Cardiac Rehab is a Work of Heart

If you or a loved one has been diagnosed with heart disease or has suffered a heart attack recently, your health problems can be scary, worrisome and even confusing.

But with effort, experts say that you can slow or reverse the damage of heart disease, and even improve other health conditions like diabetes. The answer, they say, is an effective cardiac rehabilitation program and a solid team behind you all the way.

Cardiac rehabilitation is a program designed to help restore and maintain good health while reducing the risk of future heart problems. Cardiac rehab programs involve exercise, education, nutritional guidance and other support as you make key lifestyle changes, but some cardiac rehab programs are more intensive than others.

The Texas Health family of hospitals offers two cardiac rehab programs: a traditional program, and a more intensive program based on the Dr. Ornish Program for Reversing Heart Disease™ and Lifestyle Medicine approach. In fact, Texas Health was the first health system in the state to offer this second program when it was launched by Texas Health Arlington Memorial Hospital in 2015. A year later, Texas Health Fort Worth launched its program.


Two Program Choices

Beth Arseneau, Texas Health Arlington Memorial RN Case Manager, works with patients in the intensive cardiac rehab program.

So what’s the difference between these two approaches for improving health and preventing future problems?  The time commitment, for one. Traditional programs involve 36 sessions lasting approximately 60 minutes each. The focus is on monitored exercise and education on topics related to heart disease. On the other hand, in the intensive cardiac rehab program participants attend two four-hour sessions per week for 9 weeks. Each session includes equal time devoted to 4 key elements: exercise, nutrition, group support and stress management.

“Intensive cardiac rehab takes a high level of commitment by the participants and their loved ones,” said Anita Rigues, a cardiac rehabilitation nurse manager at Texas Health Fort Worth, Burleson and Willow Park. “Each of the four elements receives equal emphasis.”

“The Ornish program is a team approach,” Rigues continued “The program is delivered by an RN, an exercise physiologist, a social worker, a stress management facilitator and a registered dietician, with oversight by a physician medical director.”

In a traditional program, the nutritional emphasis involves healthier choices that include lean cuts of meat. The Ornish program provides resources and support to transition to an eating plan in which all dietary protein is derived from plant-based sources.


Benefits of the Intensive Rehab Program

“I tell patients that traditional rehab will help them recover from a heart attack or other cardiac diagnosis,” said Juzar Lokhandwala, the medical director of the Intensive Cardiac Rehab program and a cardiologist at Texas Health Arlington Memorial. “However, the more intensive program can alter the trajectory of heart disease and actually slow, or prevent, the progression.”

“Emotional health, exercise, stress management as well as dietary changes improve heart health,” Lokhandwala said. “In the intensive program it really helps if the entire family is supportive. The program group therapy sessions help, too,” he added. “It helps to have people who are going through the same things to talk to.”

“We’ve found that learning to manage stress is important in healing.  Depression is very common among heart attack patients, and working to address that is important.”


Texas Health Arlington Memorial Exercise Physiologists Angela Vizcaino and Halla Ali review an exercise plan with an intensive cardiac rehab patient.

It’s Never Too Late to Improve Your Health Habits

“It’s never too late to make changes,” Lokhandwala said. “You are born with a set of genetics — and that doesn’t change. But those modifiable risk factors like diet and exercise are where you can make changes.”

Making changes required by the Ornish program might not be what someone who isn’t currently suffering from heart disease wants to commit to.  However, Lokhandwala and Rigues said there are still good takeaways from both traditional and intensive cardiac rehab programs for anyone wanting to improve their heart health.

“Adopt a more plant-based diet, eat less red meat,” Lokhandwala said. “Improve your exercise routine. Engage in some mindfulness and stress reduction activities like meditation or yoga.”


Eating for Health and Longevity

Want to try a meatless dinner? Here’s an Ornish-friendly recipe that your family will love!

Chiles Rellenos
Source: Ornish Kitchen

Serves 4
Serving size: One pepper stuffed with ½ cup filling
Prep: 40 minutes
Cook: 45 minutes

2 cups yellow onion coarsely chopped
2 cups red, orange or yellow bell pepper, seeds and ribs removed, coarsely chopped
1 ½ tsp minced garlic
½ tsp fine sea salt, divided
¾ cup water, divided
8 oz tempeh, finely chopped
1 cup yellow corn kernels, fresh or frozen
1 14.5-oz can crushed fire-roasted tomatoes
2 tsp fresh oregano
¾ tsp ground cumin
½ tsp smoked paprika
⅓ cup cilantro, divided
4 fresh pasilla chile peppers, 6 oz. each, 1 1/2 lbs. total
¼ cup nonfat Monterey Jack cheese, shredded
¼ cup nonfat sour cream, optional


1. Preheat oven to 350 degrees. In a medium sauté pan over high heat bring onions, chopped peppers, garlic, ¼ tsp of salt and ¼ cup of water to a boil. Reduce heat to medium and cook, stirring frequently, until onions are translucent — about 8 minutes.

2. Add tempeh, corn, 1 cup of the crushed tomatoes, remaining ½ cup of water, oregano, cumin, remaining salt, and smoked paprika. Cook together over medium heat, stirring frequently, for about 10-15 minutes, until the mixture is thick and flavors have melded. If necessary, add a little more water to keep mixture from getting too dry. Remove from heat and let cool.

3. Over high heat on a gas stovetop or barbecue grill, lightly char the pasilla peppers one at a time. Turn peppers with tongs every 20-30 seconds for 2 to 2 ½ minutes, until skin is partially blackened. Pepper should be pliable, but still firm enough to hold its shape.

4. Pile the blackened peppers on a small bowl and cover with a plate or lid. Let peppers sit for 10 minutes, or until cool enough to handle.

5. Being careful not to tear the pepper, peel or scrape off the blackened skins. Slice off the stem end, then slice of the attached “seed bundle,” discarding the seeds but reserving the stem. Remove any remaining seeds or ribs inside the peppers.  Fold ¼ cup cilantro into the cooled tempeh filling. Taste for seasoning and add more smoked paprika if necessary.

6. Spread a thin layer (about ¾ cup) of the remaining tomato sauce on the bottom of a 7×11 inch baking dish. Spoon about ½ cup of the filling into each pepper. Replace the stems. Arrange the filled peppers onto the tomato sauce in the baking dish. Sprinkle cheese evenly over the peppers.

7. Cover the dish tightly with foil. Bake until peppers are tender and piping hot, about 40 minutes. Remove foil and bake for an additional 15 minutes, until cheese is golden brown.

8. To serve, spoon tomato sauce at the bottom of the dish over the peppers and sprinkle with remaining chopped cilantro. Serve each pepper with 1 Tbsp. of nonfat sour cream, if desired.

Nutrition: 289 calories per serving, 72 calories from fat.

Want to find out your heart age? Take our assessment here to gauge your risk, and to find out more about Texas Health heart health services near you, visit our Take our assessment here page.

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