Sunday, December 6, 2009

Life After A Heart Attack


Does a person ever recover from a heart attack?

Yes, but the level of activities that they may resume depends on the degree of the heart attack. Daily life after a heart attack may look just as before the heart attack with no negative effects. A heart attack that caused more damage to the heart muscle tissue may result in a more limited list of activities for daily life. In any case, anyone suffering a heart attack needs to pay attention to their diet, exercise and other aspects of their post heart attack life to insure that they do not experience another heart attack. This may start by making sure any cigarette smokers use their heart attacks as a wake up call to quit smoking!

What sports can a person take part in after a heart attack?

This depends on the size of the heart attack. Work closely with your doctor, but exercise after a heart attack becomes an important part of recovery and resuming a normal life.

What sports should be avoided after a heart attack?

Scuba diving may need to be avoided because it causes a vagal reaction which causes a decrease in blood pressure.

Which heart disease patients should still scuba dive?
It depends on the severity of the heart attack. If the blocked artery has been corrected such as through bypass surgery or angioplasty and if the patient then has a normal stress test then diving is permitted in warm waters. However, in a person who has had extensive muscle death after a heart attack, then diving is not permitted due to the inability of the muscles to keep up with the pumping requirement needed. It is not recommended for most people with coronary artery disease who have not corrected the problem to dive.

How soon after a heart attack can a person fly in an airplane?

A person may fly in an airplane as soon as there is recovery from the heart attack.

How often can a person fly after a heart attack?

There is no restriction.

Should a person who has had a heart attack avoid saunas or steam showers?

They should be careful in these circumstances as they may cause a drop in blood pressure which may effect blood flow to the brain and to the heart. This may cause the patient to pass out or lose consciousness.

Should a person try to live a normal life after a heart attack or should they restrict certain regular activities?
The level of activity depends on the severity of the heart attack. If a large part of the heart muscle is involved and rendered ineffective then there may be more limitations on the physical activity. However, if the heart attack is mild and it is not complicated by heart failure then normal life activity may be resumed.

When can a heart attack patient drive a car again?

A heart attack survivor may drive in 2-4 weeks depending on how severe the heart attack was and if there were any complications.

How long until a heart attack victim can go back to work?

Depending on the type of work, patients can go back to work very soon after discharge from the hospital.

What if they have a physically demanding job?
A physically demanding job will need a longer time and will be evaluated based on follow up stress tests.

Are there some things I should never eat again ever for my whole life?
It depends on many variables such as your weight, cholesterol, blood pressure, and sugar levels. In general it is best to avoid fats, especially animal fats and saturated fats, desserts that are high in sugar and butter. Restrictions on diet for patients with a history of heart disease may remain in effect for the rest of their life.

I’ve talked to people who feel depressed after a heart attack, what is the relationship between depression and a heart attack?
It is believed to be mainly situational.

What can help a heart attack patient through any depression?
Cardiac rehab and anti-depressants may help through depression. In the January 24, 2007 issue of JAMA1 a study was published that showed that “citalopram or sertraline plus clinical management should be considered as a first-step treatment for patients with coronary artery disease and major depression” and that interpersonal psychotherapy did not add any benefit to the treatment.

Can a heart attack patient ever have sex again?

Yes. Sex is usually ok when a person can achieve 4-5 mets on a treadmill test without symptoms or other complications such as arrhythmia or significant ST changes (some people use ability to climb two flights of stairs without problems as their guideline for resuming sex). Usual heart rate with sex is 110-120 so when this heart rate can be achieved safely sex is usually ok. Interesting however is that the data on death and sex is from a study on business men who died suddenly - the study was from Japan. Additional circumstances included being with an unfamiliar partner, having eaten a large meal, having had an excess of alcohol and sex is added to this mix - not a generally good thing to do! It is appropriate to treat sex just like any other physical activity with the exception of adding the emotional environment to the mix! Really important is to also address the concerns of the "spouse or significant other" often the patient is ready to resume sex and the partner is scared to death!