June 27, 2018

Can I exercise after having a heart attack?

By dryeongs
Tai Chi is a gentle exercise that can be safely performed after a heart attack

Photo by Mark So on Unsplash

This is a common question for patients who have had heart attacks or ongoing heart problems.

Welcome to post #2 in my “Can I exercise…” series.

Exercise is important for post-heart attack recovery and for the prevention of future heart problems, but you have to be careful.

What exactly is a heart attack? As we all know, the heart is a muscle that pumps blood around the body, allowing your tissues and organs to receive oxygen and nutrients and function properly. The heart also supplies itself with blood to keep it going. If any of the blood vessels that supplies itself become blocked or damaged, this can restrict the blood flow to the heart, causing the muscle to have insufficient oxygen and to become damaged. This muscle damage eventually does heal by forming scar tissue, but the resulting scar tissue is never as good as the original muscle tissue. There are other ways you can get heart attacks, but the one I just described is the most common cause.

What does this mean? 1. It means that your heart is slightly damaged and won’t be as strong or as efficient as it was before and 2. If it happened once, it can happen again. Patients who have had heart attacks need to be closely monitored by their cardiologists and doctors to make sure it doesn’t happen again and to do all they can to prevent it from happening.

But I thought exercise was good for the heart. And it is. However, when you start running and doing exercise, your heart has to beat faster to send more blood to your muscles. If your heart is a little damaged, this can cause more stress to your heart. But that isn’t to say that your heart can’t be strengthened over time. Just like any damaged muscle, appropriate “rehab” in many cases, can bring your heart muscle to almost its full capacity again.

What is “heart rehab”? Straight after having a heart attack, patients in Australian hospitals are usually referred to “cardiac rehab” which helps them to start building up their heart strength again. This usually involves an exercise physiologist, possibly physiotherapists and other healthcare workers to support your rehab activities.

Each person’s rehab plan will be unique, depending on what their level of activity was prior to the heart attack and what their activity goals are for the future.


Safe exercise tips:
In general, you should start slowly and build up over several weeks. Walking or gentle stationary cycling are good activities to begin with. Tai Chi is also good as it is gentle and helps to improve balance and movement. Start with 10minutes, then gradually increase 5-10 minutes every week.

Be aware of how you feel. The best guide is you. If you’re feeling really tired one day, don’t exercise. If you’re down with a cold or virus, don’t exercise. And if ever you experience chest pain, shortness of breath, dizziness, or just don’t feel right while exercising, seek medical attention immediately.

Stay hydrated. Make sure you drink plenty of water before, during and after exercise, as getting dehydrated can affect your blood pressure and therefore your heart.

Make sure you can call for help at any time. Carry your phone with you, or exercise with a friend or family member. Tell someone where you are going and for approximately how long.

What about strength training? Resistance training is important for developing strong bones and muscles, and preventing injuries later in life. However these can increase your blood pressure in the short term, so avoid weight lifting straight after coming home from hospital. Discuss with your doctor first.

What if it’s been years since I’ve had a heart attack but I’m too scared to exercise? Then it’s best to involve the help of a professional. Your GP might be able to develop a GP Management Plan and Team Care Arrangement plan for you in conjunction with your heart specialist to involve an exercise physiologist. Exercise physiologists are kind of like personal trainers but have had special training in university to help patients with chronic diseases exercise safely.

As always, do not jump into high intensity, vigorous exercise immediately. Always work your way up to it and be aware of how you feel.

You can check out more tips from the Heart Foundation here.

If  you would like to see me to discuss your particular medical issues and how you can exercise safely, you can book an appointment here, or drop in to my walk-in bulk billed medical practice in Warringah Mall (next to McDonald’s).