What are the key components of a cardiac rehabilitation programme for patients recovering from myocardial infarction?

A cardiac rehabilitation programme for patients recovering from myocardial infarction (MI) should include the following key components:

• Exercise component: All patients, regardless of age, should be offered an exercise programme tailored to their clinical needs and physical status, with adaptations as necessary for comorbidities or reduced left ventricular ejection fraction. Exercise should be started as soon as possible, ideally within 10 days of hospital discharge ¹.
• Health education: Comprehensive education on lifestyle changes, including diet, physical activity, smoking cessation, and alcohol consumption, should be provided. This includes advice on a Mediterranean-style diet and gradual increase in physical activity to improve exercise capacity ¹.
• Stress management and psychological support: Stress management should be offered as part of the programme, with involvement of partners or carers if the patient wishes. Complex psychological interventions like cognitive behavioural therapy are not routinely recommended ¹.
• Flexible delivery options: Programmes should be accessible and culturally sensitive, offered in various venues (home, hospital, community) and at different times, including options for home-based rehabilitation validated for MI patients ¹.
• Encouragement and motivation: Staff should actively promote cardiac rehabilitation, address barriers to attendance (e.g., transport), and use reminders such as motivational letters or calls to improve uptake and completion ¹.
• Return to normal activities advice: Guidance on returning to work, driving, sexual activity, and other normal activities should be individualized based on physical and psychological status ¹.
• Structured care and follow-up: Clear responsibility for early initiation and ongoing management of rehabilitation should be established, with feedback sought from patients to improve services ¹.