How can I assess a patient's eligibility for referral to a cardiac rehabilitation programme after a cardiac event?

To assess a patient's eligibility for referral to a cardiac rehabilitation programme following a cardiac event, consider the following:

• All patients who have had a myocardial infarction (MI), regardless of age, should be offered a cardiac rehabilitation programme that includes an exercise component. This is a universal recommendation to ensure secondary prevention and recovery support ¹.
• Evaluate the patient's clinical stability and comorbidities. Patients with reduced left ventricular ejection fraction who are stable can safely participate in the exercise component of cardiac rehabilitation. If the patient has cardiac or other clinical conditions that may worsen during exercise, these should be treated before offering the exercise component, or the exercise programme should be adapted by a qualified healthcare professional ¹.
• Consider the patient’s physical and psychological status, work environment, and social factors. These factors influence the suitability and timing of rehabilitation and should be assessed to tailor the programme appropriately ¹.
• Ensure early initiation of cardiac rehabilitation. Referral and invitation to cardiac rehabilitation should begin as soon as possible after hospital admission and ideally within 10 days of discharge ¹.
• Do not exclude patients from the entire programme if they decline certain components. Cardiac rehabilitation programmes should offer a range of options and be flexible to meet individual needs and preferences ¹.
• For patients with heart failure, offer a personalised, exercise-based cardiac rehabilitation programme unless their condition is unstable. This includes those with reduced ejection fraction, provided they are clinically stable ².