Our team provides treatment to adults over the age of 18 years and specialise in providing assessment and treatment to outpatients who have heart problems and breathing pattern disorders.
Overview
The service is led by a Highly Specialist Physiotherapist; this means that we can provide you with the most effective treatment for your problem.
We work as part of a team which includes Consultant Cardiologists, Cardiac Specialist Nurses, Clinical Psychologists and Exercise Professionals.
We will help you to understand your symptoms, help you to be active safely and help you to self-manage your condition.
Our Physiotherapists assess and treat people who have a variety of needs, these may include problems with: everyday activities, return to work, sport, walking, shortness of breath, pain and dizziness.
Treatments include: supporting change to a healthier lifestyle, breathing re-education, pain management, anxiety management/relaxation, personalised exercise advice and advice on returning to hobbies and work.
We can refer you to the next stage of your recovery with the STEPS to health team who will offer you activity and education classes in the community for up to 12 weeks. Referrals can also be made to long term supervised exercise programme at Sunderland Cardiac Support Group
We also see out patients who are referred to us with breathing pattern disorders also known as hyperventilation or dysfunctional breathing. This can be due to a variety of reasons including heart problems, respiratory issues and anxiety.
Contact us
To change/cancel a first appointment or a follow up appointment: 0191 5410101
The office is open:
- Monday to Thursday – 7.30 am to 7 pm
- Friday – 7.30 am to 6 pm
- Saturday – 8 am to 1 pm
Change a follow up appointment online here: https://chsft.egressforms.com/appointments
Physiotherapy Reception: 0191 5699028
Core Hours: Monday-Friday 08.00-16.30
Finding us
Cardiac Physiotherapy Outpatient Services provide therapy that is predominantly hospital based and includes home based therapy on a needs basis.
You can find us at Sunderland Royal Hospital entrance 8.
Core Hours: Monday – Friday: 08.30 – 16.30
Referral
You are able to access physiotherapy with a referral from a Consultant Cardiologist, Respiratory Consultant, Cardiac Specialist Nurse or a GP.
Your first appointment
We provide all of our patients with a face to face initial appointment.
We will telephone our cardiac patients who have been hospitalised following discharge home. This is to find out how you are managing and to arrange an appointment to see a qualified physiotherapist.
At your first appointment we will discuss how your symptoms are affecting your function and we will start to put together a treatment plan with you. This appointment will take about 60 minutes; follow up appointments will be shorter than this.
Please bring with you:
- List of current medication
- Medication you need in case of an unforeseen delay
- GTN spray if you have one
- Some patients find it useful to write a few questions in advance of the appointment
- If you are diabetic and have a blood testing machine pleases bring it to your assessment
- Inhalers if you need one
- Wear loose fitting, comfortable clothing and supportive footwear
- Any discharge letters you have from other hospitals relating to your heart problem
Conditions
Angina
Angina is a pain or discomfort felt in your chest, this is usually caused by coronary heart disease. This usually feels like a heaviness or tightness in your chest and can spread to your arms, neck, stomach or jaw. Some people may only feel breathless and have no discomfort at all.
Coronary heart disease is the term that describes what happens when your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries. This process is known as atherosclerosis and the fatty deposits are called atheroma. Atherosclerosis can be caused by lifestyle factors and other conditions, such as diabetes, high blood pressure and high cholesterol.
Angina is usually managed by preventative medication which you take daily. You may also have a GTN spray or tablets which you can use when you have the pain for quick relief.
Physiotherapy can advise you on how to build up your fitness and manage your symptoms. We will check your blood pressure and pulse and observe how your heart is working whilst you are walking. We can also support you to change to a healthier lifestyle.
Useful links:
British Heart Foundation: https://www.bhf.org.uk
Cardiomyopathy
Cardiomyopathy is a general term for diseases of the heart muscle, where the walls of the heart chambers have become stretched, thickened or stiff. It can be an inherited disease of the heart muscle which makes it difficult for the heart to pump blood to other parts of the body. There are different types of cardiomyopathy and include hypertrophic cardiomyopathy and dilated cardiomyopathy.
Physiotherapy can advise you on how to build up your fitness and manage your symptoms. We will help you to manage your fatigue by showing you how to pace activities. We will check your blood pressure and pulse and observe how your heart is working whilst you are walking.
We can refer you to the STEPs to health exercise programme where you can exercise twice a week in a supervised environment for 6 weeks or you can chose to do an individualised home programme. If you decide to have an individual programme we will be able to review you either on the telephone or at a face to face consultation in the department.
Useful links
Cardiomyopathy UK https://www.cardiomyopathy.org
British Heart Foundation: https://www.bhf.org.uk
Coronary angioplasty
Coronary angioplasty is a treatment that helps to widen the coronary artery and improve the blood supply to your heart if you have a blockage in your artery. A special kind of balloon is gently inflated inside the coronary artery to expand the artery and often a stent is placed in your artery to allow the blood to flow freely again. You may have more than one stent placed in the artery. This will reduce your angina symptoms so you have less or even no chest pain following the procedure and will be less breathless.
Physiotherapy can advise you on how to build up your fitness following your procedure and advise you on how to manage your symptoms. We can also support you to change to a healthier lifestyle. We will check your blood pressure and pulse and observe how your heart is working whilst you are walking.
We can refer you to the STEPs to health exercise programme where you can exercise in a supervised environment or you can choose to do an individualised home programme.
