I had a heart attack which makes me nervous about exercising. What if I have another heart attack?

Exercising following a heart attack is something that should be discussed with your cardiologist. He or she may decide to have you perform a stress test to determine if your condition is suitable for you to begin exercising.

The relative safety of medically supervised, physician-directed, cardiac rehabilitation exercise programs that follow the approved guidelines is well established. The occurrence of major cardiovascular events during supervised exercise is very low and ranges from 1/50,000 to 1/120,000 patient-hours of exercise, with only 2 fatalities reported per 1.5 million patient-hours of exercise.

The benefits of regular exercise, on the other hand, are many. Exercise training and regular daily physical activities (eg, working around the house and yard, climbing stairs, walking or cycling for transportation or recreation) are essential for improving a cardiac patient’s physical fitness. Supervised exercise for 3 to 6 months helps even the most deconditioned individuals. Improved fitness enhances a patient’s quality of life and can even help older adults to live independently.

Improved fitness allows patients with advanced coronary artery disease (CAD) who ordinarily experience chest pain during physical exertion to perform such tasks at a higher intensity level before having any chest pain. Furthermore, regular exercise results in an improvement in muscular strength during daily activities, such as carrying groceries or lifting moderate to heavy objects. In addition, improvement in cardiorespiratory endurance is associated with a significant reduction in subsequent cardiovascular fatal and nonfatal events. These findings also apply to patients with chronic heart failure.

Studies have shown a reduction in both cardiac and total mortality after completion of cardiac rehabilitation programs.

Other benefits of exercise training and regular physical activity are moderate losses in body weight and adiposity, decreases in blood pressure and serum triglycerides (fats), increases in good cholesterol, and a reduction in the risk of developing diabetes mellitus.