Going Home - A New Beginning

As difficult and stressful as this experience has been for you and your family, be aware that most people do recover from a heart attack and live a full life.

Decorative image.Can This Happen Again?

Even though you have received the best available care to treat and manage your heart condition, your heart disease is not curable. Heart disease is a chronic health condition that, like any health problem, will bring uncertainty and changes into your everyday life. Learning about your risk factors and how to manage them is the best way to prevent future blockages in your coronary arteries.

Returning to Work

To help you understand whether you can return to work, you and your doctor will consider:

  • How stable your condition is
  • How safe you are to do your job
  • What the licensing requirements are (e.g., for truck drivers or pilots)
  • What the demands of your job are—both physically and mentally

What Your Doctor Needs to Know about Your Job

  • The physical work that you do such as lifting or carrying
  • Whether you use heavy tools like jackhammers
  • The conditions that you work under, such as temperature, fumes, shift work, or frequent deadlines
  • The amount of job stress you have

Tip: Take a copy of your job description to your doctor

What Papers You Need to Return to Work

Your doctor may need to write a letter stating:

  • When you can return to work
  • What you can or can’t do

Tip: If your doctor writes “light duty,” this needs to be explained: what duties you can perform, what hours you can work, and how long light duty is to continue

Where to Get Help with Questions about Work

  • A vocational counsellor who specializes in work-related issues will be available through your Cardiac Rehabilitation Program.
  • There may be help through your workplace, such as a human resources staff member, an occupational health nurse, company doctor, or union representative.
  • Your family physician may be able to help.

How to Prepare for Follow-Up Appointments with Your Doctor

To get the most from your follow-up clinic appointments:

  • Bring your updated medication list and plan to review it with your doctor
  • Make a list of your questions and concerns
  • Bring a family member or friend with you and ask them to take notes
  • Ask questions if you are not sure you understand the information

The following list includes some of the topics you may want to talk your doctor about:

  • Returning to work or returning to driving
  • Unusual symptoms
  • Changes in medication or medication side effects
  • Limitations in your activity
  • Follow-up appointment plans

The Healing Process

Decorative image.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.

For Family & Caregivers

How Family Members and Caregivers Feel

Having a heart attack or being diagnosed with heart disease can have a big emotional impact on family members and caregivers as well. You can feel frightened, angry and even feel guilty. It is important not to let these feelings build and to get help and support.

At any time during the hospital stay, please feel free to discuss these feelings with a doctor or nurse. We can help you obtain support from an advanced practice nurse, clergy, social worker or other health care professional who specializes in providing families with this type of emotional support. At anytime of the day or night you can speak with a nursing coordinator who can help answer your questions and provide support to you and your family.

Caring for Yourself

As a caregiver, it is important that you take time to look after yourself. You need to get proper nutrition and rest both during the hospital period and after. The additional stress of supporting your loved one through a cardiac event can make you even more tired and possibly more at risk for catching a cold, etc.

Sometimes family members feel that they have to be with their loved one at all times when they are in hospital. This is the best time for you to get rested and prepare for your family member to return home. Please be assured that the attending doctor or nurse will contact you should there be any change in your loved one’s condition.

Will Your Partner or Family Member Ever Be the Same?

It is important to remind yourself that the majority of people who are treated at the University of Ottawa Heart Institute for a heart attack or who are diagnosed with angina or coronary artery blockages, return to their normal lives within a couple of months.

Having heart disease does mean making some lifestyle changes to prevent reoccurrence, but these changes are positive for the whole family. In many cases, our patients and families lead more active and healthy lives!

Helpful Tips for Family and Caregivers

  • Conserve your energy. Housework and other projects can wait.
  • Rest when your partner rests.
  • Don’t be afraid of asking for help with meals and snacks
  • Try to get at least eight hours of sleep every night, or whatever you require to feel rested
  • Get outside whenever possible, especially when your partner starts walking. Fresh air and exercise are good for you, too!
  • Plan occasional breaks away with family and friends.

