With the prominence of heart disease in the United States, it’s no wonder suffering a heart attack is such a widespread fear among adults over 50. Every 40 seconds, someone suffers a heart attack, that’s about 790,000 Americans, according to the Center for Disease Control.
Despite how much we know about the onset of heart attacks, we know very little about life after this cardiac event. Individuals that have suffered a heart attack usually experience permanent cardiac muscle damage, but that doesn’t have to affect quality-of-life if the proper recovery is instituted.
Heart attack sufferers are more at risk for having a stroke, kidney disorders, peripheral arterial disease, and another heart attack. These can be prevented with the right aftercare, however, which involves the right balance of activity and rest.
After a bypass surgery or cardiac event, patients may find it incredibly difficult to realize and accept that they don’t have the same strength and stamina as before. Every area of their life changes, from how they move to the activities they can do.
It’s important to know how to approach each of these areas after a heart attack. There’s a general ABC rule for lifestyle changes after, and in the prevention of, a heart attack:
- Avoid tobacco: Smoking damages the walls of your blood vessels and makes it more difficult for blood and oxygen to reach your heart. Nicotine also raises your blood pressure, which can contribute to another heart attack. If possible, avoid secondhand smoke as well.
- Become more active: If you weren’t active before, now is the time to start – after a reasonable recovery period with limited activity and plenty of rest, of course.
- Choose good nutrition: Less bad fats, dairy, sodium, and red meat for a decreased chance of clogged arteries.
So, the general theme for physical recovery here is slow and steady, followed by a regular, heart-healthy fitness regimen and habits. But, how exactly do you implement these?
Although weight training is constantly being emphasized to us in the media lately, we must not overlook the importance of cardio. For heart attack patients, cardio exercise will help strengthen those heart muscles and optimize the way the heart uses oxygen and blood.
All you have to do is start with ten to fifteen minutes of light walking a day. Gradually increase this amount to 30-45 minutes. Pick up more and more cardio activities, from less strenuous to more strenuous. Once you can walk for 45 minutes at a steady pace without feeling winded, try swimming.
Swimming is a great option for older heart attack patients who must be mindful of their joints, as the buoyancy allows for pain-free fitness. Then, graduate to bicycling on a flat, even surface for 30 or so minutes a day.
Take it slow when doing these activities. They don’t have to be high-intensity to be effective, and you don’t want to strain your heart. You can pick up jogging and running if your doctor clears you for it, but work your way up to this after the one-year mark.
If you are going to be walking, jogging, or bicycling alone, it’s important you keep a mobile device on you at all times. Give friends and family members an opportunity to know where you are and if you need help. Don’t strain yourself just to get home.
The recommendations on driving after a heart attack are mixed. While some doctors say patients are okay to drive after a week of recovery time, driving agencies strongly suggest patients wait four weeks. This could be for a multitude of reasons. Sometimes, heart medications take a while to get used to, and side-effects can impair mobility, focus, and therefore the ability to drive.
Other times, heart attack patients live in areas where driving conditions are stressful, be they due to weather or intense traffic. This also is not conducive to recovery.
The Heart Foundation suggests heart patients wait this long to drive again for each cardiac event:
- Coronary angioplasty and stent insertion: 2 days
- Heart attack: 2+ weeks
- Coronary artery bypass graft: 4+ weeks
Even when heart attack patients do return to driving, they should do so with a friend or family member at first. They should also avoid driving for long periods and peak traffic times.
Naturally, heart attack patients will want to revisit their eating habits. In order to keep cholesterol levels low and prevent plaque buildup in the arteries, the following dietary changes should be made:
- Avoid processed and fried foods
- Don’t eat more than 1,500 mg of sodium per day
- Do not consume more than 36 oz. of sugary beverages a week
- Replace red meat with white meat
- Cut out saturated & trans fats
- Eat 4-5 cups of fruit and vegetables every day
- Have at least two servings of fish a week
- Consume at least three 1 oz. servings of whole grains (rich in fiber) each day
- Avoid high-fat dairy products – opt for non-fat or 2% milk when possible
Your diet directly affects your heart. Similarly, a poor diet can lead to being overweight or obese, which also increases your risk for another heart attack.
It’s important not to over-exert or over-excite yourself in the days following your heart attack. Most doctors won’t discourage sex completely after a heart attack but will suggest waiting about 6-8 weeks after bypass surgery to resume regular intercourse.
Otherwise, once your doctor confirms that your cardiac condition is stabilized and there are no bouts of angina or arrhythmia, you can return to your normal sexual routine. It’s certainly important to await your doctor’s approval, however.
You’ll probably leave the hospital after your heart attack with an entire inventory of medications, all with varying dosages, instructions, and purposes. Most of these medications will serve three purposes, according to Dr. O’Gara from Harvard Health: to keep your stent open, keep blood pressure and cholesterol levels low, and regulate your heart rate.
