Sunday, December 6, 2009

Exercise After A Heart Attack

What is the difference between aerobic and anaerobic exercise?

Aerobic exercise promotes cardiovascular fitness by raising your pulse to a targeted level. It helps to strengthen the heart strengthen your heart, and allows the heart to pump more blood.. Some examples of aerobic exercise are walking, jogging, bicycling and swimming. Heart rate has to be maintained for at least 15 minutes to obtain the cardiovascular benefits.

Anaerobic exercise focuses on specific muscles and their size,endurance, and strength.Weight lifting and resistance training are examples of anaerobic exercise. 

How long should each aerobic exercise session be?

This varies depending on the patient’s physical condition and goals. In general 1 hour a day at least 5 days a week is recommended. For aerobic fitness shorter durations of 10-15 minutes two to three times a day may be beneficial. For weight loss, longer exercise durations of at least 30 minutes is preferred. Longer is better: at least 30 minutes with 40 to 60 minutes preferred to burn fat. Here are some studies with their recommendations 1.

How many times each week should I exercise?

Aerobic exercise is recommended every day as best and at least 5 times a week.

In general CR (Cardio Rehabilitation) programs last one hour [15 min warm up and strength exercises 30 min of aerobics (walking, biking, dancing etc. - always based on heart rate guidelines of 70% of maximal safe heart rate and 15 minutes cool down with stretching and relaxation) There is no benefit to attempting to obtain a higher heart rate above 70% your maximum. Everyone is encouraged to exercise daily for at least 30 minutes with specific guidelines based on their heart health etc. Most people go to formal CR classes 3 times per week. Levels are advanced based on capacity and other criteria such as orthopedic concerns, age, balance, other co-morbidities.

Wouldn't hard exercise make it more likely to have a heart attack?

This depends on your physical condition. If you are in a good physical shape then appropriate exercise should not cause a heart attack, but if you are not conditioned then increasing physical demand on your body and heart may cause symptoms or heart attack.

However, it should be noted that there are those who are in good physical shape but who experience a heart attack due to plaque rupture and not to is chemia. It is unknown if these ruptures may be triggered by exercise.

What range should you try to keep your heart rate in when you exercise?

A general rule is 190-your age which equals 85% of maximum heart rate. An exercise prescription may also be given so that if the exercise is supervised then the patient can go to 85% of maximum heart rate obtained on a treadmill test. If the exercise is unsupervised, then the goal is 70% of maximum heart rate obtained on a treadmill test. Use this calculator for a rough guide, but ask your own doctor for personal exercise recommendations.


Is there a minimum heart rate I should try to achieve during exercise?

To provide a benefit to your heart you should try to attain at least 50% of your maximum heart rate during a aerobic exercise session.

How many times each week should I exercise?

Aerobic exercise is recommended every day as best and at least 5 times a week.

In general CR (Cardio Rehabilitation) programs last one hour [15 min warm up and strength exercises 30 min of aerobics (walking, biking, dancing etc. - always based on heart rate guidelines of 70% of maximal safe heart rate and 15 minutes cool down with stretching and relaxation) There is no benefit to attempting to obtain a higher heart rate above 70% your maximum. Everyone is encouraged to exercise daily for at least 30 minutes with specific guidelines based on their heart health etc. Most people go to formal CR classes 3 times per week. Levels are advanced based on capacity and other criteria such as orthopedic concerns, age, balance, other co-morbidities.

What is supervised aerobic exercise?



Most times this refers to participation in a cardio rehab program. You attend an exercise session at a center staffed by nurses and physical therapists trained in working with patients post heart attack. During exercise you wear a heart rate monitor and the staff keeps a close watch on your heart rate.

How can you tell what your heart rate is?

You can check your own pulse, but a much easier and more reliable method would be to get a personal heart rate monitor.

What is a personal heart rate monitor?



These devices usually consist of two parts. An elastic strap with a transmitting device goes around your chest. Heart rate data goes wirelessly from the transmitter in the strap to a special watch on your wrist. You can read your heart rate on the watch as well as other useful functions. Some models sense your heart rate right from your wrist and do not require a chest strap.

What other functions do heart rate monitors have?