Physical Activity

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.


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


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.

Illustration of a man performing a calf muscle stretch while leaning his hands on the back of a chair.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.

STOP and Rest If You:

  • Become very short of breath
  • Feel weak, tired, lightheaded or dizzy
  • Have any discomfort, especially chest discomfort
  • Have a fast heart rate or palpitations
  • Have nausea or excessive sweating

If these symptoms persist, call 911

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.


Rating of Perceived Exertion (RPE) Scale
6 Nothing at all
7-8 Extremely light
9 Very light
11 Light
13 Somewhat hard
15 Hard (Heavy)
17 Very hard
19 Extremely hard
20 Maximum exertion

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:

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


You will likely be taking medications following your heart attack. Your physician has carefully chosen the type of medications and dosage you need based upon your present condition. It is important to recognize that not everyone will be taking the same medications. Your blood pressure, any abnormal heart rhythm, and the extent of damage to the heart muscle, will influence your doctor’s decision.

The following is a brief outline of the medications most commonly used and their role in treating heart disease and diabetes. If your medication is not listed or you want more detailed information about your specific medications, ask your pharmacist.

Medications for treating heart disease

Type of Medicine Names of Medication How Medication Works Potential Side Effects
Antiplatelets ASA (Aspirin®, ECASA)
Clopidogrel (Plavix®)
Prasugrel (Effient®)
Ticagrelor (Brilinta®)
  • Helps prevent blood clots in injured coronary arteries
  • Helps prevent blood clots on stents (clopidogrel, prasugrel)
  • Decreases the risk of future heart attacks
  • Increased risk of bleeding & bruising
  • Stomach upset (nausea, diarrhea, heartburn)
  • Shortness of breath(Ticagrelor)
ACE Inhibitors
(Angiotensin Converting Enzyme Inhibitors)
Benazepril (Lotensin®)
Captopril (Capoten®)
Cilazapril (Inhibace®)
Enalapril (Vasotec®)
Fosinopril (Monopril®)
Lisinopril (Zestril®, Prinivil®)
Perindopril (Coversyl®)
Quinapril (Accupril®)
Ramipril (Altace®)
Trandolapril (Mavik®)
  • Widens blood vessels and lowers blood pressure
  • Decreases the risk of future heart attacks
  • Maintains the heart’s shape promoting normal function
  • Cough
  • Dizziness, lightheadedness
  • Increased potassium level in blood
  • Swelling of lips/face/throat (rare) – Call 911
Beta Blockers Acebutolol (Rhotral®, Sectral®)
Atenolol (Tenormin®)
Bisoprolol (Monocor®)
Carvedilol (Coreg®)
Labetalol (Trandate®)
Metoprolol (Betaloc®, Lopressor®)
Nadolol (Corgard®)
Pindolol (Visken®)
Propranolol (Inderal®)
Timolol (Blocadren®)
  • Lowers blood pressure and heart rate
  • Helps prevent angina
  • Improves heart function
  • Slows down irregular heart rhythms
  • Decreases the risk of future
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing
Cholesterol Lowering Medications Statins
Atorvastatin (Lipitor®)
Lovastatin (Mevacor®)
Pravastatin (Pravachol®)
Rosuvastatin (Crestor®)
Simvastatin (Zocor®)
  • Lowers LDL (“bad”) cholesterol
  • Decreases the risk of future heart attacks
  • Constipation, gas
  • Indigestion
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Cholesterol Absorption Inhibitors
Ezetimibe (Ezetrol®)
  • Usually used with a statin to lower LDL (“bad”) cholesterol