Don’t take medication matters into your own hands, follow your doctor’s directions explicitly. Create a calendar, set reminders on your phone that you can check off (so as not to face the dreaded ‘Did I take my medication?’ moment), and keep medication in a pill organizer by day.
Rehab & physical therapy
Your hospital may host, or your doctor may refer you to, some cardiac rehab programs. You would enroll in one of these about two weeks after your discharge. Not unlike physical therapy, these are weekly, three-hour long sessions that help you develop a safe exercise routine, coach you through dietary changes, and allow you to build a support network.
Heart attack patients usually aren’t enrolled in these programs for longer than a 3-month period, as they’re intended to simply prepare patients for life post-heart attack, and not as a long-term involvement. Their main benefit is to allow heart attack patients to test their limits and see what they’re capable of in a safe and monitored environment.
Returning to work
This can vary based on the kind of work, and should always be consulted with a doctor first. While most heart attack patients return to work between two weeks and three months, this period will vary based on the severity of the heart attack and the surgery they underwent.
This period may be shorter for part-time workers, people who don’t face too much stress at work, or people who aren’t under extensive physical requirements.
Manual laborers and others working in a physically-taxing industry should ease into it, however. Maybe start off by working shorter hours and ease back into part-time work over the course of a few months. Make sure to always clear it with your doctor first, and to take regular breaks – and not just when you feel you need them.
Emotional recovery is equally pertinent to your post-heart attack lifestyle as physical recovery is. Knowing you have to live with a heart condition can take a major toll on your mental health, contributing to some potential anxiety and even depression.
Right after their heart attack, patients typically exhibit a mixture of emotions. They’ll feel some nervousness, fear, and disorientation, but it often doesn’t hit right away. This is because, at first, patients have to go through the motions. Confusion upon finding themselves in the hospital is usually followed by a period of processing everything that’s going on.
Patients will be flooded with health information, tests, doctor’s visits, prescription pick-ups, and the presence of family and friends. It’s not until the hubbub passes that the real emotions begin to sink in. Depression is typically the first thing to set in, which is perfectly normal, affecting 10-20% of cardiac bypass patients. It can be difficult to swallow that life will never quite be the same.
Depression is typically coupled with anxiety and panic attacks, which must be kept at bay. If depressive symptoms persist for two or more weeks after the patient has been discharged from the hospital, treatment is recommended.
High blood pressure & stress
Depression and anxiety are dangerous in heart patients because they can lead to high blood pressure. High blood pressure puts major stress on your heart, arteries, and blood vessels, so keeping it under control with medication and a balanced lifestyle is important.
Increased levels of stress hormones, primarily cortisol, are also prevalent during episodes of depression and anxiety. High levels of cortisol increase cholesterol, blood sugar, and blood pressure – all factors that make patients vulnerable to another heart attack, and sometimes even stroke.
Anxiety can also lead to panic attacks, which have frighteningly similar symptoms to heart attacks. You may feel numbness or tingling in your arm, pain in your chest, and heart palpitations. In someone without heart disease, these symptoms can sometimes be dismissed as a heart attack. However, in the case of a cardiac patient, a panic attack can potentially transition into a heart attack.
Having safety nets, such as access to a mobile phone or an AED, will also help ease the anxiety over having another cardiac event.
The sudden influx of adrenaline and irregular heart palpitations will inflict major stress on your heart. It all comes down to this: stress is a dangerous link to heart disease in even seemingly heart-healthy people, but it is even more detrimental to those in cardiac recovery.
Treating depression while coping with a heart condition can be tricky, as taking antidepressants after a heart attack or bypass surgery can be a gray area. Some antidepressants have side effects that can alter heartbeat, blood pressure, and cause other cardiac disturbances.
As a result, it can be best to try treating depression and anxiety naturally. For starters, meditation should become a daily practice. Just five to ten minutes of meditation daily can alleviate depression and anxiety in heart attack sufferers. It can also regulate oxygen intake, thus lowering blood pressure.
Individuals who practice meditation are significantly less likely to suffer a heart attack or stroke within five years. Regular exercise and a balanced diet can also help in this regard.
Support from other sources
Perhaps the single most important aspect of recovering from a heart attack is the support of loved ones. Without this, many aspects of physical and emotional recovery are almost impossible. Heart attack patients should not let their pride overwhelm them, they should bring their support system (be it a group or just one individual) to follow-up appointments and acquaint them with their routine.
Studies show that individuals with little to no support following a heart attack make a much slower recovery, and are far more likely to face long-term depression after the event. These results were the same across the board despite gender, socioeconomic status, and age.
Heart attack patients whose families and support systems live in other locations should also consider finding a professional caregiver. There are part-time and live-in nurses who specialize in caring for heart attack patients, and their frequency can depend on the severity of the patient’s heart condition.
Not only do these nurses provide much-needed social and emotional support, but they’re also often trained to offer physical therapy and administer medications. Having a heart attack is a life-changing event no matter what, and patients will mourn that normalcy for a while, but it only becomes an affliction when the right steps and adjustments aren’t made for better heart health.