What happened?
A 47-year-old woman presented with exertional dyspnoea and severe heart failure, with a left ventricular ejection fraction of 13.1%. The case illustrates how supervised cardiac rehabilitation and activity-intensity guidance supported a gradual return to employment.
Clinical findings
- Echocardiography showed markedly reduced left ventricular ejection fraction and elevated brain natriuretic peptide.
- Cardiopulmonary exercise testing identified an anaerobic-threshold heart rate used to guide activity intensity.
Rehabilitation described in the report
- After medical stabilization, graded early mobilization and bicycle ergometer exercise were introduced during admission.
- Outpatient cardiac rehabilitation combined aerobic exercise, resistance training, education and home-activity guidance.
- A wearable device monitored pulse rate, with activity initially kept at or below the heart rate associated with anaerobic threshold.
Reported outcomes
- The patient gradually resumed work, initially for limited hours and frequency.
- Five months after discharge, she was working four days per week for eight hours without reported worsening of heart-failure symptoms.
Clinical lessons to consider
- Cardiac rehabilitation can include vocational goals and activity pacing, not only exercise capacity.
- Use individualized clinical thresholds and symptom monitoring when progressing activity after severe heart failure.
Limitations — what this case cannot tell us
- A single case cannot establish that wearable-guided activity management is suitable for every patient with heart failure.
- Concurrent medical treatment means recovery cannot be attributed to rehabilitation alone.
Original source
Kazufumi Kitagaki, Yuji Hongo, Rie Futai, Takeshi Hasegawa, Tatsuyoshi Azuma, Hiroshi Morikawa, Hazuki Koizumi, Takuya Kiyohara, Hisashi Shimoyama. “Comprehensive Cardiac Rehabilitation Utilized to Support a Patient With Heart Failure in Balancing Treatment and Work: A Case Report.” Journal of Cardiology Cases, 2025. DOI: 10.1016/j.jccase.2024.10.003
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