1. CARDIAC REHABLITATION During the past 20 to 25 years, there have been major changes in the medical management of myocardial infarction patients or patients who follow coronary artery bypass. The changes including: Shortened hospital stays.- More aggressive progression of activity.- -Earlier initiation of an ex. program (based on a low- level stress test prior to patient's discharge.

2. An aerobic conditioning program, in addition to risk factor modification, is a dominant part of cardiac rehabilitation. N.B.: DECONDITIONING: means changes that take place in cardiovascular, neuromuscular, and metabolic functions as a result of prolonged bed rest or activity. means changes that take place in cardiovascular, neuromuscular, and metabolic functions as a result of prolonged bed rest or activity.

3. INPATIENT PHASE (PHASE ):- -This phase of program occurs in the hospital following stabilization of the patient's cardiovascular status after M I or coronary bypass surgery for a period may be limited to 3 to 5 days. -When hospital stays longer, this phase often lasted to 7 to 14 days and referred to as phase of the cardiac rehabilitation program.

4. Purpose is to: -Initiate risk factor education and address future modification of certain behaviors, such as eating habits and smoking. -Initiate self- care activities and progress from sitting to standing to minimize deconditioning (1 to 3 days post event). -Provide an orthostatic challenge to the cardiovascular system (3 to 5 days post event). This is usually accomplished by supervised ambulation. Ambulation is usually monitored electrocardiography as well as manually using the heart rate, ventilation rate, and blood pressure. Ambulation is usually monitored electrocardiography as well as manually using the heart rate, ventilation rate, and blood pressure. -Prepare patients and family for continued rehabilitation and for life at home after a cardiac event.

5. OUTPATIENT PHASE (PHASE ): -This phase is initiated either upon discharge from the hospital or depending on the severity of the diagnosis from 6 to 8 weeks later. -This delay allows time for the myocardium to heal as well as time to monitor the patient's response to a new medical regimen. -Participants are monitored via telemetry to determine heart rate, rhythm responses, blood pressure, at rest and during ex. and ventilation responses are noted, these programs usually last from 6 to 8 weeks.

6. Prupose is to: -Increase the person´s ex. capacity in a safe, progressive manner so adaptive cardiovascular and muscular changes occur. Enhance cardiac functions and reduce the cardiac cost of work.- Determine the effect of medication on increasing the levels of activity.- Relive anxiety and depression.- Progrese the patient to an independent ex. program.-

7. OUTPATIENT PROGRAM (PHASE ): This phase includes a supervised ex. conditioning program, which is often continued in a hospital or community setting. Purpose of this phase: is to continue to improve or maintain fitness levels achieved during the phase program.