  • Diarrhea
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
PCSK9 Inhibitors
Alirocumab (Praluent®)
Evolocumab (Repatha®)
  • Usually used with a statin to lower LDL (“bad”) cholesterol
  • Redness or swelling at the injection site
Bezafibrate (Bezalip SR®)
Fenofibrate (Lipidil EZ®, Lipidil Micro®, Lipidil Supra®)
Gemfibrozil (Lopid®)
  • Lowers triglycerides
  • Rash
  • Stomach upset (nausea, vomiting, diarrhea, gas)
  • Mild decrease in liver function
  • Muscle pain – Notify doctor
Niacin (Niaspan®)
  • Increases HDL (“good”) cholesterol
  • Lowers triglycerides
  • Flushing
  • Mild decrease in liver function
Bile Acid Binders
Cholestyramine (Questran®)
Colestipol (Colestid®)
  • Mildly lowers LDL (“bad”) cholesterol
  • Constipation
  • Nausea
  • Bloating
Nitrates Isosorbide Dinitrate (ISDN, Isordil®)
Isosorbide Mononitrate (Imdur®)
Nitroglycerin spray (Nitrolingual®)
Nitroglycerin patch (NitroDur®, Minitran®, Trinipatch®)
  • Improves blood flow to the heart by widening the blood vessels
  • Helps prevent angina (patch and tablets)
  • Stops angina (spray)
  • Headache
  • Skin irritation at application site (patch)
  • Lightheadedness (spray)
Angiotensin II Receptor Blockers (ARBs) Candesartan (Atacand®)
Irbesartan (Avapro®)
Losartan (Cozaar®)
Olmesartan (Olmetec®)
Telmisartan (Micardis®)
Valsartan (Diovan®)
  • Relaxes blood vessels & lowers blood pressure
  • Decreases the risk of future heart attacks
  • Alternative to ACE inhibitors
  • Dizziness, lightheadedness
  • Headache
  • Increased potassium level in blood
Neutral Endopeptidase Inhibitor / Angiotensin II Receptor Blocker (ARB) Sacubitril / Valsartan (Entresto®)
  • Widens blood vessels & lowers blood pressure
  • Removes excess water by increasing urine production
  • Decreases the risk of hospitalization due to heart failure
  • Alternative to ACE inhibitors
  • Cough
  • Dizziness, lightheadedness
  • Increased potassium level in blood
  • Swelling of lips/face/ throat (rare) – Call 911
Calcium Channel Blockers Amlodipine (Norvasc®)
Felodipine (Plendil®, Renedil®)
Nifedipine (Adalat XL®)
Diltiazem (Cardizem CD®, Tiazac®)
Verapamil (Isoptin®)
  • Lowers blood pressure
  • Lowers heart rate (diltiazem, verapamil)
  • Helps prevent angina
  • Slows irregular heart rhythms (diltiazem, verapamil)
  • Dizziness, lightheadedness
  • Fatigue/tiredness
  • Headache
  • Swelling of ankles/feet
Diuretics (Water Pills) Ethacrynic Acid (Edecrin®)
Furosemide (Lasix®)
Hydrochlorothiazide (HCTZ, HydroDiuril®)
Metolazone (Zaroxolyn®)
  • Removes excess water by increasing urine production
  • Reduces swelling in legs and ankles
  • Dizziness/lightheadedness
  • Decreased potassium level in blood
  • Gout
Potassium Supplement Potassium Chloride (Slow K®, K-Dur®)
  • Replaces potassium in blood
  • Nausea/vomiting
Anticoagulants Apixaban
Dabigatran (Pradax®)
Edoxaban (Lixiana®)
Rivaroxaban (Xarelto®)
Warfarin (Coumadin®)
  • Helps prevent blood clots from forming or getting bigger
  • Increased risk of bleeding and bruising
Anti-arrhythmics Amiodarone (Cordarone®)
  • Makes the heart beat more regularly
  • Nausea/vomiting
  • Skin may burn more easily under the sun
  • Sun exposed skin may turn bluish grey
  • Thyroid abnormality
  • Decrease in liver function
  • Lung damage (rare)
Dronedarone (Multaq®
  • Nausea/vomiting
  • Diarrhea
Sotalol (Sotacor®)
  • Fatigue/tiredness
  • Dizziness, lightheadedness
  • Depression
  • Wheezing
Digitalis Digoxin (Lanoxin®, Toloxin®)
  • Slows down irregular heart rhythms
  • Strengthens the heart’s pumping
  • Nausea/vomiting – Notify doctor if persistent


