Heart attack recovery
Most people make a good recovery following a heart attack. The heart is a tough muscle and heals very well, although healing can take some time. The injured heart muscle starts to heal soon after a heart attack and takes about 6 to 8 weeks.
The final result is an area of strong scar tissue, and although it won't contract like the normal areas of heart tissue, for many people this does not affect the function of the heart or how they feel.
Psychological healing is also important and this may take longer. There is usually a lot of fear and anxiety associated with having had a heart attack.
Getting back to your normal life
When you first get home from hospital take it easy for the first few days. Recognise when you're tired and rest. Initially you may wish to limit visitors and telephone calls. Be up and dressed each day, and keep increasing your daily activities gradually. Climb stairs at a pace you find comfortable.
After a heart attack, people usually review their lifestyle. Lifestyle changes such as enjoying healthy eating, taking up regular physical activity, and stopping smoking not only improve quality of life, but also reduce the chances of further heart problems.
Cardiac rehabilitation services provide support and advice to help people with heart problems to return to an active life and to help prevent heart attacks or other heart problems in the future.
Cardiac rehabilitation starts in hospital, and then, after discharge from hospital, people generally attend an outpatient programme for 4 to 12 weeks: the programmes are run by qualified health professionals. Ask about the cardiac rehabilitation services provided by your hospital.
Regular physical activity is a vital part of your return to normal life.
As well as being an important part of recovery from a heart attack, regular moderate physical activity helps:
- control your weight;
- improve blood cholesterol;
- control blood pressure;
- treat depression and anxiety; and
- reduce your chances of having another heart attack.
People return to their usual activities at different rates. You may have been given instructions before leaving hospital, especially if you have had an exercise test. If not, you should talk to your doctor.
Moderate-intensity physical activity, such as brisk walking, is recommended for most people. Aim to accumulate 30 minutes of physical activity on most days. Your doctor may recommend you see an exercise physiologist for a tailored exercise programme.
Incorporating a variety of physical and recreational activities into your life helps increase confidence and maintain an exercise habit. If you are planning on doing vigorous exercise such as jogging, you should discuss it with your doctor first.
From the time you leave hospital, do some easy walking around the house and garden or out in the street. Go for a walk each day. Start by walking on flat ground at a pace you find comfortable, for 10 to 15 minutes a day, building up to 30 minutes if you feel able. You should be able to talk as you walk. Start off and finish your walk at a slower pace to warm up and cool down.
Each individual is different and you must progress at your own rate. As well as increasing the time, you can progress by increasing the distance and speed and by incorporating some slopes and hills into your walk.
Sport provides exercise and relaxation and is generally sociable, so it can do you good. Returning to sporting activities is usually okay after about 6 weeks. When returning to sport after a heart attack, it's important to build up gradually. For example, golfers may wish to start with just 3 to 4 holes and bowlers may wish to start with fours and non-competitive games.
Physical activities that require sudden bursts of energy, such as squash, heavy weight-lifting and diving, are not recommended after a heart attack. However, if you are really keen on these activities, discuss it with a cardiologist or specialist physician first.
If possible, you should let someone else run the house for the first week or so. Return to running the home gradually. Begin with activities such as preparing the meals, doing the dishes and light dusting. Let others help you for a while with more strenuous jobs such as vacuuming or chopping wood. When lifting, organise heavy loads into smaller ones or get help.
Resuming sexual activity
Most people can resume their usual sexual activity within a few weeks after a heart attack. You should wait until you are physically and emotionally ready – it’s best to check with your doctor first. As a guide, if you are able to climb 2 flights of stairs comfortably, your heart should be able to meet the demands needed for sex.
Less desire for sex is common after a heart attack. This may be related to tiredness, depression or anxiety. Also some heart medicines may reduce sexual drive or function. Your doctor or nurse can advise you about this. It is also important to discuss concerns with your partner, because you may both be feeling unsure. Here are some helpful points for resuming sexual activity.
- Stop and rest if you experience symptoms such as chest pain or discomfort.
- It is preferable that sexual activity does not occur straight after a heavy meal or alcohol.
- Familiar surroundings and a comfortable room temperature reduce anxiety.
- Use what was the most comfortable and easiest position in the past.
- Report to your doctor any excessive tiredness and/or chest discomfort during activity.
Fitness to work
Most people can go back to work after a heart attack, often within 2 to 6 weeks after leaving hospital. However, the nature of your work and individual rate of recovery and capabilities will need to be assessed. Discuss this with your doctor.
Most employers will co-operate with your plans to return to work as long as they are kept informed of your progress. Whether you go back part-time or full-time at first will depend on the job and your employer.
Some fatigue may be expected after a long period away. This can be mental as well as physical. Try to include the type of activity you do at work into your home exercise programme, particularly if your work involves arm activity.
Austroads is the Association of Australian and New Zealand road transport and traffic authorities, and promotes best practice for use of the road system. In their publication, Assessing Fitness to Drive, endorsed by the Cardiac Society of Australia and New Zealand, they make recommendations for driving with cardiovascular conditions.
For drivers of private vehicles, Austroads recommends that people who have had a heart attack with no complications should not drive for at least 2 weeks afterwards.
See your doctor to discuss driving restrictions after having a heart attack.
Discuss air travel plans with your doctor first. Most airlines don’t permit travel within 7 days of having a heart attack.
If you are travelling within 8 to 21 days of having a heart attack, your doctor will need to provide clearance for you to travel and your condition needs to be stable.
As well as informing airlines about a recent heart attack and any special requirements, passengers should also ensure that they take all required medicines in their hand luggage for easy access.
The fears you first felt in hospital can last for some time until you get your confidence and strength back. It is quite common to have periods when you may feel worried, irritable, angry, guilty or depressed. You may also have trouble sleeping.
The first one or 2 weeks at home may be quite stressful, not only for you but also for your family. This is common after a heart attack and will usually pass in time. It will help if you talk about it with your family and friends. Also bear in mind that they, too, are adjusting to your illness.
Speak to your doctor or cardiac rehabilitation nurse about how you are feeling, or consider joining a support group: there's always someone who understands and can help.
Suggestions for family members
- Ensure you understand the recovery process.
- Attend a rehabilitation programme with your family member, if possible.
- Discuss your feelings and problems.
- Encourage independence.
- Be aware of being overprotective.
2. Heart Foundation. Reducing risk in heart disease: An expert guide to clinical practice for secondary prevention of coronary heart disease (updated 2012). http://www.heartfoundation.org.au/SiteCollectionDocuments/Reducing-risk-in-heart-disease.pdf (accessed Mar 2015).
3. Austroads; National Transport Commission Australia. Assessing fitness to drive for commercial and private vehicle drivers. Medical standards for licensing and clinical management guidelines (March 2012; as amended up to 30 June 2014). http://www.austroads.com.au/drivers-vehicles/assessing-fitness-to-drive (accessed Feb 2015).
4. National Heart, Lung, and Blood Institute (NHLBI). Heart attack (updated 17 Dec 2013). http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack# (accessed Mar 2015).
5. MayoClinic.com. Heart attack (updated 15 Nov 2014). http://www.mayoclinic.org/diseases-conditions/heart-attack/basics/definition/con-20019520 (accessed Mar 2015).