[Rehabilitation of the coronary patient]

In the management of myocardial infarction prolonged confinement to bed has been superseded by early rising and rehabilitation, the latter being defined as all measures enabling the patient to resume his former activities and to achieve optimal physical and mental performances. Rehabilitation is primarily indicated for patients with recent uncomplicated infarction, severe exercise-induced angina untreatable by coronary bypass and after surgery of the coronary arteries or heart valves. It mainly consists of weekly training sessions aimed at improving physical performance. Its favourable physiological effects, now firmly established, include a 20-30% increase in maximum exercise and angina threshold with equivalent decrease in heart rate, blood pressure and myocardial oxygen consumption; a reduction in serum triglyceride levels, platelet aggregation and circulating and myocardial catecholamines; finally a considerable psychological impact with prompt and easy return to active life.