Medications for treating diabetes

Type of Medicine Names of Medication How Medication Works Potential Side Effects


Metformin (Glucophage®)

Metformin extended release (Glumetza®)
  • Helps reduce release of sugar from the liver
  • Makes cells more responsive to insulin so that they can use sugar more efficiently
  • Nausea, gas, abdominal pain, diarrhea that may subside

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors 

Canagliflozin (Invokana®)

Dapagliflozin (Forxiga®)

Empagliflozin (Jardiance®)
  • Decreases reabsorption of sugar in the kidneys
  • Promotes sugar loss through the urine
  • Improves cardiovascular health and survival
  • Bladder infections
  • Vaginal yeast infections
  • Rash / redness to the penis / foreskin
  • Do not take if unable to eat regular meals or drink fluids
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Albiglutide (Eperzan®)
Dulaglutide (Trulicity®)
Exenatide (Bydureon®, Byetta®)
Liraglutide (Saxenda®, Victoza®)
Lixisenatide (Adlyxine®)
Semaglutide (Ozempic®)
  • Increases insulin secretion
  • Decreases sugars made by liver
  • Slows stomach emptying
  • Decreases hunger
  • Improves cardiovascular health and survival
  • Nausea, vomiting, diarrhea
  • Increased heart rate
  • Weight loss
  • Low blood sugar (rare)
  • Pancreatitis (rare)


Dipeptidyl Peptidase 4 (DPP-4) Inhibitors Alogliptin (Nesina®)
Linagliptin (Trajenta®)
Saxagliptin (Onglyza®)
Sitagliptin (Januvia®)
  • Enhances action of gut hormones that release insulin
  • Decreases sugars made by liver
  • Runny nose
  • Low blood sugar (rare)
  • Pancreatitis (rare)
Insulin Secretagogues Glicliazide (Diamicron®, Diamicron MR®)
Glimepiride (Amaryl®)
Glipizide (Glucotrol XL®)
Glyburide (Diabeta®)
Nateglinide (Starlix®)
Repaglinide (Gluconorm®)
  • Stimulates the pancreas to make more insulin
  • Can cause low blood sugar if a meal is missed or delayed, or if more activity than usual
Thiazolidinediones  Pioglitazone (Actos®)
Rosiglitazone ((Avandia®)
  • Improves insulin sensitivity
  • Swelling due to water retention
  • Heart failure


Types of Insulin

Please note this list is not all inclusive

Type Name Action Notes

Ultra Fast Acting 

Insulin Aspart (Fiasp®) 
  • Onset: 5 - 7 min
  • Peak: 0.5 - 0.75 hrs
  • Duration: 3 - 5hrs
Very Rapid Acting Analogues (Clear) Insulin Aspart (Novo Rapid®)
Insulin Glulisine (Apidra®) 
Insulin Lispro 100 units/mL & 200 units/mL (Humalog®)
  • Onset: 10 – 15 min
  • Peak: 1 – 1.5 hrs
  • Duration: 3 – 5 hrs
  • Meal time insulin to be taken within 15 min of eating
  • May be used in an insulin pump
Short Acting (Clear) Insulin Regular 100 units/mL (Humulin R®, Novolin ge Toronto® )
Insulin Regular 500 units/mL (Entuzity®)
  • Onset: 30 min
  • Peak: 2 – 3 hrs
  • Duration: 6.5 hrs
  • Meal time insulin to be taken 30 min before eating
Intermediate Acting (Cloudy) Insulin NPH (Humulin N®, Novolin ge NPH®)
  • Onset: 1 – 3 hrs
  • Peak: 5 – 8 hrs
  • Duration: up to 18 hrs
  • Used to cover the rise in blood sugar from steroids (e.g. prednisone)
Extended Long Acting Analogues (Clear) Insulin Detemir (Levemir®)
Insulin Glargine 100 units/mL (Lantus®, Basaglar® )
Insulin Glargine 300 units/mL (Toujeo®)
  • Onset: 90 min
  • Peak: flat curve
  • Duration: varies from 16 -48 hrs depending on the product
  • Should not be mixed with other insulin
Pre Mixed (Cloudy) Insulin Aspart / Insulin Protamine (Novo Mix 30®)
Insulin Lispro / Insulin Protamine (Humalog Mix 25®)
Insulin Regular / Insulin NPH (Humulin 30/70®, Novolin ge 30/70® )
  • This depends on the mixture.
  • A single vial, cartridge or pen contains a fixed ratio of rapid or short acting to intermediate acting insulin
  • Should not be mixed with other insulin
  • Taken 15 – 30 min before eating


