Coronary heart disease is the most common form of cardiovascular disease and the leading cause of death in the U.S. and worldwide. It results when fatty material in the coronary arteries blocks the flow of blood to the heart muscle. If the blood flow can’t meet the demands of the heart, a person often feels chest pressure or a dull ache, sometimes radiating up into the neck, jaw, left shoulder or arm. This type of pain is referred to as angina. Clots may form and completely close the vessel, resulting in a heart attack. More than 1 million Americans suffer a heart attack, or myocardial infarction (MI), each year.
A regular exercise program and a healthy diet after MI can save your life. Research suggests that exercise reduces death both from cardiovascular causes and in general. Further, the atherosclerotic process is slowed, and the risk of having another cardiovascular event (such as an MI) or hospitalization is decreased. But doctors often aren’t appropriately trained nor blessed with the extra time to provide extensive nutrition and exercise recommendations, which is why cardiac rehabilitation centers are available to provide nutritional advice, guidance about weight management and exercise prescription.
So You Have Coronary Artery Disease
If you’ve recently had a heart attack, have chronic angina (persistent chest pain), had a stent placed, underwent coronary artery bypass graft (CABG) surgery, had a heart valve replaced, have chronic heart failure or received a heart transplant, your physician should refer you to a cardiac rehabilitation program; however, only 10 to 20% of appropriate candidates in the U.S. get this critically important referral. Part of the reason is due to geographic availability, or lack thereof. Part is due to physician failure to refer—particularly for women and the elderly. If you think that you should be eligible for cardiac rehabilitation, consult your physician for advice on the best type of program based on your medical history and present physical condition. Keep in mind that some people can safely start an exercise program at home or on their own.
General Exercise Guidelines
Once your physician has cleared you to exercise on your own or with a qualified trainer, you should follow a program that will best help you to meet your health and fitness goals. Following are some guidelines to help you to optimize your exercise time as well as your health and safety:
- Include at least a five-minute warm-up and five-minute cool-down in every exercise session to reduce the likelihood of oxygen deprivation to the heart in response to a sudden physical effort or abrupt cessation of exercise.
- Engage in moderate-intensity physical activity such as brisk walking for at least 30 minutes on most, preferably all, days of the week.
- Monitor your exercise intensity closely. Make sure to stay within your individual heart-rate zone (usually determined from a treadmill test under the supervision of a physician).
- Be cautious about engaging in vigorous physical activity. If you plan to begin a vigorous program, discuss it thoroughly with your physician. Also be sure to complete an exercise stress test first.
- Avoid strenuous activity in extreme environmental conditions. Vigorous exercise in the cold (such as snow shoveling) is associated with MI. Hot conditions require a dramatic increase in the heart’s workload. High altitude increases demands on the heart, particularly for individuals who are not acclimatized.
- Inform your trainer and physician if you have any abnormal signs or symptoms before, during or after exercise. These include chest pain, extreme fatigue, indigestion or heartburn, excessive breathlessness, ear or neck pain, upper respiratory tract infection, dizziness or racing heart and severe headache.
- If prescribed, always carry your nitroglycerin with you, especially during exercise.
- Never exercise to the point of chest pain or angina. If you develop chest pain during exercise, call 911 immediately.
- Make sure the facility where you exercise is well-equipped in case of an emergency. Ask the managers if the facility has an emergency response plan and an automated external defibrillator (AED) (with staff trained on how to use it) on the premises.
It’s never too late to start an exercise program or increase physical activity. In fact, combined with a healthy diet, it’s the best choice you can make for your heart health. Work closely with your physician and other healthcare providers to start slow and gradually increase your exercise frequency and duration. And know that if you ever need an extra hand, you can find an ACE-certified Advanced Health & Fitness Specialist in your area.