Answers for heart patientsతెలుగులో చదవండి
Heart failure treatment: where cardiac rehab fits in
Heart failure treatment has three parts in the NHS guide: medicines, surgery or devices, and cardiac rehab. The NHS says everyone with heart failure should be offered cardiac rehab. This page is about cardiac rehab for heart failure: the heart failure exercise part. At Cardiac Rehab, Hyderabad, we run that part under physician supervision. Your heart doctor’s medicines and devices stay as they are.
From the NHS heart failure page: treatment is medicines, surgery and cardiac rehab. “Everyone diagnosed with heart failure should be offered cardiac rehabilitation.”
What heart failure treatment includes
There is no cure for heart failure yet. But treatment and daily habits can ease the symptoms. They can keep heart failure stable for many years. The NHS guide lists these parts:
- Medicines. Water tablets (diuretics) help you pass extra fluid. Some medicines widen the blood vessels, so the heart does not have to work as hard. Beta blockers slow the heart, so it needs less oxygen.
- Surgery or a device, for some people. To open blocked arteries, repair or replace a valve, or fit a pacemaker or an ICD. In severe heart failure, a pump device or a transplant may be offered.
- Cardiac rehab. A check and advice on how to exercise safely. Exercise classes or a personal exercise plan. Help with daily habits like healthy food. A group of people with heart failure.
Your heart doctor leads the first two parts. We run the third. Cardiac rehab for heart failure does not replace medicines or devices. It sits alongside them. If your report says congestive heart failure, the treatment has the same three parts.
Why exercise, when you feel so tired?
Heart failure can make you breathless and tired. So making yourself a little more breathless on purpose can feel scary. The British Heart Foundation (BHF) explains: in the past, people with heart failure were told to rest. We now know that keeping active can ease symptoms and improve daily life.
When you keep moving, your muscles and lungs work better. That puts less strain on the heart. Exercise can also lift your mood and energy.
The BHF is clear on one thing: exercise does not cure heart failure, and does not reverse it. It still helps.
What the studies found
A 2024 Cochrane review pooled 60 trials of exercise for heart failure, with 8,728 people. In the first year, about 16 in 100 people who exercised went to hospital. For those who did not exercise, it was about 24 in 100. Their daily life was likely better too. The review found no difference in deaths in the first year.
In 2019, researchers pooled 18 trials of exercise in people with a low ejection fraction (EF), that is, low heart pumping. Steady exercise raised EF by about 4 points on average. In programmes of 6 months or more, by about 6 points. No one can promise your EF will rise. How to increase ejection fraction, and by how much, is on our EF page: how to increase heart pumping (EF).
How to exercise safely with heart failure
The BHF advice for a heart failure exercise plan:
- Speak to your doctor first. You may need to start in a supervised cardiac rehab class.
- Keep it moderate. You feel warmer and breathe a bit harder, but you can still talk.
- Warm up and cool down. Do not lie down straight after exercise.
- Avoid heavy weights, holding your breath, and press-ups or planks. Be careful in the pool.
- Little and often. A few 5 to 10 minute walks a day add up. Some is better than none.
- Listen to your body. On a bad day, rest. On a good day, do not overdo it.
Stop and tell your doctor if
- your heart pounds or skips beats while you exercise,
- you get extremely short of breath, or light-headed,
- light activities are getting harder than they used to be.
Do not exercise on days you are unwell, or more tired or breathless than normal. Ask for an urgent doctor’s visit if you are breathless lying down, cough up frothy pink phlegm, or gain weight suddenly. These are NHS warning signs.
If your legs swell, read leg swelling in heart failure. If the words themselves scare you, read what heart failure really means.
What happens at Cardiac Rehab
- A doctor checks you first.
- You get an exercise plan made for you.
- You exercise for 90 minutes, 3 times a week, for 6 months, under physician supervision.
- Step by step, the exercise gets harder as you get stronger.
Why it helps with this
At Cardiac Rehab, the exercise part of your heart failure treatment is done under physician supervision. Your heart failure exercise plan is made for you after the first check. Your heart trace (12-lead ECG) is watched while you exercise. You learn your safe level, and stop guessing.
Your heart doctor’s medicines and devices stay as they are. Bring your latest echo report and your medicine list to the first visit.
A 2024 review of 60 trials found that people with heart failure who exercised went to hospital less. About 16 in 100 went, against about 24 in 100 who did not exercise. Their daily life was likely better too.
For stable heart failure, US (AHA and ACC) and European (ESC) guidelines give exercise training their highest grade: Class I, Level A.
Cardiac Rehab, Jubilee Hills, Hyderabad runs these sessions.
Frequently asked questions
Can heart failure be cured?
Not yet. The NHS says treatment and daily habits can keep heart failure stable for many years. The BHF says exercise does not reverse it, but it still eases symptoms and improves daily life.
Is cardiac rehab a treatment for heart failure?
It is one part of treatment. The NHS says everyone diagnosed with heart failure should be offered it. It does not replace your medicines or devices. Those stay with your heart doctor.
I have congestive heart failure. Can I exercise?
Most people can, once their doctor agrees. The BHF says to speak to your doctor first. You may need to start under supervision in a cardiac rehab class. Keep it moderate: you can still talk while you exercise. Congestive heart failure treatment has the same three parts: medicines, a device for some people, and cardiac rehab.
My EF is low. How to increase ejection fraction?
Exercise is the part you can do, under supervision. In 18 trials, steady exercise raised EF by about 4 points on average, and by about 6 points in programmes of 6 months or more. Some people gain more, some less, some not at all. No one can promise. Your heart doctor’s medicines are the other part of how to improve EF of the heart.
How soon after a hospital stay can I start?
When your heart doctor says you are stable. At the first visit, a doctor checks you and makes a plan. Bring your discharge papers, echo report and medicine list.
This page is general advice. Your own doctor knows your heart. If your doctor has told you something different, follow your doctor.
Written by Dr. Muralidar Babi, MBBS, MD (CMC Vellore), Cardiac Rehab Physician. TGMCI Reg. No. 59309.