Exercise after a heart attack

Heart Smart Talk

Dr Claudine Lewis

Sunday, September 17, 2017

Print this page Email A Friend!

AFTER a heart attack, the person who sustained the attack is usually fearful about exercising or resuming their regular activities.

However, done safely, exercising after a heart attack is one of the best things that you could do to decrease the chances of having another heart attack and reducing the symptoms of heart disease, by training your heart to operate more efficiently.

The doctor will design an exercise prescription for you and this will form part of your cardiac rehabilitation. In some centres, there are formal programmes established for cardiac rehabilitation, usually done in conjunction with exercise physiologist or physiotherapist. This exercise prescription is just as important as any medication your doctor will prescribe and, along with your diet, will form the trifecta of your prevention programme — aimed at preventing you from getting another heart attack.

Patients who join a cardiac rehabilitation programme have a faster and safer recovery and better outcomes after a heart attack.

Before resuming exercise/routine activity

You will need to consult with your doctor — usually two weeks or more after you have been discharged from the hospital — to assess your current level of fitness, and to make sure your blood pressure and heart rate are stable, as well as assess for complications like heart failure which may impact your ability to exercise normally.

During this visit the doctor will take note of your vital signs and do a comprehensive review of your current level of activity and any associated symptoms. Based on this assessment, the doctor may recommend one of two things: Further testing and/or treatment; or exercise prescription.

Further testing and/or treatment

If after your heart attack you have not received any treatment to restore normal blood flow to your heart — this will be either coronary angioplasty or stenting of the blocked arteries, or bypass grafting — you will need to do a stress test before doing any exercise.

This is because the doctor will need to assess your level of heart function and your ability to exercise safely. Without doing the stress test, you may encounter problems during exercise, such as angina (chest pain), heart attack or sudden death.


This is the best test to perform after a heart attack to assess your readiness for exercise and to outline the level of exercise that is safe for you — otherwise known as an exercise prescription.

During this test, the doctor will have you exercise in a monitored setting — usually using a treadmill or ergometer (stationary bicycle). During the test, your blood pressure, heart rate and ECG are monitored as your heart rate is increased to its maximum rate for your age, while the test personnel monitors for signs of poor circulation to the heart and checks you for symptoms.

Safety precautions such as a defibrillator and other emergency equipment must be in place. The average duration for the stress test for an adult is five to six minutes, with people who are fitter with no blockage being able to exercise for up to 10 minutes.

The exercise stress test gives the doctor information about your ability to perform exercise safely and what level of exercise is safe for you. During the test, the doctor will measure the number of METs (Metabolic Equivalents) that you are able to perform without having chest pain or ECG changes. This will be used to determine the level of activity that is safe for you to perform at home.

Roughly three to four METS would be walking at a regular pace and five to seven METS would be brisk walking, light jog or swimming.

If there are any changes during the stress test that are not good — such as ECG changes, fall in blood pressure, or chest pain — the doctor will recommend adjustment in your medications and a coronary angiogram with a view for you to do an angioplasty or bypass grafting, pending the results of the angiogram. After these procedures, to restore normal blood flow to the heart you will be reassessed for fitness for exercise programme and an exercise prescription given.

Dr Claudine Lewis is an adult cardiologist and medical director at Heart Smart Centre in Montego Bay. She is also a cardiologist at the Cornwall Regional Hospital, and an associate lecturer with the University of the West Indies. Questions may be sent to For additional information call 684-9989 or visit the website




1. We welcome reader comments on the top stories of the day. Some comments may be republished on the website or in the newspaper � email addresses will not be published.

2. Please understand that comments are moderated and it is not always possible to publish all that have been submitted. We will, however, try to publish comments that are representative of all received.

3. We ask that comments are civil and free of libellous or hateful material. Also please stick to the topic under discussion.

4. Please do not write in block capitals since this makes your comment hard to read.

5. Please don't use the comments to advertise. However, our advertising department can be more than accommodating if emailed:

6. If readers wish to report offensive comments, suggest a correction or share a story then please email:

7. Lastly, read our Terms and Conditions and Privacy Policy

comments powered by Disqus



Today's Cartoon

Click image to view full size editorial cartoon