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Working Out with Heart Disease

By Janis Jibrin, M.S., R.D.

If you have coronary heart disease (CHD) in which the arteries leading to the heart have narrowed, another form of heart disease, or have had a heart attack, you might feel a little skittish about exercise. Could it strain your heart too much? “It’s a legitimate concern; I suggest talking to your doctor first about a referral to cardiac rehab,” advises Vera Bittner, MD, M.D., section head, Preventive Cardiology and medical director of the University of Alabama at Birmingham cardiac rehab program. “If, for whatever reason, this does not work, then discuss exercise with your doctor. Walking is safe for the vast majority of people with CHD. If you want to do vigorous exercise, a stress test may be warranted depending on the clinical picture.”

 

A stress test is an electrocardiogram taken while you’re exercising, usually on a treadmill. The test reflects any reductions in blood flow to the heart muscle. This, in turn, clues your doctor in to the appropriate type and level of exercise.

 

It’s crucial that you get your healthcare provider’s approval before beginning any new type of exercise (or even resuming your old routine after having a heart attack or other cardiovascular issues). Once you and your health care provider have determined a safe level of exercise, here are some general tips:

  • Warm up slowly before exercising, gradually increasing intensity. And leave time for a cool down, in which you gradually decrease intensity. This allows for a gradual increase and decrease in heart rate and breathing.
  • Monitor intensity. Your doctor will guide you to the proper intensity level (See “Get Intense” ). Some physicians will recommend using a heart rate monitor that tracks beats per minute; you’ll be told what range is safe.

 

Be on guard for warning signs that could indicate you’re stressing your heart too much or could be having a heart attack. If you experience any of these, call your doctor immediately:

  • Angina. It’ somewhat subjective but can feel like pressure, heaviness, squeezing, burning or tightness around heart and the area around the heart which might radiate out to your shoulder, back, throat or jaw.
  • Lightheadedness, confusion, dizziness
  • Feeling wiped out after exercise
  • Shortness of breath
  • Fast or erratic heartbeat

Consult your health care provider to determine a safe level of exercise for you.

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