Exercise Key for Bouncing Back from a Heart Attack
- Three times a week, Stacey Dyer of Springfield works out for an hour, often using a treadmill or an exercise bike.
- The exercise routine began in late June, not long after Dyer suffered a myocardial infarction (MI) in April -- meaning the blood supply to her heart was interrupted, a condition most commonly caused by a blockage of a coronary artery following the rupture of an unstable collection of fatty acids and white blood cells in the wall of an artery.
- But patients such as Dyer are more frequently bouncing back from heart attacks, coronary heart disease and heart ailments with physician-approved exercise programs.
Three times a week, Stacey Dyer of Springfield works out for an hour, often using a treadmill or an exercise bike.
"Now that it's summer break, I've really kicked into (the program), and I'm going from here to see how things are gonna happen," said the 31-year-old mother of two.
The exercise routine began in late June, not long after Dyer suffered a myocardial infarction (MI) in April -- meaning the blood supply to her heart was interrupted, a condition most commonly caused by a blockage of a coronary artery following the rupture of an unstable collection of fatty acids and white blood cells in the wall of an artery.
"It was pretty serious," Dyer says.
As recently as a decade ago, doctors counseled heart attack patients to avoid exercise, concerned that stressing a previously injured heart muscle might trigger a second episode, according to a WebMD. com Heart Health Special Report.
But patients such as Dyer are more frequently bouncing back from heart attacks, coronary heart disease and heart ailments with physician-approved exercise programs. The programs are designed to strengthen the heart and ward off future attacks.
Dr. Robert M. Ewart, associate professor of family and community medicine at Southern Illinois University School of Medicine in Springfield, says heart attack patients benefit from moderate amounts of exercise.
"In the 1940s, heart attack patients would have been kept in bed to let the heart heal. Now, we know (lack of exercise) increases mortality. Starting in the 1960s, early ambulating (such as walking hospital hallways a couple days following an attack) became very common.
"We get patients moving much more quickly now."
A Cochrane Collaboration Medical Analysis performed to determine the effectiveness of exercise on people with coronary heart disease - - a disease that restricts the flow of blood around the heart, often producing a feeling of tightness in the chest (angina) or a heart attack -- found that patients who exercise experience a 27 percent reduction in mortality. The study was performed on men and women of all ages in hospital and community settings.
Since surviving a heart attack three years ago, Ewart says exercise has greatly assisted in his recovery. Strengthening the heart muscle, boosting energy, losing weight, lowering blood pressure and reducing cholesterol are benefits heart attack patients receive from a physician-approved exercise plan designed to fit their needs.
Ewart says formulating an exercise plan depends on a number of variables, including a person's current health status, weight and other medical conditions.
"(Exercise) varies a lot with a person's general condition. An obese person will not have the same program as someone who's not obese. A person with arthritis in their legs will have a different program than someone who's diabetic."
When working with doctors to design a personalized plan, exercise intensity is an important consideration.
"Running puts strain on the heart muscle. Lifting heavy weights will put a sudden strain on the heart," Ewart said. "But, again, everybody's different. A doctor may recommend a patient avoid some exercises at first depending on the severity of the heart attack."
According to WebMD.com, doctors may recommend patients receive an exercise stress test to determine if he or she can tolerate exercise -- and if so, to what degree. The results of the test help determine the range a patient's pulse needs to be in for him or her to gain the most benefits from exercise without placing undue strain on the heart. According to WebMD.com, this range is 50 to 80 percent of the peak heart rate attained during the stress test.
A doctor may recommend a supervised cardiac rehabilitation program after the patient leaves the hospital. According to WebMD.com, the program focuses on exercise training and nutrition as well as counseling to reduce risk factors, such as smoking or overeating. Exercise specialists at the clinic monitor blood pressure and coach patients on the safest ways to exercise.
Ewart attended a cardiac rehabilitation program at Memorial Medical Center for one month, where he exercised under supervision. Now, he exercises on his own five times a week for at least 30 minutes a day at the YMCA.
"Generally, the average patient begins exercising with supervision within a few weeks (after a heart attack)," he says, adding that he began his exercise program less than a month after his attack. "Heart-attack patients should exercise at least three days per week."
He says his routine consists of "a combination of aerobic exercises on a stair-stepper and an elliptical machine." He also lifts weights. "I tend to stick to the low weights. I'm not Arnold Schwarzenegger."
'That's what I'm going for'
Once a patient takes the first steps into establishing an exercise routine, he or she can boost an exercise regime using higher levels of aerobic cardiovascular exercise and resistance (strength) training, according to WebMD.com.
Exercises that involve the whole body -- mainly jogging, cross- country skiing, cycling, rowing and swimming -- are effective forms of aerobic cardiovascular exercise, according to WebMD.com.
Resistance training -- using resistance machines at a gym -- should be introduced slowly as a patient's health improves and they begin to regain strength. A physician can recommend the rate at which to increase weight and resistance.
Dyer says she maintained a healthy lifestyle before her MI. "I took walks. I rode bikes with my kids and stayed pretty active," she says.
But she's made some changes following her MI: "I've thrown out the fried foods and really watched my fat intake."
After her physician enrolled her in a cardiac rehabilitation program at Prairie Heart Cardiac Rehabilitation Center in Springfield following the heart attack, Dyer began one-hour sessions three times per week on a treadmill and stationary bike to strengthen the valves of the heart.
Dyer says the program has "given me more energy."
She also has extra motivation to keep going.
"I've got two kids that are young -- one 10-year-old and one 3- year-old -- so that's what I'm going for."