Being active when you have heart disease

Exercise and Your Heart

Getting regular exercise when you have heart disease is important.

Exercise can make your heart muscle stronger. It may also help you be more active without chest pain or other symptoms.

Exercise may help lower your blood pressure and cholesterol. If you have diabetes, it can help you control your blood sugar.

Regular exercise can help you lose weight. You will also feel better.

Exercise will also help keep your bones strong.

Always talk with your health care provider before starting an exercise program. You need to make sure the exercise you would like to do is safe for you. This is especially important if:

• You recently had a heart attack.
• You have been having chest pain or pressure, or shortness of breath.
• You have diabetes.
• You recently had a heart procedure or heart surgery.

Types of Exercise You Can Do

Your provider will tell you what exercise is best for you. Talk with your provider before you start a new exercise program. Also ask if it is okay before you do a harder activity.

Aerobic activity uses your heart and lungs for a long period of time. It also helps your heart use oxygen better and improves blood flow. You want to make your heart work a little harder every time, but not too hard.

Start slowly. Choose an aerobic activity such as walking, swimming, light jogging, or biking. Do this at least 3 to 4 times a week.

Always do 5 minutes of stretching or moving around to warm up your muscles and heart before exercising. Allow time to cool down after you exercise. Do the same activity but at a slower pace.

Take rest periods before you get too tired. If you feel tired or have any heart symptoms, stop. Wear comfortable clothing for the exercise you are doing.

During hot weather, exercise in the morning or evening. Be careful not to wear too many layers of clothes. You can also go to an indoor shopping mall to walk.

When it is cold, cover your nose and mouth when exercising outside. Go to an indoor shopping mall if it is too cold or snowy to exercise outside. Ask your provider if it is okay for you to exercise when it is below freezing.

Resistance weight training may improve your strength and help your muscles work together better. This can make it easier to do daily activities. These exercises are good for you. But keep in mind they do not help your heart like aerobic exercise does.

Check out your weight-training routine with your doctor first. Go easy, and do not strain too hard. It is better to do lighter sets of exercise when you have heart disease than to work out too hard.

You may need advice from a physical therapist or trainer. Either one can show you how to do exercises the right way. Make sure you breathe steadily and switch between upper and lower body work. Rest often.

You may be eligible for a formal cardiac rehabilitation program. Ask your provider if you can have a referral.

Pace Yourself and Know Your Limits

If exercise puts too much strain on your heart, you may have pain and other symptoms, such as:

• Dizziness or light-headedness
• Chest pain
• Irregular heartbeat or pulse
• Shortness of breath
• Nausea

It is important that you pay attention to these warning signs. Stop what you are doing. Rest

Know how to treat your heart symptoms if they happen.

Always carry some nitroglycerin pills with you.

If you have symptoms, write down what you were doing and the time of day. Share this with your doctor. If these symptoms are very bad or do not go away when you stop the activity, let your doctor know right away. Your doctor can give you advice about exercise at your regular medical appointments.

Know your resting pulse rate. Also know a safe exercising pulse rate. Try taking your pulse during exercise. This way, you can see if your heart is beating at a safe exercise rate. If it is too high, slow down. Then, take it again after exercise to see if it comes back to normal within about 10 minutes.

You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of the opposite hand to locate your pulse and count the number of beats per minute.

Drink plenty of water. Take frequent breaks during exercise or other strenuous activities.

When to Call the Doctor

Call if you feel:

• Pain, pressure, tightness, or heaviness in the chest, arm, neck, or jaw
• Shortness of breath
• Gas pains or indigestion
• Numbness in your arms
• Sweaty, or if you lose color
• Light-headed

Changes in your angina may mean your heart disease is getting worse. Call your provider if your angina:

• Becomes stronger
• Occurs more often
• Lasts longer
• Occurs when you are not active or when you are resting
• Does not get better when you take your medicine

Also call if you cannot exercise as much as you are used to being able to.

References

Briffa T, Maiorana A, Sheerin N, et al. Physical activity for people with cardiovascular disease: Recommendations of the National Heart Foundation of Australia. The Medical Journal of Australia. 2006;184:71-75.

Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation. 2007;116:2762-72. 

Ridker PM, Libby P, Buring JE. Risk markers and primary prevention of coronary heart disease. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 42.

Thompson PD. Exercise-based, comprehensive cardiac rehabilitation. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 47.

Vandvik PO, Lincoff AM, Gore JM, Gutterman DD, Sonnenberg FA, Alonso-Coello P, et al. Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e637S-68S.

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