Being active when you have heart disease

Getting regular exercise when you have heart disease is important. It can help you in these ways:

• Exercise can make your heart muscle stronger, just like it makes other muscles stronger. It may also help you be more active without chest pain or other symptoms.
• Exercise may help lower your blood pressure and cholesterol. If you have diabetes, it can help you control your blood sugar.
• Regular exercise will help you lose weight, if you are trying to lose weight. You will also just feel better.
• Exercise will also help keep your bones strong.

Always talk with your doctor before starting an exercise program to make sure the exercise you would like to do is safe for you. This is especially important if:

• You recently had a heart attack.
• You have been having chest pain or pressure, or shortness of breath.
• You have diabetes.
• You recently had a heart procedure or heart surgery.

Types of Exercise You Can Do

Your doctor will tell you what exercise is best for you. Talk with your doctor before you start a new exercise program or before you do an activity that is much harder than what you have been doing.
Aerobic activity uses your heart and lungs for a long period of time, helps your heart use oxygen better, and improves blood flow. You want to make your heart work a little harder every time, but not too hard:

• Start slowly.
• Choose an aerobic activity such as walking, swimming, light jogging, or biking. Do this at least 3 to 4 times a week.
• Always do 5 minutes of stretching or moving around to warm up your muscles and heart before you start exercising harder.
• Always allow time to cool down after you exercise. Do the same activity but at a slower pace.
• Take rest periods before you get too tired. If you feel tired or have any heart symptoms, stop.
• Wear comfortable clothing for the exercise you are doing.

During hot weather, exercise in the morning or evening. Be careful not to wear too many layers of clothes. You can also go to an indoor shopping mall to walk or to a fitness center.
When it is cold, cover your nose and mouth when exercising outside. Go to an indoor shopping mall or fitness center if it is too cold or snowy to exercise outside. Ask your doctor if it is okay for you to exercise when it is below freezing.
Resistance weight training, using Nautilus and similar machines, may improve your strength and help your muscles work together better. This can make it easier to do daily activities, like lifting groceries. These exercises are good for you, but keep in mind they do not help your heart like aerobic exercise does.
Check out your weight-training routine with your doctor first. Go easy, and do not strain too hard. It is better to do more lighter sets of exercise when you have heart disease than to work out too hard.
Good weight-training exercises may include the chest press, shoulder press, triceps extension, biceps curl, pull-down (upper back), lower back extension, abdominal crunch/curl-up, quadriceps extension or leg press, leg curls (hamstrings), and calf raise.
You may need advice from a physical therapist or trainer on how to do the exercises the correct way. Make sure you breathe steadily, switch between upper and lower body work, and rest often.

Pace Yourself and Know Your Limits

If your exercise puts too much strain on your heart, you may have pain and other symptoms, such as:

• Dizziness or lightheadedness
• Chest pain
• Irregular heart beat or pulse
• Shortness of breath
• Nausea

It is important that you pay attention to these warning signs, stop what you are doing, and rest.

• Know how to treat your heart symptoms if they happen. See also: Angina - when you have chest pain
• Always carry some nitroglycerin pills with you.

If you have symptoms, write down what you were doing and the time of day. Share this information with your doctor. If these symptoms are very bad or do not go away when you stop your activity, let your doctor know about these right away. Your doctor can give you advice about exercise during your regular medical appointments.
Know your resting pulse rate and a safe exercising pulse rate. Try taking your pulse during exercise to see if your heart is beating at a safe exercise rate. If it is too high, slow down. Then, take it again after exercise to see if it comes back to normal within about 10 minutes.
You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of the opposite hand to locate your pulse and count the number of beats a minute.
Drink plenty of water, and take frequent breaks during exercise or other strenuous activities.

When to Call the Doctor

Call your doctor if you feel:

• Pain, pressure, tightness, or heaviness in the chest, arm, neck, or jaw
• Shortness of breath
• Gas pains or indigestion
• Numbness in your arms
• Sweaty, or if you lose color
• Lightheaded

Changes in your angina may mean your heart disease is getting worse. Call your doctor if your angina:

• Becomes stronger
• Occurs more often
• Lasts longer
• Occurs when you are not active or when you are resting
• Does not get better when you take your medicine

Also call your doctor if you cannot exercise as much as you are used to being able to.

Sources: "Being active when you have heart disease." Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000094.htm

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