Cardiopulmonary rehabilitation consists of a supervised exercise program that involves education, nutritional counseling, stress management, smoking cessation and other lifestyle changes, designed to prevent or reverse the progression of cardiac and pulmonary diseases.

Cardiac Rehabilitation, Testing and Monitoring

Cardiac rehabilitation cannot change your past, but it can help you build a healthier future. Cardiac rehab is a medically supervised program designed to improve your cardiovascular health following certain heart-related conditions, events or procedures. The program combines monitored exercise, education and support to help you safely regain strength, manage risk factors and return to the activities that matter to you.

Cardiac rehabilitation may be recommended if you have experienced:

Another qualifying heart condition or procedure
A heart attack
Heart failure
Angioplasty or stent placement
Heart surgery

The Three Key Parts of Cardiac Rehabilitation

1. Exercise Counseling and Training
Regular movement helps strengthen your heart and improve the way your cardiovascular system works.

Our cardiac rehab team will develop an exercise plan based on your health, abilities and goals. During your sessions, the team may monitor your heart rate, heart rhythm, blood pressure, oxygen level and response to activity.

As you progress, you will learn how to exercise safely, recognize your limits and build habits you can continue beyond the program.

2. Education For Heart-Healthy Living
Understanding your heart health can help you make informed decisions and reduce your risk of future problems.

Education may include:

Understanding your heart condition
Managing high blood pressure and cholesterol
Taking medications correctly
Making heart-healthy nutrition choices
Increasing physical activity safely
Reaching or maintaining a healthy weight
Quitting tobacco
Recognizing symptoms that require medical attention
Setting realistic, sustainable health goals

3. Support and Stress Management
Recovery involves more than physical healing. Stress, anxiety and uncertainty are common after a heart-related diagnosis or procedure.

Our team can help you identify sources of stress, develop healthy coping strategies and build confidence as you return to your regular activities. Family members and friends can also play an important role in supporting your progress.

The Four Phases of Cardiac Rehabilitation

Cardiac rehabilitation generally progresses through four phases. The timing and details of each phase may vary depending on your condition, recovery and healthcare provider’s recommendations.

Phase I: Inpatient Recovery

Phase I begins while you are still in the hospital following a heart-related event or procedure.

The focus is on safely beginning light activity, understanding your condition and preparing to continue your recovery after discharge.

Phase II: Early Outpatient Cardiac Rehabilitation

Phase II begins after you leave the hospital and receive clearance from your healthcare provider.

This structured, medically supervised phase includes monitored exercise, education and individualized risk-factor management. Your cardiac rehab team will evaluate your response to activity and help you gradually increase your strength and endurance.

Phase III: Continued Exercise and Education

During Phase III, you continue building on the progress made during Phase II.

Exercise may become more independent while the cardiac rehab team continues to provide supervision, education and support. The goal is to help you develop the confidence and skills needed to maintain an active, heart-healthy lifestyle.

Phase IV: Independent Maintenance

Phase IV is the long-term maintenance stage.

You continue exercising and practicing the healthy habits you developed during cardiac rehabilitation, either independently or through a community-based exercise program.

The Madison County Health & Rehab cardiopulmonary rehabilitation team works with patients through Phases II and III.

What to Expect in Cardiac Rehabilitation

Your program will be based on your diagnosis, medical history, physical abilities and personal goals.

Your cardiac rehab experience may include:

An initial health and activity assessment
An individualized exercise plan
Supervised exercise sessions
Monitoring of your heart rate and rhythm
Blood pressure and oxygen-level monitoring
Education about your condition and medications
Heart-healthy nutrition guidance
Support for reducing cardiovascular risk factors
Stress-management strategies
Regular progress evaluations
A plan for continuing healthy habits after the program

Getting Started with Cardiac Rehabilitation

You do not have to face heart disease alone. Cardiac rehabilitation is a team effort involving you, your healthcare providers, our Cardiopulmonary Rehab team and the people who support you.

To get started:

Ask your doctor whether you qualify for cardiac rehabilitation.
Obtain an order or referral from your healthcare provider.
Call Madison County Health & Rehab Services at (515) 462-5206.
Complete an initial evaluation with our cardiac rehab team.
Work with the team to establish your goals and personalized plan.
Attend your scheduled exercise and education sessions.
Take an active role in your care and communicate any questions or concerns.
Continue taking your medications as directed by your healthcare provider.
Practice the healthy habits you learn throughout the program.

Cardiac Stress Testing

A cardiac exercise stress test helps your healthcare provider understand how your heart responds when your body is working harder.

Some heart conditions or rhythm changes may be easier to identify during physical activity than while you are resting. A stress test can also help your healthcare team determine an appropriate and safe level of exercise.

