Helping you recover from a heart attack

Cardiac rehabilitation is a programme of education and activity to help people recover from a heart attack and lead their lives as normally as possible. You should be invited to attend a cardiac rehabilitation programme that includes exercise and sessions covering a range of topics including health education and information.

Your partner or carer should be able to be involved in your cardiac rehabilitation programme if you would like this.

Your cardiac rehabilitation programme

You will benefit most from your cardiac rehabilitation programme if you start it as soon as possible after your heart attack. This should be before you leave hospital, and you should then be invited to attend a session that will take place within 10 days of your leaving hospital.

Your cardiac rehabilitation programme should take into account any cultural and religious needs you may have, and the staff should find out about your views and beliefs regarding your health and recovery. You should also be given a choice of when and where to have the programme. For example, it could mean having sessions outside of working hours, at home, at the hospital or in the community, such as in a local sports centre. You might be able to have single-sex classes if you prefer.

A member of your cardiac rehabilitation team should explain to you the benefits of the programme and find out if there is anything that might stop you from attending – for example, problems with transport. If there are some parts of the programme you would prefer not to be involved in, you should still be encouraged to attend the rest of the programme.

You should also be asked about whether you need help with issues such as finance, welfare rights, housing and social care.

Exercise and cardiac rehabilitation

Your cardiac rehabilitation programme should include a range of different types of exercise. These should suit your age and ability and take into account any other health problems or illnesses you may have.

If you have any heart problems or other conditions that get worse when you exercise (for example, angina or asthma), your doctor should treat these before you undertake the exercise part of the programme. If the pumping activity of your heart hasn't recovered as well as it should (that is, you have heart failure), you should still be offered suitable exercise sessions, providing your condition is stable.

Resuming normal activities

You will probably be able to return to your normal daily life, including your work, after your heart attack. How soon this will happen will depend on the treatment you have had since your heart attack, how well you have recovered and the activities or work you plan to return to.

Sport

If you play competitive sport, you may need to talk with a specialist about whether it is safe for you to continue playing after your recovery.

Travel

If you drive, your doctor should be able to advise you on the latest guidelines from the Driver and Vehicle Licensing Agency (DVLA).

If you plan to fly, you should seek advice from the Civil Aviation Authority (www.caa.co.uk). Some people with a more serious heart attack may need more detailed advice before flying.

If you hold a pilot's licence, you should seek advice from the Civil Aviation Authority (www.caa.co.uk).

Stress management

Your cardiac rehabilitation programme should include how to cope with stress, but if you feel anxious or depressed after your heart attack your doctor should offer you counselling, self-help advice or, sometimes, medicine. NICE has produced advice on treating depression in adults with a long-term physical health problem, and about treating people with anxiety (see Other NICE guidance for details).

Sexual activity

If you have made a good recovery after your heart attack, it is safe to resume sexual activity when you feel ready, usually after about 4 weeks.When you have recovered from a heart attack, your risk of another heart attack being triggered by sexual activity is no greater than for someone who has never had a heart attack.

If you have erectile dysfunction (difficulty in getting or maintaining an erection), your heart attack was over 6 months ago and you have made a good enough recovery, your doctor may offer you medicine that can help.

Questions to ask about cardiac rehabilitation

  • Please tell me more about cardiac rehabilitation.

  • What happens if I don't want to go to all the sessions?

  • Can you provide any information for my family/carers?

  • Can I talk to you about whether there are any risks in having sex?

  • Does Viagra (sildenafil) or a similar tablet interact with any of the drugs I'm taking?

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