Key result
Cardiac rehabilitation improves functional capacity and secondary prevention, but reaches fewer than ~5% of patients.
Why the study?
This paper outlines the definition, stages, modern trends, and development recommendations for cardiac rehabilitation in patients with cardiovascular disease.
This review highlights the stages, functional assessment tools (DASI, 6MWT, CPET), and clinical benefits of cardiac rehabilitation while emphasizing its severe underutilization (<5%) in Bulgaria despite the country's high cardiovascular mortality.
May prompt health-system efforts to raise cardiac rehabilitation uptake in Bulgaria; leaves open implementation trials to identify scalable solutions.
Cardiac rehabilitation is a set of coordinated activities aimed at positively influencing the underlying cause of cardiovascular diseases and ensuring the best possible physical, mental and social conditions so that patients can restore or maintain optimal functioning in the community through their own efforts and, through improved health behaviors, slow or reverse the progression of the disease. Cardiac rehabilitation is suitable for all patients with cardiovascular disease, including those who have experienced a cardiovascular event, after cardiac catheterization and those after heart surgery for heart valve replacement or bypass surgery. The cardiovascular rehabilitation program involves a team effort of a cardiologist, physiotherapist, kinesitherapist, nutritionist, psychologist and others, who have a common goal – strengthening the patient‘s health and returning to self-confidence to cope with everyday life. Its main advantage is that it is a cheap method, accessible for administration by health systems, safe for patients, with proven long-term positive effects on the health of patients. IT helps them recover faster after a cardiovascular incident or after heart surgery. Cardiac rehabilitation is an integral part and a major component of preventive cardiology that allows for the non-invasive identifi cation of functional disorders of the cardiovascular system, assessment of their extent, and planning of measures for their control and secondary prevention.
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Doychinova et al. (2026) conducted a review in Cardiovascular diseases (including acute coronary syndrome, coronary revascularization, stable angina pectoris, heart failure, post-cardiac surgery, device implantation, and adult congenital heart disease). Multidisciplinary cardiac rehabilitation program (three stages: acute in-hospital, convalescence/stabilization, and long-term maintenance) was evaluated on Physical work capacity (assessed via DASI score, 6MWT, exercise stress testing, CPET), recovery, and secondary cardiovascular prevention. Cardiac rehabilitation is a safe, cost-effective, multidisciplinary intervention that improves functional capacity and secondary prevention, yet fewer than 5% of eligible patients in Bulgaria participate.
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