Occupation-specific, high-intensity cardiac rehabilitation for return to work of a young police officer after myocardial infarction from traumatic coronary artery dissection

Abstract

Following a traumatic coronary artery dissection and subsequent myocardial infarction from a nonpenetrating strike to the chest by an airborne metal pipe, a 33-year-old male police officer completed 12 weeks of high-intensity, symptom-limited cardiac rehabilitation in order to return to active duty. Physiological and perceptual responses to exercise were used to progress the patient through high-intensity activities that challenged the musculoskeletal and cardiorespiratory systems while simulating real work activities. In addition to substantial improvements in functional capacity (8.6 to 10.3 METS) and left ventricular ejection fraction (20% to 45%), the patient was able to fully return to work as an active-duty police officer.

Keywords: Cardiac rehabilitation; high-intensity; police officer; return to work; traumatic coronary artery dissection.

Figure 1.

High-intensity cardiac rehabilitation simulation activities for return to work of a 33-year-old active-duty police officer after myocardial infarction from traumatic coronary artery dissection. Warm-up and cool-down consisted of a fourth- to half-mile walk on an indoor track. Work intervals were interspersed with a one-lap walking active recovery (1/10th mile). Activities described are left to right. (a–c) Suspect chase and takedown with arrest. (d–f) Ball slams with a 12- to 20-lb weighted Dynamex ball, balance beam, and tire runs. (g–i) Hurdles (small, medium, large); agility cone shuffle and bear crawl with gear to simulate maneuver through obstacles in confined spaces.