Every year, about 805,000 people have heart attacks in the United States, with about 382,820 dying from coronary heart disease, according to the American Heart Association.
We sat down with Minal Patel, MD, Kaiser Permanente Santa Clara Medical Center medical director for the Cardiac Rehabilitation program, to learn about physical fitness recommendations for people who recently had a heart attack.
What kind of exercise do you recommend for someone who recently suffered a heart attack?
Everyone should start with walking. They should be doing that for any kind of heart attack, from moderate to severe.
The goal should be to get to 30 minutes a day, at least 5 times a week. We start by telling patients to try 10-minute increments if possible. It can be hard because baseline exercise and activity levels can vary quite a bit from person to person.
So, walking right away? No resting?
Correct. Walking is a very safe form of exercise and allows for a gradual increase in duration and intensity. Although giving your body time to heal is important, people do not need to be on bedrest after a heart attack. Exercise is a key aspect to longevity.
For more active and athletic patients, how should they proceed after a heart attack?
A lot of it depends on the extent of damage the heart attack did to the heart muscle, how much of the heart was affected, and what is the actual exercise the patient wants to do that dictates exercise levels. For someone who had a massive heart attack in their 80s, their exercise level is going to be different from someone in their 30s or 40s.
Your cardiologist will give you a target heart rate to get up to, and we will teach you how to measure that. We’ll say, ‘You got to this heart rate, now keep it up.’ If you get to 30 minutes and you enjoy what you are doing, keep doing it.
How can you measure the damage from a heart attack?
One of the measures is called ejection fraction, which is how well the heart pumps blood, and we can ascertain that with an echocardiogram. An ejection fraction above 50% is normal and below 50% is not normal. We tell patients that no matter how bad their heart pumping function is, it’s important to remain active with exercises, such as walking.
Let’s say you’re doing well walking but want to bump up the intensity. What should you do?
Patients should find activities they enjoy, like dancing, running, riding a bike, golfing. Those are the next level of physical activity after walking. The goal is to maintain that activity for 30 minutes a day.
We also ascertain what was your activity level before the heart attack. Could you run? Could you swim? Did you go to the gym? That baseline should be taken into consideration for what you can attempt to do going forward after a heart attack and after you got up to 30 minutes a day of walking, 5 days a week.
How would you know you’re doing too much, post heart attack?
Too much would be when a patient is getting chest discomfort or pain, shortness of breath, or dizzy. This is when you should stop and talk to your cardiologist.
Finally, what do patients need to know about the long term, after having a heart attack?
When patients are motivated and feel empowered, they can be successful. I really encourage people to be proactive about their health and exercise, in addition to taking their medications. Exercise and lifestyle changes are at the core of their prevention.