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Exercise and Activity After Heart Surgery (5801)

Exercise and Activity After Heart Surgery (5801) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Cardiology, Cardiovascular Surgery


Exercise and Activity after Heart Surgery

Exercise is important for healthy healing and will help you return to a more active
lifestyle. Aerobic exercise, defined as continuous training that uses the large muscle
groups (i.e., your arms and legs), conditions the entire body. It helps your heart and
lungs to work more efficiently. It also helps to control other risk factors for heart
disease and stroke.

Benefits of Exercise
ξ To decrease your risk of another heart related event.
ξ To reduce your triglyceride and LDL (bad cholesterol) levels.
ξ To increase your HDL (good cholesterol) levels.
ξ To lower blood pressure.
ξ To decrease risk of developing diabetes.
ξ To reduce blood sugar levels in persons with diabetes.
ξ To help manage weight.
ξ To reduce stress and improve your emotional well-being.
ξ To reduce risk of osteoporosis as well as colon and breast cancer.
ξ To reduce risk of stroke.
What Kind of Exercise is Beneficial?

Aerobic exercise will help you return to an active lifestyle. This involves constant
movement of your legs and/or arms. Aerobic exercise examples include: walking,
biking, swimming, and dancing. Any type of activity that makes you breathe harder
and faster for at least 10 minutes at a time is considered aerobic exercise.

Resistance training helps strengthen major muscle groups and helps burn more

Your Hospital Exercise Program
While in the hospital, you will work with the Cardiac Rehabilitation team to find an
initial program that is right for you. The staff will check your heart rate and blood
pressure while you walk which helps them to know how your body is responding to
exercise. It also helps them to suggest an initial home program that is best for you.

Your Home Exercise Program
When first home, you will want to follow these guidelines. Start your home exercise
program the day after you go home from the hospital

 What activity? Walking on a level surface or using a stationary bike or

 How often? Most days of the week (5-6 days).

 How long? Start with ___ minutes of exercise ___ times a day.
Increase your walking or exercise 1-2 minutes each day.
Build up to at least 10 minutes, 3 times a day. The ideal
goal is to reach 30-45 minutes of continuous training per
day. Your goal is to reach 30-45 minutes of continuous
exercise per day.

 How hard? Check your heart rate or your rating of perceived exertion
(RPE). This will be explained later in this handout.

How Should I Increase My Exercise Program?

An example of how to increase the time and intensity of your exercise program is
provided below. For more help go to page 5 or talk with the Cardiac Rehabilitation
staff. Their contact information is on the last page of this handout.

Time: Begin with 3-5 minutes of walking, 4-5 times per day. Add 1-2 minutes to
each session every day. As you add time, the number of sessions can be decreased.
For instance, when you complete 10 minutes of exercise, decrease your routine to 2-3
sessions per day. When you complete 30 minutes, decrease the frequency to 1
session per day.

Intensity: When you are able to complete 20-30 minutes of exercise in one session,
try to increase your intensity (i.e. how fast or hard you walk) for 3-5 minutes at a
time. Then resume your normal routine for the rest of your workout. Always keep
the Talk Test information in mind (see page 3).

How Your Body Responds to Exercise
Normally, you may notice you are breathing faster and your heart rate increases when
you exercise. You can also expect to sweat and to have some muscle fatigue.

It is also important to know what is not normal. If you notice any of these symptoms,
STOP exercising and call your local doctor. If you feel this is an emergency, call
911 right away.

 Severe chest pain, pressure, or tightness (angina)
 Excessive shortness of breath
 Excessive sweating
 Blurred vision
 Frequent skipped heart beats (palpitations)
 Dizziness, light-headedness
 Nausea
 New weakness on one side of your body either
arm or leg or both

Knowing How Long and Hard to Exercise
Your heart rate and how you feel will guide how long and hard you should exercise
and what activities you should do. Since certain medications, such as beta-blockers,
decrease your heart rate response to exercise, we recommend using the Talk Test.

 The Talk Test
Choose a level of exertion that allows you to still talk while you exercise.
You should be able to talk in short sentences, but will not be able to sing.

What to Wear for Exercise
Dress in loose-fitting, comfortable clothing. In warmer weather, a cotton T-shirt and
shorts may be enough. In cooler weather, layer your clothing if you plan to exercise
outdoors. For instance, a windbreaker over a long sleeve shirt may work well. Cover
your nose and mouth with a scarf to help warm the air you breathe.

Avoid heavy, bulky coats or jackets as they can increase your work effort. Your
body heat naturally increases as you exercise. You don’t want to become overheated
by dressing too warm.

Women should wear a supportive bra to protect the breastbone.

Wear jogging or walking shoes. Shoes with supportive arches reduce foot and knee
soreness that can occur when you exercise for longer times. If you have diabetes, be
sure your shoes have a large enough toe box and the heels do not pinch or cause


Exercise Guidelines when you reach 20 minutes of exercise.

1. Warm up for 5 minutes by slowly walking or biking with no resistance. This
will increase your blood flow and warm up your muscles for activity.

2. Increase to a moderate intensity. Increase your speed or resistance so that
you are breathing heavier but still able to talk.
ξ For walking – this means a brisk pace. If you must walk uphill, slow
down your speed to maintain a constant level of exertion and heart rate.
ξ For biking – maintain a moderate pedal speed of 40-50 rpm. After you
are able to do this for 30-40 minutes, then (and only then) tighten the
tension knob to increase your workload. Be sure to adjust the seat height
so that there is a slight bend in your knee when the pedal is at its lowest

3. Cool down for 5 minutes. At the end of your session, slow down to an easy
pace for 3-5 minutes. . This prevents sudden changes in blood pressure that
can occur if you stop too quickly.

