Cardiac Rehab: Exercising Safely After a Heart Attack or Bypass

After a heart attack, stent or bypass surgery, many people are frightened to exercise. They worry that exertion could cause another event. Yet structured cardiac rehabilitation, which includes supervised exercise, has been shown to reduce the risk of dying from heart disease and of readmission to hospital, and improves quality of life.

Always get clearance from your cardiologist before starting an exercise programme after a heart event or heart surgery.

What cardiac rehabilitation includes

• Supervised, graded exercise
• Education about heart health, medications and risk factors
• Lifestyle support: healthy eating, stopping smoking, managing weight and blood pressure
• Emotional support, as anxiety and low mood are common after a heart event

The early stage (first weeks)

• Short, gentle walks, gradually increasing distance
• Light daily activities
• After bypass surgery, follow sternal precautions as advised: typically avoiding pushing, pulling or lifting heavy items with your arms for several weeks while the breastbone heals

Building up

As your fitness improves, a typical programme includes:

• Aerobic exercise: walking, cycling, building towards 30 minutes most days
• Warm-up and cool-down: at least 10 minutes each
• Light resistance training, once cleared by your team

How hard should it feel?

A useful guide is the talk test: you should be able to talk in short sentences but feel slightly breathless. On a scale of 0 to 10, aim for around 3 to 4 at first, building to 4 to 5 as advised.

Stop exercising and seek help if you have:

• Chest pain, tightness or pressure
• Severe breathlessness
• Dizziness or light-headedness
• An irregular or racing heartbeat
• Nausea or cold sweats

If chest pain doesn't settle within a few minutes of rest (or with your prescribed spray, if you have one), call emergency services.

Safety tips

• Don't exercise straight after a heavy meal
• Avoid exercising in extreme heat or cold
• Carry any prescribed medication, such as a GTN spray
• Don't hold your breath or strain during exercise

The long-term goal

Cardiac rehab aims to make regular exercise a lifelong habit. Many people end up fitter and more confident than they were before their heart event.