Those who had a “heart attack”, the colloquial way of calling the heart attack, do not want to suffer it again. An acute myocardial infarction occurs when a coronary obstruction causes damage to the heart, this causes injury to the heart muscle.
The size of that lesion will depend on the location of the blocked artery and how long it was in that state. For patients it is possible to recover and, with proper treatment, return to the “normal life” before the cardiac event.
How to recover “normal life” after a heart attack?
According to experts, rehabilitation plays a key role: “The most important thing is that, at least during the first three months, physical activity is necessary in the context of cardiovascular rehabilitation (RHCV),” explained Dr. Cecilia Zeballos, Chief of Cardiovascular Rehabilitation at ICBA Cardiovascular Institute.
These are long-term strategies that are based on the education of a healthy lifestyle, diet, management of cardiovascular risk factors, psychosocial counseling, and physical exercise prescribed according to the clinical status of patients. In addition to being a scientifically proven treatment, for these patients RHCV is a useful tool that provides confidence and accelerates reintegration into regular physical activity.
“It is just as important to do physical activity in the context of rehabilitation as, for example, taking medication,” said Dr. Zeballos. Among patients who perform physical activity in the context of cardiovascular rehabilitation (RHCV), there is a 26% reduction in the risk of death from cardiovascular causes and 20% of new hospitalizations, the ICBA professionals explained. “The clinical practice guidelines of all scientific societies strongly recommend and indicate it,” Dr. Zeballos added.
When to start rehabilitation after a heart attack?
“As soon as possible after the discharge: there is no reason to wait if the clinical conditions are adequate,” Dr. Zeballos recommended and explained: “When we evaluate a patient to begin rehabilitation after a heart attack, we take into account the size of the infarction but, above all, we look very carefully the function of the ventricle (how does the heart pump), whether it had complications during the coronary event, the days of hospitalization, the previous physical state, current symptoms, and based on these data we program an exercise plan appropriate to their clinical condition and accompany the patients to achieve equal capacity or better than the previous one.”
In order for the patient to remain in the rehabilitation program, it is essential to pay special attention to the patient's goals in terms of physical activity, preferences and time constraints.
In larger heart attacks, with worse ventricular function, with complications during the event, with the presence of symptoms, etc., lower intensity physical activity is indicated and progression is slower, but with effort and adequate adherence to the program, results are as good as in patients at lower risk.
Heart failure (CHF) manifests itself when the heart is not able to pump enough blood to supply the organs, muscles and tissues of the body, it is a progressive and slow condition, since when the heart starts to fail compensatory mechanisms are launched, so “symptoms may not become evident, until the insufficiency is already very advanced and exceeds the mechanisms of compensation,” explained Dr. Mirta Diez, head of Heart Failure, Pulmonary Hypertension and Transplantation at the ICBA. Cardiovascular rehabilitation is also indicated in these patients.
The physical activity plan for these patients consists of aerobic activity in addition to endurance exercises and breathing exercises, as many days as possible and depending on ventricular function, symptoms and physical condition, in which the intensity and progression of the exercise are adapted.
“It's entirely possible to live a normal life with heart failure, and exercise is key to achieving that. Often the symptoms (shortness of breath, tiredness) of these patients are properly due to the condition of the heart but because they are very untrained. Patients with heart attacks can undoubtedly lead a normal life and achieve their physical activity goals, you just have to be patient and achieve the goals gradually and with the guidance of specialists”, concluded Dr. Zeballos.
Warning signs in rehabilitation
As for alarm signals, patients should be aware of the presence of symptoms such as chest pain, shortness of breath, palpitations, extreme tiredness, dizziness, etc. Physical activity should be stopped when symptoms begin.
It is important that patients comply with the indicated physical practices, because being irregular with rehabilitation sessions obviously affects the results, and it is extremely important not to stop taking medication.
Another element that benefited rehabilitation programmes was telemedicine. New technologies have also reached the field of health and RHCV, which is why there is now a new tool, telerehabilitation.
Telemedicine rehabilitation programs can overcome barriers associated with face-to-face participation, are safe and have been shown to positively impact rehabilitation plan follow-up, CV mortality and hospitalizations. “We currently have this way of rehabilitating through a novel tool that allows the patient's data to be transmitted live to the doctor and physical education teacher who is doing the virtual class,” explained the ICBA professionals.
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