The era of cardiac rehabilitation in the United States dates back at least thirty years, when Herman Hellerstein at Case Western Reserve, Andy Wallace at Duke and Ken Cooper in Dallas envisioned that a comprehensive lifestyle approach to the rehabi- tation and prevention of patients having had a cardiac event would potentially yield great benefits for the individual patient and the health care system. Until that time, the thought of vigorous exercise in the cardiac patient soon after an event was close to anathema. One of us (WEK) was introduced to Herman Hellerstein in Cleveland in the late 1960¿s, when his father sought medical opinion from him for a cardiac condition. WEK was introduced to Andy Wallace in 1979 by which time the latter had started a multidisciplinary, geographically regional cardiac rehabilitation program at Duke based upon consultations with Hellerstein and Cooper. By then, cardiac rehab- itation was progressing beyond the vision of exercise only, and since then the concept of cardiac rehabilitation has grown into the comprehensive multidisciplinary program that we know today and that we attempt to describe in this volume. The practice of cardiac rehabilitation has grown and metamorphosed in the last thirty years in parallel with the growth and metamorphosis of the practice of card- vascular medicine. During the formative stages of cardiac rehabilitation, the use of coronary care units was in its infancy. The coronary artery bypass operation was less than ten years old. The LIMA bypass had not been invented.

This volume serves as a manual to providers about the multidisciplinary nature of cardiac rehabilitation in the current era, the current state of cardiac rehabilitation, and the issues presenting to current CR programs. It contains theoretical, practical, and up-to-date cardiac rehabilitation information, including the new Center for Medicare and Medicaid Services (CMS) guidelines for reimbursement. The book offers diverse, comprehensive chapters, from nutrition to programmatic issues. It serves as a perfect resource for staff and directors that are new to cardiac rehabilitation or wish to begin a program.

Principles for Prescribing Exercise in Cardiovascular Disease.- Nutrition in Cardiac Rehabilitation.- References.- Assessment and Management of Depression in Cardiac Rehabilitation Patients.- Managing Stress to Manage Heart Disease.- Use of Readiness for Change in Cardiac Rehabilitation Programs.- Smoking Cessation: The Prescription that Every Smoker Should be Given.- Utility of Graded Exercise Testing in the Cardiac Rehabilitation Setting.- Graded Exercise Testing.- The Use of Cardiopulmonary Exercise Testing in Cardiac Rehabilitation: A Primer and Case Analysis.- Role of the 6-Minute Walk Test in Cardiac Rehabilitation.- Cardiac Rehabilitation: Statins and the Rationale for Implementation of Lipid-Lowering Therapy.- Treating to Goal: Diabetes and Hypertension.- Exercise in Patients with Cardiovascular Disease.- Exercise as a Therapeutic Intervention for Hypertension.- Diabetes Mellitus and Cardiac Rehabilitation in Clinical Practice.- Pulmonary Issues Related to Cardiac Rehabilitation.- Exercise Rehabilitation for Patients with Peripheral Arterial Disease.- Dealing with Arthritis as a Comorbidity in Cardiac Rehabilitation Programs.- Cardiac Rehabilitation for Elderly Cardiac Patients.- Expanding Your Model: Optimizing Referrals and Introducing Disease Management.- The Role of the Physician-Medical Director in Cardiac Rehabilitation.- Assessment and Treatment of Risk in the Clinic Setting.- Cardiac Rehabilitation Staffing.- Reimbursement Issues.