If you've had a heart attack, you're probably wondering how your life is
going to change.
Jerome L. Fleg, MD, a cardiologist and geriatric medicine specialist in
Baltimore, has some good news: "There is no reason why a person should
not get back into a normal routine after a heart attack," he says "There
are very few limitations, and even those have exceptions."
Over the long term, your quality of life is tied to how severe your
heart attack was and how it was treated. Beyond that, any change will
depend largely on you. If you make it happen, your life can be healthier
and more active than before. Work with your doctor on a plan.
"The most serious obstacle to having a healthy life after a heart attack
is doing nothing," says Stuart J. Glassman, MD, a fellow of the American
Association of Cardiovascular and Pulmonary Rehabilitation. Dr. Glassman
works with heart-attack patients in Concord, N.H.
"Heart attacks are a result of life patterns and an accumulation of
problems over time. The next one could be fatal," Dr. Glassman says.
That's why it's crucial to change.
The first step, Dr. Glassman says, is to work with your doctor to find
the cause of your heart attack. "This could be a matter of being
overweight, of smoking, of a lack of activity, diabetes, high
cholesterol and abnormal lipid profile, metabolic syndrome,
hypertension, or stress." A combination of factors may be to blame. Once
you know what put you at risk, he says, you need to follow your doctor's
recommendations for cutting that risk. "A heart attack doesn't remove
the risk. So prevention is an important part of recovery," he says.
Other experts agree. "After a heart attack," says Kerry J. Stewart, EdD,
"your risk for heart attack becomes two or three times greater than it
was before." That doesn't mean, though, that the second heart attack has
to happen. Dr. Stewart is a Baltimore exercise physiology expert. There
are five strategies you and your doctor can use to make your life
Change your diet.
Become more physically active.
Undergo angioplasty or surgery.
Take your medicine.
You may need surgery to fix damage to heart muscle or angioplasty or
surgery on the blood vessels that put you at risk. But surgery by itself
is never enough. "Unless you make changes in the lifestyle that caused
the damage in the first place, the problems will simply reappear," says
How can you move toward a healthier lifestyle?
"Stopping smoking is the single most important thing a person can do,"
Dr. Stewart says. If you smoke, ask your doctor about programs that help
Exercise strengthens your heart muscle so it can pump blood more easily
and strengthens other muscles so the heart doesn't have to work so hard.
It can help you lose weight, lower your blood pressure, decreases
stress, and decrease your cholesterol levels. A routine that focuses on
aerobic exercise for 30 minutes a day at least three days a week should
be your minimum goal., says Dr. Glassman. Aerobic exercise—the type that
raises your heart rate—can be as easy as a brisk, 30-minute walk. Start
slowly and follow your doctor or rehabilitation specialist's advice.
Dr. Fleg warns that arthritis or other problems may make some exercises
tough. But that doesn't mean you shouldn't be active. Your doctor or a
rehabilitation expert can help.
If walking is too painful, try a workout that doesn't stress the joints.
Ride a stationary bike, for instance, or swim. "Research shows that
people in a supervised program of physical activity after a first heart
attack reduce their risk of dying from another heart attack by 25
percent," Dr. Stewart says. Talk with your doctor about the safest way
Diet changes can help lower your cholesterol level, weight, and blood
pressure. Dr. Glassman says you should avoid high-fat foods and shift to
a leaner diet higher in fiber and possibly lower in salt. That means
more fruits and vegetables, fewer eggs, and less butter and red meat. A
dietitian can help you spot and change unhealthy eating patterns.
Don't be afraid of having sex after a heart attack. As with other
activity, you may have to start slowly and gradually work into your
normal habits. Some of the medications you may take after a heart attack
can affect your interest in sex or the ability to have an erection or
orgasm. Talk to your doctor about when you can begin to have sex or if
you think medications may be causing problems.
After a heart attack, medicine is important for lowering cholesterol and
controlling blood pressure. Make sure you understand when and how to
take your medicine, and take it as instructed. Talk with your doctor if
the medicine causes problems for you. Don't change or stop medication
use on your own. Stopping suddenly can be dangerous with some medicines.
If stress is a factor in your life, it can increase your blood pressure,
increase your heart rate, and make your heart disease worse. If you are
under stress from work or home, get advice on stress reduction
techniques or see a counselor for suggestions on how you can reduce your
stress or change your response to stressful situations.
Cardiac rehabilitation programs aim to help people who have had a heart
attack make the changes they need for a healthy lifestyle. In a rehab
program, health professionals will work with you to show you how to
watch your blood pressure, help you stop smoking, alter your diet, and
set up an exercise routine.
"Most people who have had a heart attack get a great deal of benefit out
of a cardiac rehab program," Dr. Fleg says. "Rehab helps the person who
has had a heart attack take control of his or her own recovery. And
taking control is what will make recovery work."
The goal of rehab, Dr. Stewart says, is to form habits that will make
and keep you healthy. "There's almost no reason anyone can't start a
rehab program as soon as they're released from the hospital," he says.
If your doctor hasn't talked with you about a cardiac rehabilitation
program, says Dr. Stewart, you should ask about it.
Recovering from a heart attack means changing your life in positive
ways—not smoking, lowering cholesterol, controlling blood pressure,
staying active, and forming partnerships with health professionals.
Those steps don't just reduce your risk and fear of another heart
attack. They also make life healthier and more fun.
Family members can help a heart-attack patient recover and live a
"Family members are a major part of the environment and are very
important in the process of recovering," Dr. Fleg says. Husbands and
wives can exercise together, for instance. "It provides support and
encouragement and it can be beneficial to the partner as well."
The family can also help by joining recovering kin in a healthy diet,
encouraging them to complete a rehab program or quit smoking, and
reminding them to take medication.
Family members can also watch a person's mood and mental well-being, Dr.
Stewart says. Depression is common after a heart attack. If it doesn't
start to ease within a few weeks, it can hinder recovery and cause the
person to avoid vital, positive steps. Relatives should encourage
efforts to get help and call the health care provider right away.
But doctors say family members can also hamper recovery. "If a family
member smokes," Dr. Glassman says, "it makes it hard for the person who
has had a heart attack to stop smoking." Other lifestyle habits that
contribute to a heart attack, such as lack of exercise and a high-fat
diet, can be family patterns.
For more information, call 1.866.CALL.MLH.