Peak Exercise Capacity and Angina Threshold Improvement after Cardiac Rehabilitation in a Patient with Stable Angina and Low Hemoglobin

Abstract

Cardiac rehabilitation (CR) is recommended for all patients with stable angina (SA) as an effective treatment. Hemoglobin (Hgb) levels predict exercise performance and may affect symptom threshold in SA patients. A multidisciplinary CR intervention was individually tailored for a 72-year-old patient with a diagnosis of SA, low Hgb (<10 g/dL), and typical chest pain at light-to-moderate exercise (<5 metabolic equivalent task), who was stratified as at high risk for cardiac events during exercise. Two symptom-limited exercise tests were performed before and after 36 sessions of supervised exercise training producing near-optimal accumulated total volume load and chronic training load. In this case report, we show that an individually tailored CR intervention in a patient with SA and low Hgb is feasible, effective, and safe at reducing the burden of symptoms while increasing peak exercise capacity, health-related quality of life, and physical activity engagement.