Exercise and Activity after a Heart Attack
After a heart attack, the damaged heart muscle needs time to heal. This involves
allowing scar tissue to form. The scar from a heart attack needs about 6 weeks to
become strong enough to handle moderate to heavy work. During this time, be
sure to avoid any excess physical and emotional stress.
Benefits of Exercise
ξ To decrease your risk of another heart attack.
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 includes:
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
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 biking 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 exercise
How hard Use the Talk Test to gauge how hard you are working.
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 3-4).
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’s 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.
ξ Severe chest pain, pressure, or tightness
ξ Excessive shortness of breath
ξ Excessive sweating
ξ Blurred vision
ξ Frequent skipped heart beats (palpitations)
ξ Dizziness, light-headedness
ξ 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
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 likely not be able
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. Covering your nose and mouth with a scarf can also help to warm the air you
Avoid heavy, bulky coats or jackets. They can increase the work it takes to move
your body. Your body heat naturally increases as you exercise. You don’t want to
become overheated by dressing too warmly.
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 blisters.
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
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 level.
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.
Climbing stairs can be strenuous activity. While healing, you may need to climb
stairs at a slower rate. At first, be sure to pace yourself to one stair every 2
seconds. As you heal, you can slowly increase your rate.
Step up and down with the leg on your dominant side. If you are right handed, this
would be your right leg.
Activities You Can Expect to Do
If you have had a cardiac catheterization or stent placed in an artery of your heart,
avoid lifting more than 10 pounds for 7 days.
The First 6 Weeks after a Heart Attack
Light housework (dishes, dusting, cooking)
Home crafts and light carpentry
Driving for short distances, riding the lawn mower
Dining out, shopping for short times
Light auto work, appliance repairs
Level walking or outdoor biking at a relaxed speed
Talk to Your Doctor before Adding These Activities
ξ Heavy arm work or lifting over 30 pounds (young children, armloads of
wood, water softener bags, garage doors, snow shoveling)
ξ Heavy hammering
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. That would
likely be “somewhat hard” on the exertion scale. During sex, the heart rate may
peak at 120 beats per minute and remains at that rate for only a short time.
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 Careful 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°F 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°F.
Cold weather – avoid exercising outdoors when the temperature or wind
chill factor is below 0°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.
Your exercise should never feel harder than “somewhat hard.”
Shoveling –You may be able to shovel light snow again after you have recovered.
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 near your home.
Your local Cardiac Rehab program: _______________________
Phone number: _______________________________________
UW Health Cardiac Rehabilitation (608) 263-6630
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 © 4/2017 University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6090