Cardiac rehabilitation (CR), as originally proposed in the mid of last century, was primarily aimed at returning life back to normal, with emphasis on aspects of physical, mental and professional plenitude. At that time, a few paradigms were modified. Instead of four to six weeks of bed rest and immobilization following acute myocardial infarction, patients were oriented to sit on chairs, which was described as “armchair treatment“; right after, studies began to show the favorable results of early ambulation. This has evolved and currently the Brazilian Society of Cardiology guidelines proposing and advising how to implement and to start supervised exercise programs for CR. Those guidelines comprise aerobic, muscle strengthening and flexibility exercises to be started as soon as clinical stability is reached after myocardial infarction. Currently CR is aimed at providing patients with better or much better conditions than those prior to the cardiac event or the diagnosis of cardiovascular disease.

Although CR is a frequent and recurring theme of several presentations in scientific meetings of the specialty, being thus known by clinical cardiologists, there is worldwide consensus that only a very small part of patients with coronary artery disease is usually referred by their physicians for CR programs. Several are the reasons for that insufficient referral and they will not be addressed in this editorial.

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