심장재활의 개요 및 국내 현실

Abstract

Cardiac rehabilitation (CR) is an integral component of the continuum of care for patients with cardiovascular disease (CVD). Today, the efficacy and safety of CR are well established and it is practiced in 111 countries, but the participation rate of CR is low. The actual rate of CR practice for acute myocardial infarction patients in Korea is very low only 1.5%. CR restores a patient’s exercise capacity and decreases recurrence, re-hospitalization, and re-intervention, as well as mortality. The core components of CR are patient evaluation, dietary treatment, weight management, blood pressure management, blood lipid management, diabetes management, smoking cessation, psycho-social management, physical activity counseling, and exercise training. In order for exercise training to be safely conducted, the risk stratification for exercise-related CV complication needs to be evaluated and high-risk patients should be exercised under the supervision including ECG monitoring. Currently CR programs have been practiced in 47 hospitals (28%) out of 164 CV specialty hospitals which practice percutaneous coronary intervention, but there were not many hospitals with active CR practice. In order for CR to be actively practiced in Korea, CR programs need to be developed in as many CV specialty hospitals as possible, and to increase participation rate, education to clinical staff and patients, more systematic consultation systems, less financial burden to patients, and more flexible CR environment including utilization of home-based CR and non-contact tele-CR technique are needed. These efforts by medical professionals should be accompanied by governmental support in policy making and budget execution.