Observational Study of Recurrent Heart Attacks and Barriers to Participation in Exercise Training Cardiac Rehabilitation: A Serial Case Report

Abstract

: Acute coronary syndrome (ACS) is the most common cause of mortality in Coronary Artery Disease (CAD) patients, 20% of ACS survivors will experience a recurrent heart attack. Exercise training as a part of cardiac rehabilitation increases the quality of life, functional capacity, prevents recurrent heart attack and reduces mortality but the participation rate is still very low. Among 36 patients who were admitted in July 2019 in ICCU Ward, RSCM, 14 patients had recurrent heart attacks where 11 patients did not follow phase II cardiac rehabilitation while 2 patients took part in cardiac rehabilitation. Recurrent heart attacks are influenced by modifiable and unmodifiable factors and exercise training as a core of cardiac rehabilitation is important to prevent this cardiac event because it has cardioprotective mechanisms. Patients who got recurrent heart attacks had barriers to participate in exercise training included lack of education, difficulty to arrange schedule, transportation or distance, no rehabilitation center and lack of awareness. Exercise training in cardiac rehabilitation has beneficial effects in preventing recurrent heart attacks and barriers to participate in it are challenges that we must overcome.