Why Is a Stress Test Ordered?

Your healthcare provider may order a stress test to:

Evaluate chest discomfort, shortness of breath or lightheadedness
Look for possible signs of reduced blood flow to the heart
Evaluate an irregular heart rhythm during activity
Measure your exercise capacity
Determine an appropriate level of physical activity
Evaluate how well a heart treatment or procedure is working
Gather information before beginning an exercise or rehabilitation program

A stress test is only one part of a complete cardiac evaluation. Your healthcare provider will consider your test results along with your symptoms, medical history and other diagnostic information.

FAQs About Cardiac Stress Tests

If your healthcare provider recommends a cardiac stress test, you may have questions about what it involves and how to prepare. These common questions can help you understand the different types of stress tests and know what to expect before, during, and after your visit.

1. What is a cardiac stress test?
A cardiac stress test checks how your heart works during physical activity. Your care team watches your heartbeat and blood pressure while you walk on a treadmill. Some tests use medicine instead of exercise to check how your heart responds.

The results can help your provider understand what may be causing your symptoms.

2. What types of cardiac stress tests are available?
We offer three types of cardiac stress tests. Your provider will choose the best test for you based on your symptoms, health history, and what they need to learn about your heart.

Nuclear stress test, also called myocardial perfusion imaging (MPI): This test uses a small amount of a radioactive substance and a special camera to take pictures of your heart. The pictures show blood flow to your heart muscle at rest and during exercise or medicine-based stress testing.
Treadmill stress test: You walk on a treadmill while your care team checks your heartbeat and blood pressure.
Stress echocardiogram, or stress echo: This test uses sound waves, called ultrasound, to take pictures of your heart before and after exercise or medicine. The pictures show how well your heart pumps.

3. Why might my provider order a stress test?
Your provider may recommend a stress test to find out whether your heart could be causing symptoms such as:

A heartbeat that feels fast, fluttering, or uneven
Chest pain or discomfort
Shortness of breath
Dizziness

4. Is cardiac stress testing safe?
Stress tests are generally safe, but they do have some risks. Your care team will watch your heartbeat, blood pressure, and symptoms closely throughout the test.

They can stop the test and provide care if needed

1. Do I have to exercise on a treadmill?
Not always. If walking on a treadmill is difficult or unsafe for you, some tests can use medicine instead. Depending on the test, the medicine makes your heart beat faster or changes blood flow to your heart.

Your provider will decide which option is right for you.

2. How should I prepare for my stress test?
Your instructions will depend on the type of test you are having. Follow the directions your care team gives you about eating, drinking, caffeine, and medicines.

You can also review Preparing for Your Cardiac Stress Test for more information. If you have not received instructions or have questions, call 515-462-5206 before your appointment.

3. Can I have caffeine before my stress test?
You may need to avoid caffeine before your test because it can affect how some stress-test medicines work. Caffeine is found in coffee, tea, many sodas, energy drinks, chocolate, and some medicines.

Follow your preparation instructions to find out what to avoid and for how long. If you have caffeine by mistake, call your care team before your appointment.

4. Should I take my medications before my test?
Your care team will tell you which medicines to take before your test and whether you need to skip any doses.

Do not stop taking a prescribed medicine on your own. If you are unsure what to take, call your care team before your appointment.

1. What happens during a treadmill stress test?
Small, sticky patches are placed on your chest and connected to a machine called an EKG to track your heartbeat. A cuff on your arm checks your blood pressure.

You will start by walking slowly. The treadmill will gradually get faster and tilt upward, making the walk more challenging.

Your care team will watch you closely throughout the test. Tell them right away if you feel unwell or need to stop.

2. What happens during a stress echocardiogram?
First, a member of your care team moves a small device over your chest to take ultrasound pictures of your heart while you rest.

You will then exercise or receive medicine to make your heart work harder. More pictures are taken to see how your heart pumps when it is working harder.

3. What happens during myocardial perfusion imaging (MPI)?
For this test, a small amount of a radioactive substance, called a tracer, is given through an IV in your arm. A special camera takes pictures that show blood flow to your heart muscle.

Pictures are taken while your heart is at rest and after you exercise or receive medicine that changes blood flow to your heart. Your care team also monitors your heartbeat during the test.

4. When will I receive my results?
After your test is reviewed, the results will be sent to the provider who ordered it. That provider will explain what the results mean and whether you need any follow-up care.

Ask your provider when you should expect to hear from them.

Additional Questions?

Call our Health & Rehab Services department at (515) 462-5206 if you have questions about your cardiac stress test appointment, preparation instructions, or medicines.

