How Hard Can You Exercise After a Heart Attack?

How to exercise safely after a cardiac event

Elderly man on treadmill

You would love to get back to your daily run — the wind on your face and your favorite podcast in your ears. But if you recently had a heart attack, it can be downright scary to think about taking a jog or hitting the gym.

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Will you ever be able to break a sweat without panic?

It’s possible, says Erik Van Iterson, PhD, MS, clinical exercise physiologist and director of Cardiac Rehabilitation. Give it some time and take the right steps, and you can even get back to running and the other high-intensity activities you once loved.

“Don’t be afraid to exercise,” Dr. Van Iterson says. Here’s how to get back in the groove.

Exercise after a heart attack: Cardiac rehab can help

Moving your muscles is good for you — even in the early days after a heart attack. Try to get up and walk as much as possible even before you leave the hospital, Dr. Van Iterson says.

And once at home, plan to at least keep your walking exercise going on a regular basis. While it’s possible to design your own training program after a heart attack, it’s a good time to lean on the experts for help. That’s what cardiac rehabilitation is for.

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Advantages of cardiac rehab:

• You’re under expert care: Cardiac rehabilitation programs provide exercise and nutrition education and supervised physical activity. Your safety is the No. 1 priority.
• It’s designed for you: Cardiac Rehab specialists develop a safe workout plan to get you started. As you get stronger and re-build confidence, expect to dial up the intensity.
• You’ll ramp up, slowly: “Cardiac rehab is designed to slowly reintroduce physical activities in a safe way,” Dr. Van Iterson says.
• It’s probably covered by insurance: Most outpatient cardiac rehab programs are covered by insurance. So if your cardiologist hasn’t mentioned it, now’s the time to ask for a referral.

High-intensity exercise: Yes or no?

As you might expect, you’ll want to ease back into your workouts. Focus on healing, not scaling Mount Kilimanjaro. Over time and demonstrating consistency with your plan, you can most likely get back to the activities you love — even the high-intensity variety.

In theory, any exercise can be fair game after a heart attack, Dr. Van Iterson says. But that doesn’t mean anyone can (or should) become an ultramarathoner after a cardiac event.

• Do what’s right for you: What you can do — and how soon you can do it — depends on many factors, including your current health and fitness level. Your doctors and cardiac rehab team can help you figure out a reasonable plan and pace of progression.
• Work hard but not too hard: How intense should your workouts get? Breaking a sweat is totally cool, but you shouldn’t gauge your intensity by how much you sweat. If you’re gasping for air, that’s a sign you’ve pushed too hard, says Dr. Van Iterson. And if you have any pain or discomfort in your chest, back off and talk to your doctor, he adds.

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Moderate intensity exercise is A-OK, too

It’s also OK not to push yourself as hard as you used to. If you love running and want to get back to it, that’s a great goal. But you don’t need to work out at maximum intensity to be healthy, and in-fact, in most cases you shouldn’t be exercising at max intensity every time you go out to exercise. Giving 100% effort doesn’t have to mean 100% intensity.

Don’t beat yourself up if you decide that high-intensity training isn’t the best choice right now — even if it used to be your jam. “You don’t have to go for maximal exercise for it to be effective,” Dr. Van Iterson points out.

There is no one right way to exercise after a heart attack, as long as your goals are realistic. “You might not get to your pre-heart attack level,” Dr. Van Iterson says. “That was a different time in your life. If you can acknowledge that, you can set realistic goals that are still rewarding while getting back to a challenging level of exercise in a safe way.”

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