Physical activity is an important part of a cardiac rehabilitation program

Exercise can be a frightening proposition in the aftermath of a heart attack. Many survivors worry that stressing the heart—a muscle that has already been injured by the heart attack—will trigger a second episode. But research indicates that a reasonable amount of regular exercise is an excellent way to strengthen the cardiovascular system.

Among the benefits: increased strength and stamina as well as better control of blood pressure, diabetes and weight. As a result, survivors who exercise usually require less medication, are less likely to need bypass surgery or angioplasty, and are less likely to die of a second heart attack than those who remain sedentary.

To exercise safely, heart attack survivors need sound advice and careful supervision. Many have never exercised before; even those who have been active need to know how to exercise safely with their present health situation.

For virtually all heart attack survivors, doctors recommend a supervised cardiac rehabilitation program that focuses on exercise training and nutrition as well as counseling and interventions to reduce risk factors such as smoking, high blood pressure, elevated cholesterol levels and excess weight. Such programs are so effective that they are now also recommended for people with almost any type of heart disease, whether or not they've had a heart attack.

Starting an Exercise Program after Heart Attack

Within a day or two of your heart attack, your doctor will likely ask that you begin to move around, possibly by stretching and walking in your hospital room or the hallway. Then, before you leave the hospital, your doctor may recommend that you have an exercise stress test to see how much exercise your heart can tolerate. If you don't have a stress test before you leave the hospital, it's likely you'll have one before starting the rehabilitation program.

The results of the stress test will help determine the range your pulse needs to be in for you to gain the most benefits from exercise without putting undue stress on your heart. Usually, this range is 50 to 80 percent of the peak heart rate attained during the stress test.

Your doctor will then give you an exercise "prescription" to follow when you begin an exercise program.

Exercising after Hospital Discharge

If a cardiac rehabilitation clinic is available in your area, your doctor may recommend that you exercise there in the first weeks after the heart attack. Exercising in a rehabilitation clinic will allow the staff to coach you in the correct ways to exercise and to monitor your electrocardiogram and blood pressure during exercise periods. If no problems are identified after about six to 12 weeks of supervised exercise, many patients can then exercise on their own, checking in occasionally with the rehabilitation staff.

Publication Review By: Gary Gerstenblith, M.D., and Simeon Margolis, M.D., Ph.D.

Published: 03 Jul 2013

Last Modified: 15 Jan 2015