Croatian Cardiac Society
Working Group for Cardiovascular Prevention and Rehabilitation
SESSION OF THE WORKING GROUP
Zagreb 9th March 2010
Description of the implementation of the medical procedures in the cardiovascular patients
during the 21-day rehabilitation program
Cardiologic rehabilitation is an organized set of procedures aimed at diagnostic evaluation,
optimization of therapy and preparation of patients for a permanent autonomous secondary
prevention of the disease of heart and blood vessels. By an analyze and integration of the present
Guidelines of the European Society of Cardiology (ESC) as well as standards and norms applied
in the clinical practice of the countries members of ESC, procedures which are applied in the non
complicated rehabilitation procedures should have the scope as follows:
Normal course of treatment and rehabilitation
Number of procedures
Medical visit and consultation
3x
Ergometry
2x
Monitor of blood pressure
60 x
ECG (12-channel electrocardiograph)
3x
Anthropometry
2x
Psychological test
1x
Half hour relaxation test, number of the group: 10 patients
15 x
Interval training on cycle, 20 min with ECG telemetry
20 x
On spot treatment in the form of training with resistance, 2 hours 6 x
In adequate functional groups, kinesiotherapy in water
(use of swimming pool, aerobic exercises in water)
20 x
Consultation on nourishment
2x
(interview, targett consultation on nourishment interventions)
Standard education programs – lectures,
Programs for prevention of particular cardiovascular risks
6x
(combined individual and group programs – interview, consultations, workshops)
School of non-smoking
Diet school
Diabetes advisory clinic
Targeted (individual) psychological treatment on indication
6x
6x
6x
6x
These are standard medical treatments appertaining, with partial individual variations, to all
patients included in the cardiologic rehabilitation procedure. They should be comprised by daily
lump amount (prices) in two categories – for stationary and ambulatory rehabilitation.
1
In case of need for further procedures of rehabilitation treatment, they can be alternatively
increased with a based medical exposition.
Further procedures:
6 minute walking test
Dynamic 24 hour electrocardiograph (Holter ECG)
Dynamic 24 hour measurement of blood pressure (Holter – RR)
Ergospirometry
Spirometry
Transtoracic echocardiography
Transesophageal echocardiography
Stress echocardiography
Ultrasound scanning of the abdomen
Doppler of the blood vessels of the legs
Doppler of the blood vessels of the arms
Color Duplex of the carotid and Doppler in vertebrobasilar vasospam
Consultation visit/other specialties
Routine lab examinations with lipidogram test
INR/PV
Evaluation of control of glycemia regulation
Blood glucose profile
HbA1C
Fe, UIBC
TSH
fT3, fT4
Proteinogram
CRP
Hemoculture, urinoculture
Such procedures do not belong to the program of standard rehabilitation, but sometimes they are
clinically indicated and can be successfully carried out during the rehabilitation procedure and
which are necessary; in case of their motivated indication, they should be additionally financed.
Doctors of the working group present to the session:
Prim. Mirjana Jembrek Gostović, M.D. – internal medicine specialist - cardiologist
Ass. Prof. Viktor Peršić, M.D. – internal medicine specialist - cardiologist
Ass. Prof. Alen Ružić, M.D.- internal medicine specialist - cardiologist
Ass. Prof. Duško Cerovec, M.D. - internal medicine specialist - cardiologist
Vladimir Jonke, M.D..- internal medicine specialist - cardiologist
Prim. Ph.D. Inge Heim, M.D. - epidemiologist
Prim. Ph.D. Mario Ivanuša, M.D. - internal medicine specialist - cardiologist
Prim. Ph.D. Goran Krstačić, dr. med. – internal medicine specialist - cardiologist
Mia Rončević, M.D. internal medicine specialist – cardiologist
Ph.D. Verica Kralj, M.D., specialized epidemiologist
President of the Working Group:
Ass. Prof. Viktor Peršić, M.D.
2