Manage Your Medications Safely

When you are discharged, you will receive a prescription for your new medications.

1. Make sure your doctor knows all the medications and supplements that you were taking previously so you can both feel confident that you are getting the right prescription.

2. When you receive the prescription, make sure you ask:

  • The name of the medication
  • Why it is being prescribed
  • When and how should it be taken
  • How long you will need to take it
  • What side effects you should expect to have
  • What you should do about the side effects

3. When you pick up your prescription, ask your pharmacist:

  • To explain the best way to take the medication
  • To explain what is written on the labels
  • To provide written information about the medication

4. Try to use the same pharmacy for all your prescriptions. It is important for your pharmacist to have a complete list of all your medications. Your pharmacist can then evaluate if all your medications can be safely taken together.

5. Carry your medication list with you. Make sure the list includes:

  • All your medications, as well as any vitamins, supplements and herbals
  • Your allergies, immunizations and pharmacy phone number

6. Review the list regularly with your doctor or pharmacist.

7. If you have trouble remembering to take your medications, the following tips are “tried and true”:

  • Take your medications at the same time each day.
  • Associate your medications with daily activities like:
    • Brushing your teeth or
    • Mealtimes or
    • Bedtime
  • Use a pill organizer (dosette) with different compartments for different times of the day.
  • Ask your pharmacy if they can organize your pills in blister packs.
  • Keep a one-day supply of your medications in your handbag or at the office.
  • If your medications are complicated, ask your doctor if something simpler can be prescribed.
  • Put a note on your calendar to remind you to pick up your prescription refills.

8. Do not store your medication in hot or humid areas, such as the bathroom or glove compartment of your car. These conditions will shorten the expiry of your drugs.

9. Take the medication as it is prescribed by your doctor. If you have concerns about taking medications, discuss them openly and honestly with your doctor. If you experience troublesome side effects, your doctor may be able to prescribe a different kind of medication.

10. If you are worried about the cost of your medication, ask your doctor if a less expensive medication can be substituted, or check with the Trillium Drug Program for possible assistance:

In Case of an Emergency

Before you are discharged from the hospital, your nurse will supply you with your Vial of Life kit. If you are ever in need of emergency medical help, the Vial of Life is a quick way for paramedics and hospital staff to know what medications you are taking, your emergency contacts, and any pertinent health information.

When preparing your Vial of Life:

  1. Print clearly.
  2. Complete your Vial of Life Medication Sheet.
  3. Complete your Vial of Life Information Sheet.
  4. Place both forms in your vial and store it in the freezer door of your refrigerator.
  5. Place the Vial of Life magnet on the top right corner of your refrigerator.
  6. Remember to update your medication list every time your prescription changes.



If you experience angina discomfort/pain please do the following:

At the first sign of discomfort > Stop immediately and rest
If no relief with rest > Take 1st nitroglycerin tablet/spray
If no relief within five minutes > Take 2nd nitroglycerin tablet/spray
If no relief within five minutes > Take 3rd nitroglycerin tablet/spray


It is important to let your cardiologist and family doctor know if you experience any changes in your symptoms.

Participate in a Cardiac Rehabilitation Program

What Is Cardiac Rehabilitation?

