Heart Attack

Living After A Heart Attack

Simply surviving a heart attack is just the beginning of a long process of recovery.

Heart attack survivors now require shorter hospitalizations than years ago. Most heart attack survivors remain free of complications and are discharged from the hospital five to seven days after admission.

Improved medical treatments, such as the early use of clot busting drugs, beta blockers, and angiotensin converting-enzyme inhibitors, also means that heart attack survivors tend to be healthier after their heart attacks.

Advances in angioplasty and coronary artery bypass surgery also have improved outcomes. Most people who have suffered a heart attack can regain normal or near-normal lifestyles. Some actually enjoy better health than before their heart attacks.

But there are still many questions as recovery begins.

Frequently asked questions about recovery include:

• What happens after I go home from the hospital?
• When can normal activities be resumed?
• What is this feeling of depression about?
• What is cardiac rehabilitation and secondary prevention?

What Happens After Discharge From The Hospital?

After being discharged, the patient is scheduled for follow-up appointments with his doctor. After one to three weeks, he or she may join a cardiac rehabilitation program. Activities can be resumed gradually over the next three to six weeks.

Most heart attack survivors return home taking cardiac medications. Some of these are drugs that were started in the hospital. Typical discharge medications include:

• Aspirin to prevent blood clot formation and lower the risk of subsequent heart attack or death
• A beta blocker, if tolerated. Beta blockers reduce the chance risk of death following a heart attack by about 25 percent for more than several years.
• An angiotensin converting enzyme (ACE) inhibitor in a survivor with reduced pumping capability of the heart. ACE inhibitors have long-term beneficial effects following a heart attack, including reducing both undesirable structural changes in the ventricle (ventricular remodeling) and the risk of a subsequent heart attack.

There may be other heart-related medications to treat

• Hypertension or high blood pressure
• Heart failure
• Abnormal heart rhythm

In some cases, especially if cholesterol levels are too high, treatment with a cholesterol-lowering drug, in addition to dietary changes, is needed.

Follow the doctor’s directions when taking medications. Ask questions. If side effects from your medications occur, call the doctor right away.

• If medications are prescribed by different doctors, always be sure that each doctor knows what the other doctor has prescribed.
• Bring a list of all medications to each doctor visit.

When Can Routine Activities Be Resumed?

After arriving home, heart attack patients should gradually increase physical activity over the next one to three weeks. If cardiac function is maintained, they can often return to their normal activities within six weeks. A supervised and monitored cardiac exercise program that is customized to the patient’s age, lifestyle, and cardiac status, is generally recommended.

According to the American Heart Association (AHA), most people can return to work within weeks. But if your job requires extensive physical activity, or complications have limited your ability to perform tasks, a different work circumstance may be needed. The AHA offers vocational rehabilitation programs that may be of help.

Heart patients may be concerned about resumption of sexual activity. Such activity is generally fine when the person feels ready. Try these guidelines:

• Choose a time when they feel relaxed and rested.
• Wait one to three hours after eating a full meal so digestion can be completed.
• Select a familiar, peaceful setting that is free from interruptions.
• If prescribed, take medicine prior to sexual relations.
• Discuss any concerns with their doctor.

What Is This Feeling Of Depression About?

Although better treatment and earlier rehabilitation programs help people recover swifter from a heart attack, adjusting to the psychological impact can take longer. Many survivors of a heart attack experience feelings of helplessness and depression.

The survivor and his or her family need to confront potential underlying fears and anxieties. Don’t keep feelings bottled up inside. He or she should be encouraged to:

• Be patient. Feelings of fear, anxiety, depression, or anger are common after a heart attack and usually are temporary.
• Discuss feelings with his or her medical team, family, and friends.
• Keep a journal. Often, writing about feelings can help a heart attack victim feel better.
• Arrange for counseling if depression, anger, or withdrawal persists for more than four weeks. Their doctor can be helpful in arranging this.

What Is Cardiac Rehabilitation And Secondary Prevention?

An important event that helps individuals recover from a heart attack, as well as learn about positive lifestyle changes, is cardiac rehabilitation. Cardiac rehabilitation is a structured program of exercise, education, and support that is designed to:

• Educate the person about heart disease and its proper management
• Initiate a supervised, monitored exercise program tailored to the individual’s needs
• Help the person alter or modify risk factors, such as high blood pressure, smoking, high blood cholesterol, physical inactivity, obesity, and diabetes
• Provide nutritional guidance
• Look for signs of depression or anxiety disorders, sexual dysfunction, excessive distress/stress, dependence, and inadequate social support
• Provide emotional support, counseling, and stress management
• Assist with vocational guidance (returning to work)
• Supply information on physical limitations, if appropriate

Cardiac rehabilitation programs are run by specially trained health care professionals and may be held at a hospital or other locations. People usually join a cardiac rehabilitation program within several weeks of leaving the hospital. A physician referral may be required.

At cardiac rehab, participants learn ways to regain confidence, improve strength, and prevent a second heart attack, including:

• Appropriate exercise
• A healthy diet with the correct amounts of fat, cholesterol, sodium, and more
• Weight reduction (if necessary)
• Smoking cessation (if a smoker)
• Appropriate management of conditions that are risk factors for a subsequent heart attack including diabetes, high blood pressure, high cholesterol, and stress.

Goals of secondary prevention include:

• Extending overall survival
• Improving quality of life
• Decreasing the need for medical interventions, including angioplasty or coronary artery bypass surgery
• Reducing the risk of a subsequent heart attack