Every year, thousands of Canadians survive a heart attack, go back to work and enjoy a normal life. Your heart is healing and with each passing day you’ll get stronger and more active. With a heart attack, a portion of your heart muscle has been damaged. This is sometimes a difficult concept to understand because you cannot see the damage that has been done to your heart.

Every year, thousands of Canadians survive a heart attack, go back to work and enjoy a normal life. Your heart is healing and with each passing day you’ll get stronger and more active. With a heart attack, a portion of your heart muscle has been damaged. This is sometimes a difficult concept to understand because you cannot see the damage that has been done to your heart.

How Long It Will Take Your Heart to Heal

The post heart attack healing period varies, often depending on the size of your heart attack and can last anywhere from one to three months. If you are not sure how big your heart attack was, please ask your doctor before you are discharged.

The first week is important because your heart is starting to heal. It is important to have a calm and relaxing environment for the heart to rest and recover.

From the second week on, your heart will continue to heal through the following weeks. During this time, we will ask you to gradually increase some physical activities and limit others. You may be told not to drive for four weeks following your heart attack. Check with your doctor before your discharge regarding when you can drive.

It is normal to sometimes feel tired or drained for the first few weeks. Some patients find it helpful to plan short rest periods to allow them to have more energy to complete daily activities. You will find more information on activity after a heart attack in the Physical Activity section.

Social Work in the Hospital Setting

You can ask to speak to a social worker while you are in the hospital or if you are taking part in the Cardiac Rehabilitation program. Social workers can assist patients and their families with a number of concerns:

• Applying for financial assistance
• Assessing resources to ensure that you get your medication in a timely way
• Assistance in ensuring appropriate discharge and return to the community
• Providing emotional support and counselling to alleviate depression, anxiety and adjustment to your health condition
• Assisting with communication within the family
• Providing emotional support and access to resources to yourself and your family
• Advocacy and Liaison services with other health care professionals and community resources

If you would like to speak to a social worker, let a member of your health care team know and a referral will be made.

Regular physical activity will:

• Improve the function of your heart and lungs
• Improve your HDL (good) cholesterol and triglycerides
• Lower your blood pressure
• Help you achieve a healthier body weight
• Improve your blood glucose levels
• Improve your muscle tone and bone density
• Increase your endurance and improve your confidence
• Improve your ability to cope with stress and decrease anxiety and depression

How to Increase Your Physical Activity

Once you are home, you should continue all the activities you followed while you were in the hospital. The longer you are home, the more you should be able to do.

A balance of rest and activity should still be maintained to allow for continued healing and to conserve your energy. Activity should be increased gradually. Everyone’s recovery is different. The rate at which you progress will depend on the severity of your cardiac event and your previous activity level. After four to six weeks, you should be back to performing your regular activities.

Walking is one of the earliest activities you are allowed to resume and it is one of the best exercises for improving your health. We have given you a walking guide below to help get you started.

You will be referred to a Cardiac Rehabilitation Program to provide you with exercise and lifestyle guidelines. This is an important part of your recovery. You are strongly encouraged to participate. You may also want to discuss details with your doctor about returning to more intense activities.

Walking Program

The instructions provided below on how to start a walking program are important to follow for anyone who has had a heart attack or who did not have a regular exercise program before their cardiac event.

WEEKS 1 TO 2

• Five to 10 minutes of leisurely walking once or twice daily

WEEKS 3 TO 6

At this point you are ready to begin your walking program:

• Begin with 10 minutes of slow walking once or twice daily.
• Increase by one minute per day until you are walking 20 to 30 minutes per walk.
• Increase your speed and distance as tolerated, remembering that it is important to avoid shortness of breath and fatigue. Always begin your walks at a slow stroll for the first few minutes, then increase your pace. Your walking time can be maintained at 30 minutes once or twice daily.

After your walks, stretch your calf muscles. They are likely to get tight as you begin to increase your daily activity.

After your walks, stretch your calf muscles. They are likely to get tight as you begin to increase your daily activity.

• Stand up straight close to a solid surface on which you can use your hands for balance.
• Step back with one foot, with both your feet pointing forward.
• Bend the knee that is forward while keeping the back leg straight until you feel a stretch in the back leg.
• Hold for 30 to 60 seconds. Repeat with the other leg.

If the above program,feels too difficult for you, you can use interval training. This is a type of exercise where you alternate harder exercise with easier exercise for short periods of time For example, each interval could include:

• Walking two to five minutes
• Then resting two to five minutes

Repeat this pattern as many times as you are able to, gradually increasing the number of intervals.

