In-Patient Cardiac Rehabilitation in Rheumatic Heart Disease: Insights from a Case Series

Abstract Background: Rheumatic heart disease (RHD) remains a major cause of valvular heart disease in developing countries. Patients may experience dyspnea, fatigue, reduced exercise tolerance, and functional limitations, particularly during hospitalization and after cardiac surgery. However, evidence regarding the clinical benefits of early Phase I cardiac rehabilitation in hospitalized patients with RHD remains limited. This case series evaluated the effects of structured in-patient cardiac rehabilitation on clinical and functional outcomes in patients with RHD admitted to the intensive care unit (ICU). Materials and Methods: Five patients aged 36–55 years with confirmed RHD underwent a structured Phase I cardiac rehabilitation program comprising breathing exercises, graded activity progression, early mobilization, and continuous monitoring. Outcomes assessed before and after rehabilitation included the ICU mobility scale (IMS), New York Heart Association (NYHA) functional classification, Functional Status Score for the ICU, ejection fraction (EF), and World Health Organization Quality of Life questionnaire. Results: Mean IMS scores increased from 1.6 to 8.4, indicating improved mobility. NYHA functional classification improved from Class III–IV to Class I–II, while mean EF increased from 53.6% to 58.6%. Functional independence and quality-of-life scores also improved following rehabilitation. Conclusion: Early Phase I cardiac rehabilitation improved mobility, functional independence, and quality of life in hospitalized patients with RHD. However, these preliminary findings require confirmation in larger controlled studies.