Physical activity and cardiac rehabilitation after myocardial infarction: the risk of obtaining large benefits

Cardiac rehabilitation (CR) is a cornerstone in the management of patients recovering from myocardial infarction (MI), significantly improving survival, functional capacity, and quality of life. Recent evidence highlights the critical importance of early initiation of rehabilitation, ideally within days to weeks following the acute event. Early cardiac rehabilitation facilitates prompt recovery of cardiovascular function, reduces complications, and enhances patient motivation and adherence to therapeutic regimens. The multidimensional nature of modern CR programs addresses not only physical reconditioning but also psychological, nutritional, and social factors, recognizing the complex interplay affecting patient outcomes. Physical exercise training, tailored to individual risk profiles and functional status, promotes myocardial perfusion, endothelial function, and autonomic balance. Concurrently, psychosocial support targets anxiety, depression, and stress, common sequelae post-MI, which are known to influence prognosis negatively. Nutritional counseling ensures optimal dietary patterns that support cardiovascular health, while smoking cessation and risk factor management are integral components. The multidisciplinary team - comprising cardiologists, physiotherapists, dietitians, psychologists, and nurses - collaborates to develop personalized care plans that maximize patient engagement and long-term adherence. Early, multidimensional cardiac rehabilitation ultimately reduces rehospitalization rates and mortality, improving comprehensive health outcomes. This review underscores the value of initiating rehabilitation promptly after MI and implementing a holistic approach to enhance recovery, prevent recurrent events, and promote sustained lifestyle changes.