The Ultimate Guide to Cardiac Rehabilitation: What to Expect After a Heart Event

Recovering from a heart event — whether it’s a heart attack, heart surgery, stent procedure or another cardiac procedure — can be physically and emotionally challenging. You might have questions about how soon you’ll feel better, what exercise you can safely do, and how to reduce the risk of another event. Cardiac rehabilitation (cardiac rehab) plays a central role in recovery and lifelong heart health, giving you the support and confidence to return to everyday life safely.

In this guide we break down:

• The clinical phases of cardiac rehabilitation

• The multidisciplinary team that supports you

• What each stage looks like in practice

• Safety protocols and return-to-exercise principles

• What to expect in real life

This is designed to be reassuring, evidence-informed and practical — reflecting both best practice and the experience of patients in the Australian healthcare system.

What Is Cardiac Rehabilitation?

Cardiac rehabilitation is a structured programme of exercise, education and support designed to help you recover after a cardiac event, reduce your risk of further heart problems, and improve your quality of life. It’s recommended for people who’ve had:

• A heart attack

• Coronary artery stents or angioplasty

• Heart surgery (bypass, valve repair/replacement)

• Chronic heart disease or heart failure

• Cardiac arrest or rhythm problems

• Certain device implants (e.g. pacemaker)

A cardiac rehab programme combines exercise training, risk factor education, lifestyle advice and psychological support with medical and allied health input, helping you get back to the things you value.

The Phases of Cardiac Rehabilitation

In Australia, cardiac rehabilitation is typically delivered in three main phases (sometimes described in four stages in international literature), progressing from early recovery in hospital through to long-term well-being.

Phase 1 — Inpatient (Hospital) Phase

When: Begins as soon as medically stable in hospital — usually within 1–3 days after your heart event or surgery.

Focus: Early mobilisation, preventing complications, education and planning for discharge.

What happens:

• Gentle movement and sitting up, progressing to short walks

• Breathing exercises and circulation work to reduce chest/lung complications

• Basic advice on medication, symptom recognition, lifestyle changes

• Education on heart health and setting expectations for recovery

  
  

Why it matters:

Even simple movement — like sitting up, standing and walking short distances — helps reduce deconditioning that happens during bed rest in hospital. You also begin learning about your heart condition and what comes next. By the end of this phase, you and your care team will usually have a plan for when and how your next phase of rehab begins.

Phase 2 — Outpatient (Supervised Rehabilitation Program)

When: Usually starts within 1–6 weeks after discharge, depending on clinical recovery and your cardiologist/GP recommendation.

Duration: Commonly 6–12 weeks, often with 2–3 sessions per week.

Focus: Structured, individually tailored exercise with close monitoring; education on risk factors and lifestyle change.

What happens:

• Supervised exercise sessions — aerobic activities such as walking, cycling, treadmill work, guided by heart rate and perceived effort

• Education sessions — nutrition, stress management, medication adherence, quitting smoking support

• Strength training — light resistance work to help regain muscle strength

• Monitoring — blood pressure and heart rate checks, sometimes ECG monitoring during exercise

Why it matters:

This is often considered the “core” part of cardiac rehab because you’re actively rebuilding cardiovascular fitness and confidence in a safe, monitored setting. It’s normal to feel challenged here — but you’re not alone. Your cardiac rehab team will adjust exercise to your ability and progress at your pace.

Phase 3 — Community or Maintenance Rehabilitation

When: After completion of your supervised programme or as part of a longer outpatient journey.

Focus: Building independence, transitioning exercise into everyday life, maintaining and improving gains from Phase 2.

What happens:

• Exercise may take place in community settings, gyms, home programmes or longer-term rehab clinics

• Regular activity is encouraged based on your preferences (walking groups, swimming, cycling, heart-healthy classes)

• Focus on sustaining heart-healthy habits and continued risk factor management

Why it matters:

Phase 3 helps bridge you from supervised rehab into a long-term, sustainable lifestyle. The aim is not just fitness, but confidence and autonomy — understanding how to maintain a heart-healthy routine that suits your life.

Who’s On Your Cardiac Rehab Team?

Cardiac rehabilitation is multidisciplinary — meaning multiple health professionals work together to support your recovery and long-term heart health. This may include:

• Cardiologists and physicians – medical oversight and clearance

• Physiotherapists – exercise prescription, safety monitoring and functional guidance

• Exercise physiologists – tailored exercise sessions and progression

• Nurses – education, clinical checks and continuity of care

• Dietitians – nutrition support and food guidance

• Psychologists or counsellors – mood, coping and behaviour support

• Pharmacists – medication advice and reconciliation

This team works collaboratively so your programme feels tailored to you, rather than one-size-fits-all.

Safety Protocols: Making Exercise Safe After a Heart Event

Safety is central to cardiac rehab. Programs use clinical monitoring and individualised thresholds when prescribing activity. Standard safety measures include:

• Monitoring vital signs (heart rate, blood pressure)

• Progressing exercise based on symptoms and tolerance

• Starting at low intensity and gradually increasing

• Using perceived exertion scales alongside clinical readings

• Educating about warning signs (e.g. unusual chest discomfort, dizziness)

Cardiac rehab is considered safe, with low rates of adverse events when delivered in experienced programmes. It also provides reassurance and structured increase in activity rather than guessing on your own.

What Exercise Looks Like in Cardiac Rehab

Exercise prescription in cardiac rehab is individualised — it reflects your medical history, baseline fitness and recovery progress. Commonly included exercises are:

• Walking (treadmill or outdoor)

• Stationary cycling

• Light strength work (bands, light weights)

• Flexibility and balance work

• Progressions to more dynamic activities as tolerated

Your rehab team will help you understand not just how to exercise safely, but how to integrate it into your life long-term.

Everyday Expectations: A Gentle Timeline

Below is a simplified overview of how cardiac rehab typically unfolds (individual experiences vary):

Hospital stay (Phase 1): Gentle mobilisation and education before discharge

2–6 weeks after discharge (Phase 2): Structured, supervised exercise and education

3+ months onward (Phase 3): Transition to ongoing heart-healthy activity

Lifelong habits: Continued physical activity and risk factor management

Common Myths and Plain English Realities

Myth: “Exercise after heart surgery must be intense.”

Reality: Exercise is progressive and tailored, starting very light and increasing safely over weeks.

Myth: “It’s normal to just rest and do nothing.”

Reality: Early mobilisation and guided activity are part of safe recovery and help prevent deconditioning.

Myth: “I should only start rehab months later.”

Reality: Research supports early engagement — starting in hospital and continuing soon after discharge — to get the best outcomes.

When to Seek Help During Cardiac Rehab

You should stay in touch with your medical and rehab team if you notice:

• New or worsening chest discomfort

• Unusual shortness of breath

• Light-headedness not explained by exertion

• Palpitations or irregular heart sensations

• Persistent limb swelling or pain

If you’re ever unsure about a symptom or how hard you should be working, ask your healthcare provider — treatment is safer when guided, not guessed.

Final Thoughts: Recovery Is a Journey, Not a Race

Cardiac rehabilitation guides you from the hospital bed to lifelong heart health. It’s not just about exercise — it’s also about understanding your heart, managing risk factors, and building confidence to enjoy daily life again.

Cardiac rehab can help you return to walking the dog, playing with grandchildren, or just feeling more confident on your feet. It’s about quality of life as much as fitness.

If you’d like guidance tailoring these stages to your own recovery — or aren’t sure where to start — a physiotherapist trained in cardiac rehab can help you navigate the next steps with confidence.

We’re always happy to help you take the next step in your recovery.