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Patient Instructions

You had a heart attack and were in the hospital. You may have had angioplasty and had a stent placed in an artery to open a blocked artery in your heart.

See also:

• Angina - discharge
• Heart attack - discharge

While you were in the hospital, you should have learned:

• How to take your pulse
• How to recognize your angina symptoms and what to do when they happen. See also: Angina - when you have chest pain

Your doctor may recommend a cardiac rehabilitation program to you. This program will help you learn what foods to eat and what exercises to do to stay healthy. Eating well and exercising will help you start feeling healthy again.

Before starting to exercise, your doctor will do an exercise test and recommend an exercise plan. This may happen before you leave the hospital or soon afterwards. Do not change your exercise plan before talking with your doctor or nurse first.

Take it easy at first:

• Walking is the best activity when you start exercising.
• Walk on flat ground for a few weeks at first.
• You can try bike riding after a few weeks. Walk your bike up any hills, or ride a stationary bike in an easy gear.
• If it is windy, walk or bike with the breeze behind you.
• Do not walk outside if it is very cold or very hot. Go to a shopping mall and do your walking inside.

Slowly increase how long you exercise at any 1 time. If you are up to it, repeat the activity 2 or 3 times during the day. You may want to try this very easy exercise schedule (but ask your doctor first):

• Week 1: about 5 minutes at a time
• Week 2: about 10 minutes at a time
• Week 3: about 15 minutes at a time
• Week 4: about 20 minutes at a time
• Week 5: about 25 minutes at a time
• Week 6: about 30 minutes at a time

After 6 weeks, you may be able to start swimming, but stay out of very cold or very hot water. You can also begin playing golf. Start easily with just hitting balls. Add to your golfing slowly, playing just a few holes at a time. Avoid golfing in very hot or cold weather.

You can do some things around the house to stay active, but always ask your doctor or nurse first. Avoid a lot of activity on days that are very hot or cold.

You may be able to cook light meals by the end of your first week. You can wash dishes or set the table if you feel up to it.

By the end of the second week you may start doing very light housework, such as making your bed. Go slowly.

After 4 weeks, you may be able to:

• Iron -- start with only 5 or 10 minutes at a time
• Shop, but do not carry heavy bags or walk too far
• Do short periods of light yard work

By 6 weeks, your doctor may allow you to do more activities, such as heavier housework and exercise, but be careful.

• Try not to lift or carry anything that is heavy, such as a vacuum cleaner or a pail of water.
• If any activities cause chest pain, shortness of breath, or any of the symptoms that you had before or during your heart attack, stop doing them right away. Tell your doctor or nurse.

Call your doctor if you feel:

• Pain, pressure, tightness, or heaviness in the chest, arm, neck, or jaw
• Shortness of breath
• Gas pains or indigestion
• Numbness in your arms
• Sweaty, or if you lose color
• Lightheaded

Also call your doctor if you have angina and it:

• Becomes stronger
• Occurs more often
• Lasts longer
• Occurs when you are not active
• If drugs no longer help ease your angina symptoms as well as they did

These changes may mean your heart disease is getting worse.

Heart attack - activity

Antman EM. ST-Elevation Myocardial Infarction: management. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders; 2007:chap 51.

Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.