Cardiac rehabilitation — ABIM Board MCQ

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EasyCardiovascularCardiac rehabilitationABIM Board

A 61-year-old man is being discharged after uncomplicated PCI for an NSTEMI. His LVEF is 48%, and he has no ongoing angina or heart failure symptoms. He is receiving guideline-directed secondary prevention but is worried about resuming physical activity. Which of the following should be included in his discharge plan?

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Correct answer: A — Referral to outpatient cardiac rehabilitation

The correct answer is A. Patients recovering from NSTEMI and PCI should be referred to a comprehensive outpatient cardiac rehabilitation program before discharge. Cardiac rehabilitation provides medically supervised, progressively prescribed exercise together with cardiovascular risk-factor management, medication support, nutrition counseling, and psychosocial care. It reduces recurrent cardiovascular events and hospitalizations while improving functional capacity and quality of life. His mildly reduced LVEF does not preclude participation. Prolonged bed rest or indefinite exercise avoidance causes deconditioning and is not appropriate after an uncomplicated course. Routine surveillance angiography is not indicated without recurrent symptoms or objective evidence of ischemia. Beta blockers should not be withheld simply to permit exercise; exercise intensity can be individualized while therapy is continued.

Reference: Rao SV, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes, secondary prevention/cardiac rehabilitation recommendation. Circulation. 2025. https://professional.heart.org/en/science-news/2025-guideline-for-the-management-of-patients-with-acute-coronary-syndromes/top-things-to-know