Exercise Based Cardiac Rehabilitation in a Resuscitated; Post Mitral Valve Replacement Middle Aged Woman - A Case Report

Introduction- Rheumatic heart disease (RHD) affects more than 30 million people globally and accounts for about 30,000 fatalities. RHD can worsen with time, leading to significant mitral stenosis and/or mitral regurgitation, which affect more than 30% of patients. Case Presentation- A 39 years old female, known case of Rheumatic valvular heart disease since 2005; came with a complaints of palpitation and dyspnea on exertion. Investigations revealed severe mitral stenosis with severe tricuspid regurgitation for which she underwent Mitral valve replacement and Tricuspid valve repair and was referred for physiotherapy. On POD-5, she developed VF with asystole and was revived post resuscitation. Once she was hemodynamically stable, physiotherapy sessions were re-started thrice a day, post which recovery was seen in majority of the outcome measures. Management and Outcomes- Patient underwent regular exercise based Phase I cardiac rehabilitation program. Outcome measures assessed were NYHA, chest expansion values, single breath count, 30 seconds sit to stand test, distance ambulated and RPE. Discussion- Cardiac rehabilitation post cardiac surgery has proven to be beneficial in terms of length of hospital stay, functional capacity as well as prevention of postoperative pulmonary as well as vascular complications. Conclusion- Exercise based cardiac rehabilitation helped our patient to overcome respiratory complications in the immediate post operative period. It helped in improving the lung expansion, cardiovascular endurance as well as the functional capacity. It also helped in reducing the fatigue and rate of perceived exertion levels.