Cardiac prehabilitation Programs: indications, implications, challenges and future directions

Introduction: Cardiac prehabilitation programs have emerged as effective multimodal strategies in preparing patients for elective cardiac surgeries. These programs aim to optimize the clinical condition of patients, especially the most vulnerable, reducing risks and improving postoperative outcomes. Objective: To summarize cardiac prehabilitation programs, analyzing their main indications, clinical benefits, implementation challenges and prospects for future research. Method: This is a critical narrative analysis based on a review of the current scientific literature on cardiac prehabilitation, focusing on studies that address program components, evidence of effectiveness and implications for clinical practice. Results: Cardiac prehabilitation programs include aerobic and strength training, respiratory muscle strengthening, nutritional support and psychobehavioral interventions. Evidence highlights significant improvements in functional capacity, reduced length of hospital stay, lower incidence of pulmonary complications and increased quality of life, especially among frail elderly patients and patients with comorbidities. Implementation requires careful planning and interdisciplinary action, with emphasis on the central role of nursing. Conclusion: The integration of cardiac prehabilitation into perioperative protocols represents an opportunity to improve clinical outcomes and the efficiency of health care. Investments in team training, organizational structure and future research are essential to consolidate this approach in clinical practice.