How Can Exercise Help People With Heart Disease?
“The minute I get short of breath or feel my heart racing a little, I worry. If I am walking I sit down somewhere and wonder if my heart is going to be ok. Will I be ok?”
Does this sound familiar? Do you wonder if you’ll “ever feel normal again?”It’s a natural (protective) response to try and avoid activities that cause pain and or breathlessness. However, the less active you are, the greater the risk of your heart disease getting worse. A small amount of prevention is better than a large amount of treatment.
The benefits of being more active if you already have a heart condition, include:
- Living longer
- Improving your energy and fitness levels and quality of life
- Improve the blood flow around the body. Regular physical activity triggers a cascade of ‘chemical’ responses within the lining of the blood vessels, causing a dilation of the vessels and preventing platelets from sticking together. This improves the blood flow within and around the heart as well as to the rest of your body.
- Help prevent early death and hospital admissions. Physical activity reduces the overall risk of coronary heart disease and stroke by 20–30% in men and 10–20% in women.
- Help prevent fatigue and stress.
- Lower your risk factors for diabetes and blood pressure.
Physical activity also has benefits for those that suffer from chest pain or angina, including:
- Increasing blood flow to the heart
- Improving perception of chest pain
- Improving how effectively your heart beats and pumps blood out around your body
- Helping to prevent inflammation within the blood vessels, which can reduce your risk of developing clots
- Helping to prevent risk of further heart attacks
- Helping to prevent development of heart failure.
All these benefits will help you feel better about yourself and your condition, improve your sleep, daily routine and mood by releasing hormones called endorphins which are ‘feel good’ hormones. Your energy and fitness levels will improve and you’ll feel less breathless, less fearful and more able to participate in activities or do daily chores.
So, now that you have an idea of the many benefits of physical activity, you may be motivated to do more, but still have some fears and concerns to overcome. Here are some specific tips regarding your condition and how to prepare yourself for being more active.
What do I do if I get chest pain?
Stop, sit down and rest. Use your GTN spray or tablets for an acute attack. The pain should go away within 5 minutes, if not use your spray or medication again. If the pain still persists, call emergency numbers.
Avoid vigorous exercises (where the effort is such that you are unable to speak a full sentence while exercising), keep to moderate intensity exercise and always start slow and build up gradually.
Always carry your medication with you. If recently diagnosed or unstable seek medical advice before starting any exercise program.
The more physical activity you do, the stronger your heart muscle will get, and this will stimulate the growth of new vessels to improve its own blood flow. The heart becomes stronger and functions better resulting in chest pain being less severe and less frequent.
I am already breathless, will being active make it worse?
Mild breathlessness is normal for anyone doing activity. The fitter you become over time, the less breathless you will be. Activity improves your lungs and heart’s ability to work efficiently. Also, the more you do, the stronger your muscles become and they in turn they demand less oxygen, reducing your level of breathlessness.
What intensity is safe?
There is no evidence to suggest that doing exercise at a low or moderate intensity can cause harm. So, whatever you are doing make sure you can speak (or sing to yourself) relatively comfortably throughout – this will ensure the intensity is not too high.
Will I have a heart attack if I start exercising?
The risk of dying during physical activity is very low. The risk to your health in doing nothing is far greater. The risk of death while exercising for men is 1 per 23 million hours and 1 per 36.5 million hours for women. Avoid sudden vigorous activity to be safe. Gradually increase your level of activity over time, especially in the first 3 months to be safe.
I already struggle to breathe, will exercising make it worse?
A slight increase in breathlessness and muscle soreness is normal with activity, especially when getting started. This is normal and should subside immediately after completing exercise. Any muscle soreness should also resolve within 24– 48 hours, if the pain persists maybe you did a little too much and should cut down a little for the next few weeks and then gradually build up again. Any dizziness, excessive shortness of breath, sickness, blacking out, chest pain – stop immediately and wait for the symptoms to settle within minutes. If they do not, then call for help.
I am already so tired, how can I start being more active?
Physical activity is the most important treatment for persistent fatigue as it helps with body conditioning and boosts energy levels. It can ultimately help you gain control of your body and health.The more active you are, the stronger your muscles become making tasks seem easier and requiring less effort. In addition, stronger muscles have better blood flow and use less oxygen,making you feel fitter and less tired. This will help motivate you to do more.
A good place to start would be with an assessment from our exercise physiologist, Nicole Smith, who specialises in supporting people with cardiac conditions to exercise safely. Cardiac rehab doesn’t change your past, but it can help you improve your heart’s future.
Cardiac rehab is a medically supervised programme designed to improve your cardiovascular health if you have experienced a heart attack, heart failure, angioplasty or heart surgery. It can also be a great way to prevent cardiac conditions from developing.
At our clinic Nicole runs classes held in a controlled environment where she can monitor your vital signs while you exercise. This will help you slowly build your confidence and fitness before going out on your own. Nicole can also incorporate educational times to learn about stress management, coping strategies and to gain a better understanding of your condition.
A good idea before starting an activity is to sit down with your therapist or even a family member or friend and write down what it is you want to achieve. Set goals, easy achievable ones initially. These will help build self-esteem and confidence. Then you can start looking from short-term easier goals (which may be as simple as walking 10 minutes every day, or achieving a walk around the block 3 times a week)to middle- and long-term ones, extending over the coming months and year. Nicole is great at helping you set your goals and making them achievable.
‘Action planning’ is the next step. Write down what you are going to do each day or as a weekly plan. Keeping these plans, together with a daily diary, will help you stay motivated and see the improvements over time. You can use self-monitoring devices like pedometers, wrist-worn accelerometers or smartphones to keep track of your daily step count. There are also many activity apps that can be downloaded to mobile phones to help you monitor your activity levels, motivate you or provide you with daily exercise routines. Nicole Smith our exercise physiologist is the perfect person to help you and advise you about what would best suit you and your condition.
Make sure you have support – be it family and friends, a supportive exercise group or exercise programme. The right support will be invaluable in keeping you motivated and encouraged, particularly on those bad days, and make you accountable for changing your life!
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