Exercise after heart attack

a word to the wise.

home health information on exercise after a heart attack Exercise after heart attack is serious - it's a fine line to walk. You can always count on disease or trauma to leave weak links in your body system. Myocardial infarctions (or heart attacks) are no exception. This is why prevention is so much easier and economical to pursue than the bill and heart ache (pardon the pun) of the lifestyle lived before the heart attack, the pain and trauma during, and the blood, sweat and tears after discharge from the hospital!

But, you're here now... so let's move towards a better, healthier life, while at the same time using wisdom and precaution to avoid the onset of more heart attack symptoms.

Your heart attack (myocardial infarction or MI) may leave you with weak links in response to exercise (listed below). It is wise to consult your physician about any abnormal symptoms that you experience during exercise if you have had a heart attack. Your life depends on your heart. Guessing at what is OK and not OK could cost you your life. You must tread softly with any cardiovascular disease.

Weak links can include:
  • changed cardiorespiratory response,
  • blood flow reactions,
  • lowered aerobic capacity,
  • decreased ability of the heart to push blood out to the rest of the body,
  • lowered oxygen transport in the body,
  • decreased systolic BP response to exercise,
  • increased heart rate,
  • sloppy emptying of the chambers of the heart,
  • chest pain symptoms,
  • ventricular arrhythmia's.

Despite the sometimes grim outlook on exercise and heart attack history, there is good rationale for exercise training with history of MI.

Remember that there are other prevention and prophylactic measures you can take to get healthier despite your heart or medical history. Every little step towards getting healthy and staying that way counts! It's never too late.

Think of it this way. If you were to take a long trip 100 miles away or so and didn't have a car, would every step count? Absolutely! You may or may not be able to depend on a lot of exercise to get you healthy, but every other step counts just as much.

Regardless of damage... some exercise is better than nothing. This may mean that you develop a walking program with the help of your doctor instead of training for a marathon... remember each step counts.

Exercise after heart attack is something you should discuss with your physician while considering the enormous benefits:

  • increased VO2Max
  • increased breathing response to exercise
  • decreased chest pain
  • improved heart rate variability
  • decreased body weight
  • decreased fat
  • decreased blood pressure,
  • decreased blood cholesterol,
  • decreased serum triglycerides,
  • decreased LDL's (bad cholesterol)
  • increased HDL's (good cholesterol)
  • improved well being
  • improved heart protection against strenuous physical activity

Overall, exercise appears to improve the health of individuals by decreasing chances of dying by 20-25% from a heart related issue. All results and are individual and not guaranteed - discussing an exercise plan with your physician is the safest thing to do.

Most patients who have had a heart attack are now taking related medications. It is important to know that certain medications can alter and affect your body's response to exercise. These include:

  • diuretics
  • Beta Blockers
  • vasodialators
  • Calcium channel blockers
  • central nervous system-active drugs
  • alpha receptor blockers
  • anti arrhythmic agents
  • digitalis

This is not an exhaustive list and again, follow the advice and orders from your doctor.

Other considerations:

Aerobic Training

Based on your physician guidance, exercise after a heart attack may start during your hospital stay. Simple, yet effective periods of sitting up or standing can help slow your strength loss. Later on, it is better to work the large muscle groups with rhythmic exercises such as rowing, cycling , walking or stair climbing.

Strength Training

Don't forget to work your upper extremity muscles as well as your legs - the benefits don't cross over! Mild to moderate resistance training as an exercise after heart attack can improve cardiovascular function, improve body composition, flexibility, muscle strength and endurance.


Chose static stretching vs. dynamic stretching 2-3 days a week under the guidance of your doctor or physical therapist. My Wheelchair e-book discusses the three major muscle groups that weaken quickly with age or disease and illustrates various ways to strengthen and stretch for improved health, strength and function.

Frequency and Duration

Generally, exercise after heart attack considerations should be low to begin with. Starting with as low as 40% of VO2Max. Use 11-15 score range on the RPE scale or 6-20 on the Borg scale.

When you are instruced to, exercise after heart attack 3 days a week (but not 3 days in a row!) for 20-40 continuous or accumulated minutes. Don't surpass the 5-10 minute warm up and cool down at the beginning and end (respectively) which are critical for an injured heart.

Take it easy and remember that "on your own" exercise after heart attack can be dangerous. However, with the help of your doctor and physical therapist or certified personal trainer, you should be doing very well in 4-6 months!

Some of the above information was taken from

ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities-3rd Edition


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