Stair Climbing
While healing, you may need to climb stairs at a slower rate. At first, climb one stair
every 2 seconds. As you heal, you can slowly increase your rate.

Do not pull yourself up using the stair rails.
This is to prevent putting stress on your breastbone.

If you had bypass surgery, follow the instructions below.
ξ To climb up stairs, step up with the leg that you did not have surgery on. This
may be called your good leg. Bring your other leg to the same stair and pause
a few seconds.
ξ To go down stairs, do the reverse. Use the leg you did have surgery on (this
may be called your bad leg) and then follow with the other leg. Again, pause a
few seconds.

If you had heart surgery other than bypass, follow the instructions below.
ξ Step up and down with the leg on your dominant side. If you are right handed,
this will be your right leg.

Activities You Can Expect to Do


 Light housework, crafts
 Dining out
 Stair climbing
 Shopping but no heavy lifting
or reaching above the head

 Biking indoors
 Dancing
 Chipping with a golf club

Things to Avoid For the First 6 Weeks
ξ Do not lift over 8 pounds. For the following 6 weeks, do not lift over 20
ξ Do not drive for 4-6 weeks or while taking narcotics. Sit in the back seat of the
car and use your seat belt.
ξ Avoid push-pull arm movements such as vacuuming and sweeping.
ξ Avoid arm motion that causes pain in your incision. If you feel any pulling,
stretching, or popping in your chest, stop what you are doing. Do not repeat
the motion that caused this feeling.
ξ Keep your elbows below shoulder height.
ξ Avoid putting extra pressure on your arms when getting up from a chair or
climbing stairs.
ξ Brace your chest when coughing or sneezing. This is vital during the first 2
weeks at home.

Things to Avoid for 12 Weeks (3 months)
ξ Shoveling snow.
ξ Biking outdoors.
ξ Swimming.
ξ Driving a motorcycle.
ξ Heavy garden work.
ξ Lying on either side.

Arm Exercises
Your lifting and arm work is limited for 2-3 months while the breastbone and chest
incision heal. During this time, the muscles of your chest and upper limbs need to
stay mobile and flexible. The exercises below allow you to stretch your muscles
without putting too much pressure on your wound. They also help you to maintain
range of motion and avoid losing muscle tone in your chest, shoulders, and arms.

Plan to do these exercises daily for 1-2 months after surgery. Start by doing 5 of each
daily. Slowly work up to 15 of each per day. While you exercise, remember to
breathe. Do not hold your breath.

The Chest Stretch
Start with your arms in front of your chest. Hold a towel shoulder width apart.
ξ Slowly raise your arms to the point just before your feel discomfort.
ξ Slowly bend your elbows while bringing the towel into your chest.
ξ Straighten your elbows and return to your starting point.
ξ Repeat.

Arm Circles
ξ Place your hands on your shoulders.
ξ Move your arms clockwise as if you are drawing circles with your elbows. Start
with little circles. Make the circles bigger and bigger.
ξ Repeat in the opposite direction.

As your breastbone heals, you should shower daily with your back facing the
showerhead. This prevents water from spraying directly on your incision. Do not
take long, hot showers. Do not bathe in a tub, hot tub, or sauna for 30 days or until
wounds are fully healed. Use fragrance-free soap and pat your incision dry when

Sexual Activity
Once home, you may engage in sexual activity as you feel able and have the desire.
The peak effort with sex is equal to climbing stairs at a moderate pace. As you are
healing, you may want to try new positions to protect your incision. Positions that
place less stress on your upper body work best.

Some heart medicines can affect your sexual drive and ability. If you have questions
or concerns about this, please talk with your doctor or heart care team.

Being Wary of Weather Extremes

 Hot weather – Heat and humidity can cause strain on your heart and blood
flow. Avoid exercising in direct sun or when it is over 85 θF unless the
humidity is low, there is a breeze, or there is shade. Early mornings and
evenings are best.

Exercise outdoors only if the heat index is less than 85 θF.


 Cold weather – Avoid exercising outdoors when the temperature or wind chill
factor is below 0º F. The body and heart have to work harder to walk against
wind and snow. Learn to pace yourself and avoid sudden bursts of effort. You
may need to work and rest at intervals to maintain this rating.

Snow shoveling – You may be able to shovel light snow after 3 months.
Before doing so, warm up, do gentle stretches and pace yourself. Use the Talk
Test. If you are unable to talk in short sentences, you are working too hard.
Avoid holding your breath.

Your Cardiac Rehabilitation Program
Cardiac Rehabilitation is a medically supervised program that features exercise and
education for people recovering from a heart attack, bypass surgery, coronary
angioplasty or stent, heart transplant, or valve surgery. The program is designed to
help strengthen your heart and other muscles, as well as guide you to a heart healthy
lifestyle. You can receive this follow-up care through the UW Health Cardiac
Rehabilitation program or through a program close to your home.

Your local Cardiac Rehabilitation program: ___________________________
Phone number: ____________________________________________

UW Health Cardiac Rehabilitation (608) 263-6630

Preventive Cardiology Inpatient Cardiac Rehabilitation

The Spanish version of this Health Facts for You is #7740

Your health care team may have given you this information as part of your care. If so, please use it and call if you have
any questions. If this information was not given to you as part of your care, please check with your doctor. This is not
medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health
needs are different, you should talk with your doctor or others on your health care team when using this information. If
you have an emergency, please call 911. Copyright © 5/2017 University of Wisconsin Hospitals and Clinics Authority.
All rights reserved. Produced by the Department of Nursing. HF#5801