Exercise Based Cardiac Rehabilitation for Unstable Angina: A Case Report

A 42-year-old male was hospitalized with unstable angina (UA) which had resulted in severe impairment of his daily activities. Coronary angiography revealed a 100% occlusion of the right coronary artery (RCA) and a 50% stenosis within the left anterior descending coronary artery. However, in view of the previously occluded RCA that was supplied by discernible collaterals, medical management was recommended and he was rehabilitated using a progressive exercise regimen to increase his anginal threshold and functional capacity. Following rehabilitation, the patient demonstrated increases in the rate-pressure product of his anginal threshold, as well as his symptom-limited walking distance. At discharge, he was able to negotiate 400 m without angina and was asymptomatic during his daily activities. He was started on a home-based exercise program and followed for 9 months during which time he was functionally independent and walked at least 1 km each day. These findings highlight the benefits of an exercise-based cardiac rehabilitation program among patients with previous UA in whom other treatment options have been exhausted.