Rehabilitación cardíaca

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Course Overview

El propósito de este curso es la formación en rehabilitación cardíaca de todos los profesionales relacionados con el diagnóstico y tratamiento de los pacientes con cardiopatías, especialmente la cardiopatía isquémica de especial relevancia por ser la primera causa de mortalidad en nuestro país.

Según la evidencia científica, la rehabilitación cardíaca ha demostrado que disminuye la mortalidad y la aparición de nuevos infartos en estos pacientes, mejorando por tanto la calidad de vida.

El objetivo de la rehabilitación cardíaca es limitar los efectos fisiológicos y psicológicos negativos de la enfermedad cardíaca, para controlar los síntomas, estabilizar o revertir la progresión de la enfermedad, mejorar la situación psicosocial y profesional del paciente y reducir el riesgo de muerte y reinfarto.

El contenido del curso presenta un contenido específico en las áreas de intervención de los programas de rehabilitación cardíaca. Esto es entrenamiento, factores de riesgo y aspectos psicológicos y/o sociales.

Los pacientes candidatos a ser incluidos en los programas de rehabilitación cardíaca precisan una cuidadosa valoración inicial por parte del cardiólogo que suele llevarse a cabo en consultas monográficas centradas en prevención secundaria y rehabilitación cardíaca.

A dichas consultas son remitidos los pacientes, generalmente tras el alta hospitalaria por el evento agudo, y en ella se realiza una valoración clínica cuidadosa basada en una anamnesis y exploración física detallada y en los resultados de pruebas complementarias básicas. Tras esta valoración y dependiendo del estado clínico del paciente y el resultado de dichas pruebas se ajusta el tratamiento médico para lograr el mejor estado clínico posible (mejorar síntomas), cumpliendo con las normas de prevención secundaria correspondientes.

La valoración inicial de un paciente con una enfermedad coronaria incluye antecedentes personales y familiares, factores de riesgo cardiovasculares, tipo de cardiopatía, sintomatología, características del cuadro agudo, evolución y complicaciones, localización y extensión del infarto, y situación actual. Hay que analizar los resultados de la valoración complementaria como ECG, ecocardiografía, holter, coronografía (si procede) y prueba de esfuerzo; esta última es imprescindible para la planificación y posterior orientación de las recomendaciones de ejercicio físico al paciente.

Inicialmente, las unidades de rehabilitación cardíaca no existían, ya que la rehabilitación cardíaca fue desarrollada en la década de los 60 al comprobarse los beneficios de la deambulación en los pacientes con cardiopatía isquémica, acortándose el periodo de reposo y convalecencia.

Con el mejor conocimiento de las enfermedades cardiovasculares y de los factores de riesgo cardiovascular, la OMS, en 1994 define la rehabilitación cardíaca de una forma más integral, abarcando una serie de intervenciones físicas, psíquicas y sociales, para la recuperación del paciente cardiópata y su integración en la sociedad. Comienza a aparecer el término equipo multidisciplinario.

Esta definición abarca algo más que el entrenamiento físico, incluyendo el control clínico y de los factores de riesgo, el consejo nutricional, el tratamiento psicológico, el consejo vocacional, el laboral y el estudio de familiares de primer grado de pacientes con alto riesgo de cardiopatía isquémica.

Así, en 1993, la OMS da una definición más actual y real de la rehabilitación cardíaca: «La rehabilitación cardíaca es la suma coordinada de intervenciones requeridas para influir favorablemente sobre la enfermedad, asegurando las mejores condiciones físicas, psíquicas y sociales, para que los pacientes, por sus propios medios, puedan conservar o reanudar sus actividades en la sociedad de manera óptima. La rehabilitación no debe considerarse como una terapia aislada, sino que debe ser integrada en el tratamiento global de la cardiopatía, de la cual, esta forma solo una faceta».

Desde 4Nurses recomendamos al usuario completar los conocimientos que se imparten en este curso con los que se desarrollan en «Componentes del programa de Rehabilitación cardíaca».

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    »
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