Useful links:
British Heart Foundation: https://www.bhf.org.uk
Heart attack or primary PCI
A heart attack can also be called acute coronary syndrome or myocardial infarction( MI). This occurs when the blood supply to the heart muscle is suddenly blocked usually by a blood clot. Early treatment to get the blood flowing to the damaged part of your heart muscle again can save your life and limit the amount of permanent damage to your heart muscle.
You might be taken to the catheter laboratory for an emergency angiogram which will show if you need a stent inserted into your arteries: please see angioplasty for more details.
Physiotherapy can advise you on how to build up your fitness following your procedure and how to manage your symptoms. We can also support you to change to a healthier lifestyle. We will check your blood pressure and pulse and observe how your heart is working whilst you are walking. We will help you to return to your hobbies and get back to work again. Many people are more active following their heart attacks than they were before.
It is often a shock to have a heart attack and we can support you emotionally and can refer you for extra support from the clinical psychologist if you require it.
Our team has specialist skills in being able to assess your breathing pattern which is can change after a heart attack. We will show you breathing exercises and relaxation techniques to do at home. We will teach you to be able to recognise when chest pain is coming from the heart and when it is due to muscular or breathing issues. This will enable you to feel in control of your chest symptoms and to know what to do should you feel discomfort.
We can refer you to the STEPs to health exercise programme where you can exercise in a supervised environment or you can chose to do an individualised home programme.
Useful links:
British Heart Foundation: https://www.bhf.org.uk
Heart surgery
Heart surgery includes valve surgery and coronary artery bypass surgery:
Coronary Artery Bypass Surgery (CABG)
A CABG is a surgical procedure where the surgeon bypasses the blockage using a blood vessel from another part of your body. The sternum is cut to do this procedure and wired.
This surgery is used when the coronary arteries are twisted and cannot be corrected with a stent or when stents have furred up again (re-stenosis) or if the patient has several blockages over 70% in different arteries.
Valve Replacement
A valve replacement is surgery to a diseased or damaged valve which can be repaired or replaced with a tissue valve usually a pig valve or with a mechanical valve. The sternum is cut to do this procedure and wired.
Common valves replaced are:
- Aortic
- Mitral
- Pulmonary valve in congenital pathologies
It is important that if you have had surgery where they have had to open your sternum that you do not do any lifting or pulling for 12 weeks post-surgery.
Physiotherapy can advise you on how to build up your fitness following your procedure and how to manage your symptoms. We can also support you to change to a healthier lifestyle. We will check your blood pressure and pulse and observe how your heart is working whilst you are walking.
Following surgery you may experience breathlessness on effort, fatigue and sometimes chest pain.
Breathlessness can take 3 months to settle post operatively. Our team has specialist skills in being able to assess your breathing pattern; we will show you breathing exercises and relaxation techniques to do at home.
Chest pain can be due to heart, muscular or breathing issues. We will teach you to be able to recognise when chest pain is coming and this will enable you to feel in control of your chest symptoms and enable you to know what to do should you feel discomfort.
We can refer you to the STEPs to health exercise programme where you can exercise twice a week in a supervised environment for 6 weeks or you can chose to do an individualised home programme.
Useful links:
British Heart Foundation: https://www.bhf.org.uk
Pacemaker and or Implantable Cardioverter Defibrillator (ICD)
Pacemaker
A pacemaker is a medical device that uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or there is a block in the heart's electrical conduction system.
Implantable Cardioverter Defibrillator (ICD)
An ICD consists of leads/electrode which are passed through a vein into your heart and then connected to a pulse generator box (approximately the size of small matchbox)and is implanted under skin in upper chest, near the collar bone.
An ICD combines a cardioverter and a defibrillator into one implantable unit. The device is programmed to detect abnormal heart rhythms and correct them by delivering a brief electrical impulse to the heart.
Some patients have a combined a pacemaker and an ICD in a single implantable device. Others have multiple electrodes stimulating differing positions within the heart to improve synchronisation of the lower chambers (ventricles) of the heart.
The arm where the pacemaker or the ICD has been fitted (usually the left) should not be lifted above shoulder level before your first medical follow-up appointment, normally 6 weeks since insertion.
Gentle arm and shoulder exercises should be encouraged at this stage.
Vigorous or violent movement of the arm should be avoided during the first 6 weeks.
Unnecessary lifting or weight bearing should be avoided during the first 6 weeks.
Physiotherapy can advise you on how to build up your fitness following your procedure and how to manage your symptoms. We can discuss any mobility issues you may have including provision of walking aids as required. We can also support you to change to a healthier lifestyle.
Useful links:
British Heart Foundation: https://www.bhf.org.uk
Sunderland Cardiac Support Group: sunderlandcardiac.org.uk
Breathing Pattern Disorders
Breathing pattern disorders affect people in different ways some people and make you feel short of breath and this can be associated with chest pain. You may have undergone many tests usually with no abnormalities found before being referred to physiotherapy.
Physiotherapy will assess your breathing and we will teach you breathing exercise to do at home. The assessment also considers life style, fitness, anxiety and stress. We are able to offer lifestyle, fitness and relaxation advice; we can also refer you to other services if this is needed.
Treatment includes face to face contact and you will need to do a home programme too. It takes time for changes to take place usually 4-6 weeks before you will notice any improvement.
Useful links:
Physiotherapy for breathing pattern disorders resources ...