Exercise Guidelines

• Walk on flat ground initially. If hills are unavoidable, walk more slowly when going uphill.
• It is best to wait about an hour after a meal before you exercise as extra energy is required for digestion.
• It is important to start exercising for short periods of time and at a slow walking pace. Gradually increase the length of your walks before you increase the speed.
• If you are feeling well enough, you may exercise twice per day.
• You should be back to your pre-walk or resting state within 10 minutes of completing your exercise. If not, the next time you exercise, reduce your walk time or speed.
• If you feel tired, shorten your walking time. Go back to the previous level of activity for a few days. Listen to what your body is telling you. You may be trying to do too much too soon.
• Avoid exercising in extreme temperatures, such as hot humid days or cold windy ones. During this time, exercise indoors using stationary equipment or walk in the hallways of your house or apartment, or in a mall.
• If you are using a treadmill, keep it flat. It is best not to use the incline.
• A stationary bicycle can also be very valuable, especially if you have joint problems which make walking more difficult. Make sure you pedal at a slow speed with little or no tension.
• Avoid exercises where you hold your breath or bear down.

Self-Monitoring Tools

The following tools will help to guide you with the progression of your exercise program.

Walk and Talk Test

This is the simplest test of all. At all times, you should be able to carry on a light conversation while exercising ,without being short of breath. If you are too short of breath to speak clearly, you should slow down.

Rate of Perceived Exertion (RPE) Scale

This is a number-based scale used to describe how you feel during your exercise session.

The number you choose should reflect your overall level of effort and fatigue during your activity, including your breathing. There is no right or wrong answer but if you feel you are above level 15 (or “Hard/heavy” exertion, then you should slow your pace. If you feel you are exercising at a level below “light” (level 11), then you may try to increase your effort a little bit.

As your recovery and fitness improve, so too will your perceived level of effort. The change in effort that you feel over time, for the same exercise, is a measure of your improvement.

Rest and Activity at Home

It may be hard to understand why we recommend such a slow return to your normal activities, especially if you were very physically active before your heart attack and are relatively young.

It is important to understand that your heart is a muscle and at any age or fitness level, your heart and your body needs time to recover. This means taking it slow, and gradually increasing your activities back to normal. After recovery, most of our patients are able to do all the activities they enjoyed before their heart attack. For higher intensity activities, such as playing hockey, starting back to the gym to lift weights or running, you may benefit from some guidance on how to progress gradually. We recommend you to do this with the assistance of a Cardiac Rehabilitation Program where it can be done safely under the supervision of a Physiotherapist or exercise specialist.

The following guidelines offer some helpful advice about activity in general:

• Try to get eight hours of sleep every night during your recovery period.
• Minimize activity immediately after meals. Sit and watch TV or read the newspaper for about an hour before exercising after a meal.
• Stop and rest when you feel tired.
• Give yourself enough time for activities so that you won’t feel tense or rushed.
• Plan your day to achieve a balance between active periods and quiet times. Spread out more difficult tasks and alternate an easy task with a difficult one.
• Housework is not advised for the first week you are home. After that, you may resume light housework, such as helping with meals, and increase as your tolerance improves.
• Standing still for any length of time is very tiring. During your recovery, sit for as many activities as possible, e.g., washing dishes, food preparation.

Some additional guidelines for resuming activities of daily living:

WEEK 1

• Walking slowly
• Writing, drawing, painting
• Reading
• Watching TV, using computer
• Knitting , needlework
• Meditation
• Stretching exercises
• Climbing stairs slowly
• Short outings
• Lifting no more than 5 to 10 pounds (when necessary, not for strength training)

WEEKS 2 TO 3

• Light laundry
• Easy sweeping, dusting
• Washing dishes, preparing light meals
• Walking the dog

WEEKS 3 TO 6

• Walking at a moderate pace
• Cleaning sinks and toilets
• Mopping floor, vacuuming
• Ironing, bed-making
• Light gardening, raking leaves
• Pushing light power mower
• Lifting up to 20 pounds (when necessary, not for strength training)
• Bowling
• Golfing with power cart
• Shuffleboard, croquet, billiards
• Playing a musical instrument
• Gentle beginner’s level yoga (no inversions)

A Cardiac Rehabilitation program will help you determine which activities are best for you at this stage.