April 22, 2019

Can You Exercise After a Heart Attack?

Absolutely! In fact, in many ways it’s key to recovery

Elderly man on treadmill

A blood-pumping workout puts extra demands on your heart. You can feel it, too, with every thumping heartbeat as you push through a weightlifting set, swim another lap or gobble up miles on a run or ride.

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So if you’ve had a life-threatening heart attack and experienced the pain and worry that comes with it … well, you might be a little hesitant to test your ticker again.

Know this, though: You CAN exercise again. In fact, it’s the best thing for your heart.

But there’s a deliberate process to getting back in action that should be followed. Let’s break it down with sports cardiologist Tamanna Singh, MD, and Cleveland Clinic Director of Cardiac Rehabilitation Erik Van Iterson, PhD.

Exercise during heart attack recovery

In the early days right after a heart attack, moving your body and activating muscles — particularly in your legs — is good for you. Try to get up and leisurely walk as much as possible even before you leave the hospital, says Dr. Van Iterson.

Consider every footstep part of your cardiac rehabilitation journey. “We want to stimulate recovery in a graceful, smooth and uneventful manner,” adds Dr. Singh.

Once at home, it’s important to take a sensible approach to being active. Gradually turn short strolls into longer walks as you recover and feel stronger. You’ll want to ease back into exercise with a slow-and-steady approach.

Focus on rebuilding your endurance and stamina, not on how strong you are and how much you can lift. The goal is to use exercise to heal — not for scaling Mount Kilimanjaro.

“The time you invest doing things slower with less intensity right off the bat is going to pay dividends when you’re six months or a year out from your heart attack,” says Dr. Singh. “Give yourself a little bit of grace.”

Benefits of cardiac rehabilitation

While it’s possible to design your own training program after a heart attack, consider this an ideal time to lean on the experts for help. Enrolling in a cardiac rehabilitation program can help you rebuild aerobic capacity and strength.

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Advantages of cardiac rehab include:

  • A best-practices approach. Outpatient cardiac rehabilitation programs provide supervised exercise training, nutrition (diet) education and physical activity counseling. Your safety during the process is the No. 1 priority, but a close second is ensuring you receive optimal therapeutic benefits.
  • Personalized exercise program. Cardiac rehab specialists develop a safe workout plan that fits you, your medical history and your current fitness level, whether you’re an athlete or someone new to working out.
  • Steady progression. Cardiac rehab is designed to slowly reintroduce and promote the continual progression of intentional exercise training in a safe and effective way. Exercise intensity levels can be dialed up as you improve stamina, get stronger, and rebuild confidence.

It should be noted that most outpatient cardiac rehab programs are covered by health insurance. A standard cardiac rehab program typically involves three sessions a week for a total of 36 sessions performed over three months.

However, it’s always good to contact your insurance provider before you get started in a program to confirm your coverage and the number of sessions allowed. Rehab session limits can vary depending on your plan.

Signs you’re overdoing it

Physically recovering from a heart attack requires patience — an attribute that’s often in short supply. It’s natural to want to push ahead, after all, admits Dr. Singh.

But when you push too hard, your body will let you know. Warning signs include:

  • A familiar pain. Remember how that heart attack felt? You may experience some of the same symptoms of chest pain, tightness and discomfort if you overdo it during the recovery process.
  • Shortness of breath. Consider it a red flag if you’re more winded than normal while doing a familiar activity. “If you’re gasping for air, it’s a sign you’re doing more than you should,” says Dr. Van Iterson. “An effective workout does not need to make you out of breath and or mean going until you can’t physically continue.”
  • Fatigue. Exercise can make you tired, of course … but if you’re exhausted following a post-heart attack workout it may indicate you’re asking your body to do more than it is ready to handle.
  • Feeling lightheaded or dizzy.

“It’s important to listen to your body and don’t minimize what you’re feeling,” suggests Dr. Singh. “The more attuned you are to what’s going on the better we’ll be able to develop a plan of action moving ahead.”

Can you get back to high-intensity exercise?

A heart attack doesn’t have to mean the end of high-intensity exercise. In theory, any exercise can be fair game after a heart attack, says Dr. Van Iterson. Just know that it’ll take time to get there.

What you can do — and how soon you can do it — depends on a variety of factors, including:

  • Your current health and fitness level.
  • Past experience with exercise training.
  • Damage done to your heart muscle during the heart attack.
  • The complexity of any procedure done following your heart attack.

“There are so many different things that go into the timing of when you can return to exercising and the intensity of what you can do,” says Dr. Singh. “But the more you invest in following a gradual process, the more successful you will probably be in getting to the level you want.”

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There are no guarantees, of course. Some people find that they can’t return to the same level of training following a heart attack and need to adjust their expectations and goals. “Every case is different,” notes Dr. Singh.

Work with your healthcare provider and cardiac rehabilitation team to figure out a reasonable plan and pace of progression.

Moderate exercise is OK, too

While staying active is important for your health following a heart attack, high-intensity workouts are not a requirement or necessarily more beneficial than moderate-intensity workouts. Cardiac rehab doesn’t need to mimic training for an IRONMAN® competition.

“You don’t have to go for maximal exercise for it to be effective,” emphasizes Dr. Van Iterson. “Focus on setting realistic goals that are rewarding, build upon one another and help you get started for the first time or get back to exercising in a safe and enjoyable way.”

Acknowledge exercise fears

Don’t underestimate the mental aspect of restarting an exercise program, either. Dr. Singh says she encourages people who go through a heart attack or other cardiac event to talk to a psychologist, psychiatrist, therapist or counselor.

“Something just happened to a pivotal life organ in your body,” says Dr. Singh. There is going to be stress and concern. Talking to someone is a way to build some confidence and reassurance to move forward while feeling safe.”

Final thoughts

Exercise isn’t just possible after a heart attack. It’s necessary to make you and your heart stronger for the years of life ahead.

“Exercise is huge in the recovery process from a heart attack and key to preventing future heart attacks and further damage,” says Dr. Singh. “I can’t emphasize enough how important it is to get moving in some way.”

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