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Medical Disability Advisor  >  Angina Pectoris  >  Rehabilitation

Angina Pectoris


Related Terms


  • Angina
  • Angina Attack
  • Angina Syndrome
  • Cardiac Angina
  • Exertion Angina
  • Stable Angina
  • Vasomotor Angina

Differential Diagnoses


Specialists


  • Cardiovascular Internist

Comorbid Conditions


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Factors Influencing Duration


The ability to return to work depends on the type and outcome of treatment, severity of residual symptoms, other medical conditions, and demands of the individual's occupation. The individual's willingness to address correctable risk factors such as smoking, sedentary lifestyle, and obesity will influence the length of disability. For some individuals, cardiac rehabilitation may facilitate return to optimal function.

Duration Trends from Reference Data


DURATION TRENDS
 ICD-9-CM: 413, 413.9  
CasesMeanMinMaxNo Lost TimeOver 6 Months
20555103050.2%3.8%
 
  
 
Percentile:5th25thMedian75th95th
Days:6143171167
 
  
 

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes


ICD-9-CM:
411.1 - Intermediate Coronary Syndrome; Impending Infarction; Preinfarction Angina; Preinfarction Syndrome; Unstable Angina
413 - Angina Pectoris
413.1 - Prinzmetals Angina; Variant Angina Pectoris
413.9 - Angina Pectoris, Other and Unspecified

Rehabilitation


Cardiac rehabilitation can be very helpful and is often prescribed for individuals with angina pectoris. With a specifically designed exercise program, an individual with angina pectoris can decrease his or her chest pain and substantially improve fitness levels. Rehabilitation addressing angina pectoris is progressed throughout phases used in many other cardiac conditions.

Phase 1 often begins with low levels of exercise to prevent excessive stress and overexertion and promote overall mobility of the body. Exercise may begin in the coronary care unit of a hospital starting with low-level exercise in the supine position. The individual progresses with exercises to sitting and eventually to standing. Progressive walking (ambulating) and eventual stair climbing are an important part of individual's exercise program while hospitalized.

Phase 2 usually begins after the individual is discharged from the hospital. Individuals not hospitalized because of angina pectoris usually begin at this phase. Goals are to improve functional capacity by increasing physical endurance and promoting return to activity. This is done in an outpatient setting such as a rehabilitation center. Individuals are typically attached to an ECG monitor, a device used to record the continuous electrical activity of the heart muscle. A physical therapist keeps a daily log of the individual's blood pressure, heart rate, and cardiac rhythm, both during exercise and at rest.

Phase 3 continues in the outpatient setting such as a rehabilitation center. Usually 3 to 6 months have lapsed from the start of rehabilitation to this point. Depending on the individual's condition, this phase may last for several months. Individuals may stay involved with an outpatient program for up to a year to accomplish all their goals. Eventually, the patient is advanced to higher levels of exercise with the addition of recreational activities as tolerated. This should be supplemented by an increase in daily lifestyle activities such as walking breaks at work, using stairs, gardening, and household work. Individuals should also be encouraged to decrease weight and stop smoking if necessary, in addition to increasing daily exercise.

Modifications may be needed in the rehabilitation program if anxiety or musculoskeletal pain occurs. Relaxation techniques and counseling may help determine the sources of the anxiety. Inflammation of the cartilage of the rib cage and/or sore chest muscles can also interfere with the rehabilitation process and should be addressed.

Source: Medical Disability Advisor






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