Medical Problems of Patients in an Outpatient Cardiac Rehabilitation Program

This study compared medical problems experienced by 365 medically and surgically treated patients during participation in a 12-week outpatient cardiac rehabilitation program. The following medical problems differed significantly for the medical and surgical patients, respectively: angina pectoris, 34% versus 19% hypotension, 9% versus 4% and low-back complaints, 13% versus 6%. Other prevalent medical problems that were not significant between groups were complex arrhythmias, 33% versus 40% lightheadedness, 20% versus 24% dyspnea, 23% versus 19% and ST-segment changes, 14% versus 9 %. Although the overall occurrence of arrhythmias was not different between groups, the occurrence of ventricular tachycardia was significantly higher in the surgical group (12% vs 4%). Not significantly different between the medical and surgical patients respectively were supra-ventricular arrhythmias (13% vs 19%), ventricular arrhythmias (31% vs 30%), frequent premature ventricular contractions (PVCs 18% vs 20%), multifocal PVCs (19% vs 19%), and couplets (19% vs 22%). In addition, surgical patients showed an 18% incidence of incisional discomfort/pain and a 3% incidence of sternal movement. Physician referrals for medical problems associated with surveillance in the cardiac rehabilitation program were similar for both groups (18% vs 22%) and more frequent in the first month. These referrals resulted in a 12% hospitalization rate for further study or surgery. The results indicate a substantial prevalence of medical problems in medical and surgical patients and these problems are readily detected through structured cardiac rehabilitation during the first 12 weeks postdischarge from a cardiac event or surgery. Furthermore, referral to a physician after detection of these problems may lead to better patient care.