-- Question: How long should I rest after a heart attack?
Answer: This is a very important question because we do recommend that patients exercise after a heart attack, they get involved in physical rehabilitation programs. It's very important because exercise is good for your heart, it's good for your blood vessels, and actually helps to control all of your risk factors.
Undoubtedly, after a heart attack you're taking medicines to reduce those risk factors, but exercise makes that medication effect much more effective. Therefore, we do recommend exercise, but it has to be individualized. There's not a one-size-fits-all approach to this. It depends on the size of the heart attack, whether it was a major heart attack or a small heart attack. What medications are being required, whether you had the artery opened at the time of the heart attack; did you have a percutaneous intervention where they put a stent in the artery to restore the blood flow, or are you left with a blocked artery that didn't get opened entirely? Those all can be treated effectively and safely, and we can keep people healthy, but whether you should be exercising right after a heart attack would depend on a lot of those factors.
Let's assume you had a small heart attack and that the artery was opened very quickly and effectively at the hospital; you got to the hospital early and the artery was opened and your heart muscle is relatively healthy. In that case, there's very little reason not to begin exercise almost in the week or two after the heart attack. Begin slowly, especially if you're out of shape, but get into a cardiac rehab program or deal with other ways that you can, in a programmatic fashion, increase your level of exercise -- but there's no reason why that couldn't begin very, very promptly.
On the other extreme, if you're in a situation where the artery could not be opened promptly, and/or the artery is still closed or narrowed now, and when you exercise not enough blood is getting to your heart muscle, then this needs to be looked at more carefully. And in that situation, we usually recommend you have a stress test done first, before you begin an exercise program, just to be sure that your heart is healthy enough to withstand the rigor of exercise. And in some cases, we would also recommend a more gradual step-wise approach, maybe not starting for a couple weeks after the heart attack and then getting into a much more slow and gradual fashion.