Should You Exercise After a Heart Attack?

After a heart attack, many patients’ natural reaction is to avoid exercise as there is a fear of stressing the heart. This is a common misconception. In truth, inactivity is what leads to poorer heart function, poorer quality of life and earlier death.

Like any other muscle in the body, the heart gets stronger with exercise. A stronger heart works more efficiently and demands lesser oxygen. Similarly, keeping the rest of your body muscles fit and strong also makes them more efficient and decreases their oxygen demand. Hence, the heart needs to work less hard to pump blood around the body.

Importance of exercise

Regular exercise brings many benefits:

• Engaging in regular low to moderate-intensity exercise further reduces stress on the heart after a heart attack.
• They lower blood pressure and keep blood glucose levels in check.
• Maintaining healthy body weight through exercise makes it easier to undertake normal daily activities and boosts our confidence and mental health.

Exercises are recommended for everyone who has survived a heart attack, whether it is mild or severe. Where possible, it is highly recommended for heart attack survivors to join a cardiac rehabilitation programme as guidance from professional healthcare workers ensures that exercises are safe for the individual.

When to begin?

Always check with a healthcare professional before embarking on any physical exercise. In general, once medically stable, heart patients can start with light walking as early as just a few days after the heart attack. Those who had a severe heart attack can wait a little longer until their medical condition has stabilised before starting with lighter and easier exercises.

With training and improvement in fitness, survivors can even go on to engage in higher-intensity exercises. However, as the relative risk of cardiovascular adverse events is higher with higher-intensity exercises, those who wish to do these exercises should train gradually for it under supervision of a cardiac rehabilitation professional.

Stay safe while exercising. We advise patients to:

• Avoid exercising if unwell
• Do warm-ups and cool-downs. A proper warm-up decreases the chance of experiencing angina (chest pain or discomfort) during exercise while a proper cool-down can help prevent or minimise any muscle soreness the following day.
• Take all medication as prescribed. If a GTN (Glyceryl trinitrate – used to relieve the pain of an angina attack) spray was prescribed, bring it along to your workouts.
• Measure your blood pressure before and after exercise. If your pre-exercise blood pressure deviates significantly from the usual, postpone your exercise session.
• Stay hydrated.
• Diabetics, especially those taking insulin, are strongly recommended to check their blood sugar before and after exercising. Carry a source of easily-absorbed sugar (e.g. sweets) while exercising in case blood sugar gets too low.
• Exercise at a heart rate that is within your safe range. To determine your safe range, do an exercise test with a healthcare professional who can guide and adjust the range for you. It is therefore highly recommended to wear an accurate heart rate monitor during exercise.

Article contributed by Ms Chan Pui Yee, Assistant Principal Physiotherapist of Singapore Heart Foundation.