Cardiac rehabilitation is a program of exercise, education, and counselling that is designed to help you learn how to make heart healthy living a part of your everyday life. Research demonstrates that people who participate in a cardiac rehabilitation program are more successful at managing their risk factors compared to those who do not.

Participating in a cardiac rehabilitation program will dramatically reduce your risk of future heart problems. There are a variety of programs available for you to choose from. Your program will be personalized to meet your needs. Your risk factors will be measured at different time points to monitor your progress and improvement.

In most cases, your cardiologist or cardiac surgeon will automatically refer you to a cardiac rehabilitation program. If you have not received your cardiac rehabilitation appointment within a few weeks of being discharged from the hospital, you should contact your doctor and discuss whether cardiac rehabilitation is right for you.

Overview of Cardiac Rehabilitation Options

Cardiac rehabilitation programs are designed to assist you in achieving and maintaining a heart healthy lifestyle and to help you return to everyday life. There are a number of program options available to residents living in the Ottawa-Carleton and surrounding regions. There is no cost for participation in these programs.

On-site Supervised Program

Phone: 613-696-7068

  • Two- to three-month program
  • Supervised on-site, twice-weekly exercise sessions (one hour/session)
  • Medical assessment by cardiac rehabilitation physician
  • Nutrition workshops
  • Referral to services if needed, such as:
    • Nutritional counselling
    • Stress management
    • Smoking cessation
  • Vocational counselling
  • Psychological counselling
  • Social work counselling
  • Follow-up evaluation scheduled after three and twelve months
Case-managed home program

Phone: 613-696-7068

  • Flexibility for those unable to participate in hospital-based program
  • Three-month program
  • Tailored program focused on your personal heart health goals
  • Coronary risk factor assessment
  • Nutrition workshops
  • Total of 15 appointments, approximately 30 minutes each
  • Three appointments at Heart Institute, remainder by phone
  • Individual home exercise program, no supervised exercise sessions
  • Referral to services if needed such as:
    • Nutritional counselling
    • Stress management
    • Smoking cessation
    • Vocational counselling
    • Psychological counselling
    • Social work counselling
  • Follow-up evaluation scheduled after three and twelve months
Brief Program

Phone: 613-696-7068

  • Coronary risk factor assessment
  • Nutrition workshops
  • Exercise evaluation and tailored home exercise program, no supervised exercise sessions
  • Total of 2 or 3 appointments at the Heart Institute
  • Follow-up evaluation scheduled after three and twelve months
  • Referral to services as needed such as:
  • Nutritional counselling
  • Stress management
  • Smoking cessation
  • Vocational counselling
  • Psychological counselling
  • Social work counseling

Peer support program led by women with heart disease for women with heart disease The Women@Heart program aims to provide women with heart disease, in every community, with access to emotional and educational support and a caring environment for better recovery after a cardiac event. Call 613-696-7000 ext. 10412 or visit the website.

Francoforme* (French Case-Managed Home Program)

*open to Franco-Ontarians only
Phone: 613-696-7068

  • Three-month program offered in French
  • Flexibility for those unable to participate in a hospital-based program
  • Tailored program focused on your personal heart health goals
  • Coronary risk factor assessment
  • Nutrition workshops
  • Total of 15 appointments, approximately 30 minutes each
  • Three appointments at Heart Institute, remainder by phone
  • Individual home exercise program, no supervised exercise sessions
  • Follow-up evaluation scheduled after three and twelve months
  • Referral to services if needed such as:
    • Nutritional counseling
    • Stress management
    • Smoking cessation
    • Vocational counselling
    • Psychological counselling
    • Social work counseling
Virtual Care Program

Activating patients to proactively manage their heart health

The Virtual Care Program is an online cardiovascular health management system that provides best practice strategies for the control and management of risk factors for primary and secondary prevention of heart disease. The features of the platform include: assessments and preferences, personal wellness plan, trackers and progress reports, integration with wellness devices and cellular application push messaging, health library and content tagging, reminders, circle of care invitations, online social forums/support groups, and wellness challenges. The platform is designed to raise awareness about an individual’s heart health status and motivate them to manage and improve their health and well being. Email or visit

Cardiac Prehabilitation

Phone 613-696-7000 extension 19999
*This program is for patients waiting at home for some types of cardiac surgery.

