[Clinical cardiac rehabilitation].

Outpatient cardiac rehabilitation (CR) is offered in at least 100 hospitals in the Netherlands. The majority of cardiac patients are well-served with physical training and education. Some patients with complex cardiac pathology and other problems, including health problems, may however benefit from multidisciplinary in-hospital CR. We present three cardiac patients. The first patient, a 58-year-old man, had coronary and pulmonary disease, suboptimally treated diabetes and psychological problems. He participated in in-hospital CR for 7 weeks, which led to an improved physical and emotional condition. The second patient was 80 years old and did not recover properly following an aortic valve replacement. With in-hospital CR she acquired new skills for mastering the activities of daily life. The third patient we described, a 57-year-old man, suffered from ischaemic heart failure and had had recurrent implantable cardiac defibrillator (ICD) shocks. He was referred for cardiac transplantation but 7 weeks of in-hospital CR resulted in an improved exercise tolerance, significant weight loss and an adequate level of coping with his disease. In-hospital CR is a niche service, but may provide relief for some cardiac patients.