Heart Disease and Exercise: The How and The Why

“Exercise?  Yeah, I know I should, but where do I begin?”

This question takes on a whole new meaning when asked by someone with a heart condition.  Instead of deciding which gym to join or which video to purchase, those of us in this distinguished group have bigger things to consider.  For instance, if my heart rate goes above a certain number, am I gonna die?!!?  It’s these types of questions that make your exercise choices very personal and specific.

I’ve heard it from my doctor; no doubt you have too.  ‘Exercise is an important part of keeping your condition under control’.  That’s all good and fine, but where do I begin?

The truth is, changes will need to be made to your past exercise routine.  As an example, I used to be able to ride my bike for miles and never break a sweat.  Now, just looking at my bike gets me winded.

Of course, there are many facets to heart disease.  No two conditions are alike and only your doctor is in the best position to offer specific recommendations.  That being said, here are some things to discuss with your doctor:

- Medication:  New medications can greatly affect your body’s response to exercise.  Before continuing with your current routine,    check to see that it is still safe.

- Heavy Lifting:  Check to see if lifting or pushing heavy objects (i.e. chores such as raking, shoveling, mowing, scrubbing) are ok.   Even chores we may have had no trouble with in the past now leave us tired.  Do only what you are able to do.

- Safe Exercises:  As for the old standards (lifting weights, use of a weight machine, jog, swim, etc.) ask first then do.

The good folks at WebMD have put together a fantastic list of do’s and don’ts that should be discussed with your doctor.

1.)  Be sure any exercise is paced and balanced with rest.

2.)  Avoid isometric exercises such as push-ups and sit-ups.  Isometric exercises involve straining muscles against other muscles or an immovable object.

3.)  Don’t exercise outdoors when it is too cold, hot, or humid.  High humidity may cause you to tire more quickly; extreme temperatures can interfere with circulation, make breathing difficult, and cause chest pain.  Better choices are indoor activities such as mall walking.  (Plus you can shop; that’s exercise, right??)

4.)  Stay hydrated. It is important to drink water even before you feel thirsty, especially on hot days.

5.)  Extremely hot and cold showers or sauna baths should be avoided after exercise.  These extreme temperatures increase the workload on your heart.

6.)  Steer clear of exercise in hilly areas.  If you must walk in steep areas, slow down when going uphill to avoid working too hard.  Monitor your heart rate closely.

7.)  If your exercise program has been interrupted for a few days (for example, due to illness, vacation, or bad weather), ease back into the routine.  Start with a reduced level of activity, and gradually increase it until you’re back where you started.

While dropping a quick 40 pounds may not be possible, focusing on long-term goals meant to increase your strength and stamina will keep you encouraged.  Find what works best for you and stick with it.  You’ll be glad you did.

[TatiSD]

Good post, and so right.  Just giving the advice to exercise isn't enough for those with arrhythmias as well since there are so many things to consider.  Personally, I find that building up slowly and doing consistent, even type of exercises (treadmill, elliptical) where you can maintain a consistent, healthy elevated HR works best against getting PVC's.

[ed34]

You know, I look at what doctors recommend and wonder if it inhibits natural recovery of heart problems. The body in everyone probably has the ability to form collateral vessels to provide extra vascularisation, but this has to be kicked into action. From what I have observed, which may be different to what research has found, is that people who had very demanding physical jobs developed collaterals. They felt many discomforts but were
misdiagnosed or put them down to other problems themselves such as pulled chest muscles etc. Working through the symptoms seemed to force these extra vessels to form. I met others at the other end of the scale who had desk jobs and hardly exercised, these didn't seem to have collateral development.
When exercising, it is not uncommon to start a long walk and feel out of breath or discomforts soon into the task and have to stop. Most people at this stage think their limit has been reached, go home and relax. However, some people have found if they relax for a couple of minutes, then resume walking, the discomforts are harder to reach.
'Perhaps' this is the point which collaterals are triggered into forming but it obviously takes more than one walk, it would take weeks. Good exercise for the heart doesn't have to be anything more than a good walk, in fact it's a perfect thing for the heart. It allows it to gently speed up at the start and gently slow down at the end.
Other muscle groups in the body obviously will require different forms of exercise, but getting the heart stronger is the best first move.

[joanincarolina]

It's difficult to eliminate exercise if one has been used to it and had activity as an important part of lifestyle.And there are times when you can work through the discomforts. Retrospectively, I'd have to say that reassurances from my doctors to keep on exercising was very risky behavior for me with MVD. Listen to your body and know the difference between out of breath and shortness of breath. When a sudden laugh or slight exertion can feel like an upper cut knock out to the diaphragm leaving you gasping, then it's time to curtail exertional activity.It's not worth the risk.Joan.

[Riz711]

I live in the UK with our "infamous" National Health Service.  I had my heart attack 3 months ago and could not have received more professional and kinder treatment that at my local hospital.   What I had not expected was the quality of the after care.  There is a full time Cardiac Rehab Unit.  I have just finished one of their 6 week rehab programmes.  It has been a revelation.  

7 weeks ago I could barely walk a hundred yards without being breathless and exhausted.  Now I can walk 3 miles with only a little discomfort.  I have 2 hourly work out classes a week and I have a special work out DVD provided by the Rehab Unit for working out at home.   Our Government recommends at least 5 half hour sessions of aerobic exercise each week.  More if you can manage it.

The great thing for me has been the knowledge provided by the Rehab Unit and the especially tailored work out sessions.  

[Riz711]

Oh!  I forgot the most important thing I have learnt.  Don't attempt any exercise without a full 15 minute warm up and finish off with a full 10 minute cool down.  The difference it makes is amazing.

[RadioAstronomyObserver]

Warm-up and Cool-down does make the difference!!  I learned this through walking around the village,  I can walk around the block without warm-ups but with warm-ups I can walk to the other side of the village and back and still have room for more.