  • Phone assessment by Cardiac Rehabilitation nurse
  • Two hour educational workshop to help patients prepare for cardiac surgery
  • Led by program nurses, physiotherapists, registered dietitian, diabetes educators, and stress management experts
  • Home exercise program provided; no supervised exercise sessions
  • Referral to other services as needed

Tele-Rehab Programs in the Region

  • Using the telemedicine system, remote sites connect to a live cardiac rehab class onsite at UOHI
  • Patients are referred from their stay at UOHI and receive cardiac rehab programs at their local hospital or health center
  • Patients attend 1 hour/2 X week for 8-12 weeks with follow-up evaluation scheduled after three and twelve months completion


  • Cornwall: Seaway Valley Community Health Centre
    Phone: 613-936-0306 ext 106
  • Winchester: Winchester District Memorial Hospital
    Phone: 613-774-2420 ext 6870
  • Almonte: Ottawa Valley Family Health Team
    Phone: 613-256-9370 ext 2065
  • Barry’s Bay: St. Francis Memorial Hospital
    Phone: 613-756-3045 ext 256
  • Arnprior Family Health Team and Arnprior Regional Health
    Phone: 613-622-5763 ext 109

Community and Regional Programs


Phone: 613-746-4621 ext. 4125 Fax: 613-748-4913
*open to Ontario residents only

  • 8-12 week program
  • 2 exercise sessions/week
  • Group sessions (8-12 patients)
  • Exercise supervised by a physiotherapist or a kinesiologist and a nurse
  • Medical assessment
  • Bilingual staff

Phone: 613-732-2811 x8091

  • Three- to six-month program, modelled after Heart Institute on-site program
  • Supervised on-site, twice-weekly exercise sessions
  • Education sessions
  • Medical assessment
  • Referral to a dietitian or social worker, as needed
  • Case-managed home program also available

Phone: 613-632-1111 x177 – Contact Nathalie Aupin

  • 12-week program
  • Supervised on-site, twice-weekly exercise sessions
  • Education sessions
  • Bilingual staff

Phone: 613-345-5645 x1414, Fax: 613-345-8348

  • 12-week program focused on your personal heart health goals
  • Supervised on-site, twice-weekly exercise sessions
  • Risk factor assessment with education sessions
  • Medical assessment
  • Referrals available for individualized risk factors
  • Case-managed home program also available

Phone: 819-966-6214

  • Based on the Heart and Stroke Foundation of Quebec program
  • Personalized physical exercise program
  • Stress management program
  • Nutrition management workshops
  • Five meetings with a case manager plus four optional information sessions
  • One-year case managed home program

Exercise after Cardiac Rehabilitation


Phone: 613-696-7387, Email:

The Heart Wise Exercise program was developed to help individuals with heart problems exercise safely. It is a model for cardiac safe exercise developed by the University of Ottawa Heart Institute in partnership with many community agencies to address the barriers to exercise experienced by cardiac clients. Ideally, this program supplements a formal cardiac rehabilitation program. It could also be an alternative if no cardiac rehabilitation programs are accessible.

There are a variety of Heart Wise Exercise program options allowing patients and their families to choose one that is best suited to their needs and location. Free walking programs are offered in Ottawa shopping malls and in local high schools in Leeds, Lanark and Grenville County, Renfrew County and Prescott- Russell County. All programs must work with the Heart Institute, including attending a training workshop, to meet program criteria and become designated as a Heart Wise Exercise site.

For information regarding additional Heart Wise Exercise criteria, assistance in locating a program or how to start a program in your community, please contact the Regional Manager, Prevention and Rehabilitation Centre, University of Ottawa Heart Institute as indicated above.

See also: Heartwise website