Holter and Event Monitoring

Symptoms such as a racing heart, skipped beats or dizziness may come and go. Because a standard EKG records only a brief period of your heart’s activity, an irregular rhythm may not always be present during an office appointment.

Holter and event monitors are small, portable devices that record your heart’s electrical activity while you complete your regular daily activities. The information helps your healthcare provider compare your symptoms with your heart rhythm.

Why Is Heart Rhythm Monitoring Ordered?

Your healthcare provider may order a Holter or event monitor to investigate:

A racing, pounding or fluttering heartbeat
Skipped or irregular heartbeats
Dizziness or lightheadedness
Fainting or near-fainting
Unexplained shortness of breath
Intermittent chest discomfort
Unusual weakness or fatigue
A known heart rhythm condition
Whether a heart medication or treatment is working

What Is a Holter Monitor?

A Holter monitor continuously records your heart’s electrical activity for a set period of time—often one or two days, although the length of monitoring may vary.

Small adhesive patches or sensors are placed on your chest and connected to a lightweight recording device. While wearing the monitor, you will usually continue your normal daily activities.

Because it records continuously, a Holter monitor may capture rhythm changes that do not appear during a brief EKG.

What Is an Event Monitor?

An event monitor is generally used when symptoms occur less frequently and may not happen during a shorter Holter-monitoring period.

Depending on the device ordered, an event monitor may be worn for several days or several weeks. Some devices record automatically when they identify a rhythm change. Others allow you to activate a recording when you feel symptoms.

Your healthcare provider will determine which type of monitor and monitoring period are appropriate for you.

What to Expect

During your appointment, a member of our team will:

Prepare your skin and place the monitor
Explain how the device works
Show you how to record symptoms, if needed
Review activities or equipment you should avoid
Explain how to care for the monitor
Tell you when and how to return the device

Most people can continue their normal daily activities while wearing a heart monitor. Follow the instructions provided with your specific device, particularly regarding bathing, swimming and keeping the monitor dry.

Keeping a Symptom and Activity Record

You may be asked to keep a written or electronic record while wearing the monitor.

Record the time and details if you experience:

Chest discomfort
Shortness of breath
Dizziness or lightheadedness
Fainting or near-fainting
A racing or irregular heartbeat
Skipped beats
Unusual weakness
Another concerning symptom

Also note what you were doing when the symptom began. Your healthcare provider can compare this information with your recorded heart rhythm.

After Monitoring Is Complete

Once the monitoring period is finished, follow the instructions you received for returning the device.

The recorded information will be processed and sent to the appropriate healthcare provider for interpretation. Your provider will discuss the results with you and explain whether additional testing, medication changes or follow-up care are needed.

Important Safety Information

A Holter or event monitor is a diagnostic tool and does not replace emergency medical care.

Do not wait for the monitor to identify or report an emergency. Call 911 immediately if you experience severe or worsening chest pain, significant difficulty breathing, fainting or another potentially life-threatening symptom.

Our Cardiopulmonary Rehab Team

Sally McDonald, RN
Cardiopulmonary Rehab

Pulmonary Rehabilitation

Pulmonary rehab is a supervised medical program that helps people who have lung diseases live and breathe better. You may need pulmonary rehab if you have a lung disease such as chronic obstructive pulmonary disease (COPD). During the program, you will learn exercises and breathing techniques.

Who Needs Pulmonary Rehab?

Your doctor may recommend pulmonary rehab to help you breathe easier and improve your quality of life for certain lung conditions, such as COPD, asthma, pulmonary hypertension and cystic fibrosis. It can also improve daily life for people who have scoliosis or other health problems that affect how well the lungs work.

Your doctor may also recommend pulmonary rehab before and after surgery for a lung transplant or lung cancer.

What Happens During Pulmonary Rehab?

To help design your pulmonary rehab plan, our team will administer one of the following tests:

Exercise stress test to measure your oxygen level, blood pressure, and heart rate while you exercise
Breathing tests to check how well your lungs are working
Six-minute walk test to measure how far you can walk in six minutes

Your pulmonary rehab plan may include the following training and education:

Breathing techniques
Education
Psychological counseling
Exercise training
Nutritional counseling

How Long is the Pulmonary Rehabilitation Program?

Usually, pulmonary rehab is a series of 2 or 3 weekly sessions, lasting several weeks or months. At the end of your program, you will be given tests to check your lung function again to see if your breathing has improved. Some of these tests, such as exercises tests, will be the same ones you had at the start of your program.

Our Respiratory Therapist

Medical Referrals

Some services offered require a referral from your primary care provider. Talk with your doctor about whether these programs are a good fit for you. To schedule an appointment, or for more information, give us a call at 515-462-5206.