coronary angiography (X-ray imaging of the coronary vessels) is performed. In the hospital, the patient is mobilized at an early stage and is instructed by the physiotherapist in active movement. The duration of the hospital stay is approximately 7-14 days in the case of uncomplicated courses of the heart attack.
- Follow-up treatmentDuring this phase, the patient continues to be treated in a rehabilitation clinic or an outpatient therapy center.
In addition to therapeutic elements such as exercise training, health education and testing the patient’s condition under stress, training is also provided to reduce anxiety before a new heart attack. Patients often combine physical activity with the heart attack, which leads to the avoidance of sports and physical exercise. However, such passive behavior is associated with a higher risk of a re-infarction. The patient is also prepared for his or her reintegration into the workplace.
- Reintegration into everyday and working life, further outpatient careAfter the heart attack and the completed rehabilitation measures in the rehabilitation clinic or therapy center, patients are reintegrated into their professional and everyday life, i.e. they carry out their work and everyday tasks as before the heart attack. Acquired measures to reduce the risk of coronary heart disease (CHD) and myocardial infarction, e.g. a change in diet and avoidance of nicotine, should be applied in everyday life.
Prophylaxis after heart attack
A further step in the care after a heart attack is secondary prophylaxis: Through targeted preventive measures, the progression and worsening of coronary artery disease (CHD = coronary artery disease) can be prevented or stopped by eliminating risk factors for a heart attack. These include the control of blood sugar (diabetes mellitus) and blood pressure (reduction of high blood pressure), abstinence from nicotine, reduction of body weight, normalization of blood fat and cholesterol levels and regular physical activity. The patient should eat low-fat and high-fiber food, consume regularly.
Participation in the program of a heart sports groupcoronary sports group is recommended. Within the scope of cardiac sports, the patient’s endurance training is adapted to his individual capacity. Patients exercise 3 to 7 times a week for 15-60 minutes at 40-60% of their maximum physical capacity.
Physical activity reduces the risk of a new heart attack. Avoiding stress, annoyance and excessive exertion as well as learning relaxation exercises promotes the well-being of the heart attack patient. As part of secondary prophylaxis, drugs are used to improve the prognosis of a heart attack by reducing the risk of mortality.
- Fruit
- Vegetables
- Fish and
- Unsaturated fatty acids (e.g. in olive oil)
This includes the following groups: If cardiac arrhythmias occur in the post-infarction phase, i.e. the time after the heart attack, they can be prevented with the antiarrhythmic drugs amiodarone (e.g.
Cordarex®) or sotolol (e.g. Darob®). If the cardiac arrhythmias cannot be treated with a drug-based, conservative therapy, the installation (implantation) of a pacemaker with integrated defibrillator function for ventricular fibrillation (ICD) is a possible therapeutic step. A defibrillator can stop the electrical derailment of the heart in ventricular fibrillation, which is tantamount to cardiac arrest because there is no longer any orderly cardiac action, and restart the heart to restore a normal rhythm.
This is done by applying a current pulse to the heart.
- Beta-blocker (for effect see Therapy of myocardial infarction (active ingredient e.g. metoprolol, preparation e.g.
Beloc ®)
- Platelet aggregation inhibitor (active ingredient e.g. acetylsalicylic acid, preparation e.g. Aspirin®)
- Cholesterol-lowering drugs (statins), (active ingredient e.g.
Simvastatin, preparation e.g. Simvahexal ®)These drugs inhibit the formation of cholesterol and have the effect of lowering LDL (“bad/damaging” cholesterol) and increasing HDL cholesterol (“good” cholesterol) in the blood.
- ACE inhibitors (active ingredient e.g. captopril, preparation e.g. Lopirin ®) They slow down the process of remodelling after a heart attack. The heart is relieved and blood pressure is lowered.