Almost all act as a standard watch, most as stop watches. Many have alarms to let you know if you are excersizing at a heart rate too low to help your heart as well as an alarm if you get your heart rate over your target to where it might present a danger. Some models interface with a computer for tracking. Often standard treadmills, exercise cycles, steppers or other cardio machines in a gym have heart monitors built in that read the signals from your regular chest strap transmitter on their own display without the need to wear the watch part.

How much do personal heart rate monitors cost?

The most well known personal heart rates monitors come from Polar, you may even see on cardio machines that they work with Polar equipment. In some cases people use "Polar" for heart rate monitors like they use the name "Kleenex" for tissues, but Polar represents a specific manufacturer. Polar heart rate monitors start at about $80. Other brands without the Polar name will do the job too and even work with Polar cardio machines as they all use the same frequencies to transmit your heart rate from the strap to the receiver either in the heart monitor watch or the gym equipment. You can find personal heart rate monitors starting at around $40 or less. With fancy features you may see some personal heart rate monitors priced over $400.

Where do you buy personal heart rate monitors?

Online, many sites will even offer free shipping on Polar or inexpensive heart monitors. You may find personal heart rate monitors in a local sports store too, try the running department or sports watch areas.

Are there special personal heart rate monitors for women?

Yes, a personal heart rate monitor for a woman might have a smaller watch face on the monitor and a smaller wrist band.

If you are wearing a personal heart monitor with an alarm in you exceed your target heart rate would that be considered supervised aerobic exercise?

No, for definition as supervised exercise you need trained staff with you in addition to having your heart rate monitored. This should not belittle the benefit of wearing a personal heart rate monitor when you exercise on your own?

Why would you want a personal heart rate monitor for unsupervised aerobic exercise?

Patients find these devices very helpful. Keeping your heart rate in the desired range during aerobic exercise holds the key to gaining the cardio benefits of the workout. If you do not get your heart rate up high enough you are not doing enough to help your heart. If you increase your heart rate too high you risk another heart attack. Taking your own pulse while you exercise can be difficult and inaccurate. Personal heart rate monitors help you to keep in the proper range and get the most out of your aerobic exercise time. Many people also find comfort in the heart rate readings to know they have a safe pace. People instructed by their doctors not to exceed a certain maximum heart rate might find themselves scared to push to hard and not workout hard enough, or go too hard because they have no accurate way to see their own heart rate and risk problems. A personal heart monitor helps on both ends of the spectrum, allowing the patient to exercise with more comfort and confidence. After a heart attack this can become quite important.

Where should you set the upper and lower limits on your personal heart rate monitor?



While you can use some of the information above as a start, this question really should be answered by your own physician based on your own age, health, risk factors and medications.

What do medications have to do with it?

Drugs such as beta blockers change your heart rate, so when recomending the proper heart rate for aerobic exercise the effect of the medicine must be taken into account.

What should you do if you exceed your target heart rate and the alarm on your heart monitor sounds?

Generally slow down. In most cases you should not abruptly stop your exercise unless you also have other symptoms. Look and the monitor and slow up until your heart rate gets back into the proper range and continue your workout. You can check you your own doctor for a personal answer to this part, but sometimes for a very short period of time if you have the proper conditioning going over a bit can be acceptable. An example of this would be someone who has returned to good physical condition and exceeds their target heart rate just before the top of a hill while bicycle riding. Going a little further at just a little over the target rate would be alright, but ask your own doctor what you should do in such a case.

My personal heart rate monitor stopped working?
Start by checking both the batteries, remember there is a battery in the wrist monitor and another in the chest transmitter.

Why does losing weight help lower the risk of a heart attack?



Losing weight helps lower lipids/cholesterol, blood pressure and the general work load on the heart.

If adjusting diet and exercise isn't enough what drugs can help?

Lifestyle changes do make a difference in heart disease. In addition to diet and exercise cholesterol lowering medications and anti-hypertensives help reduce the risk for heart disease. Learn more in the heart drug FAQ.

Does excersise help your heart in any other ways?

Exercise may help develop collaterals.

What are collaterals?

Arteries which grow to help circulate blood by circumventing the clogged arteries.