Safe Exercise for Patients with Heart Disease

This information was reviewed and approved by Andrew M. Freeman, MD, FACC, FACP (1/1/2016).

There is almost no disease that exercise doesn't benefit. As such, just because you've had a heart attack, a weak heart (congestive heart failure) or other heart disease, doesn't mean that you have to sit around and do nothing. In fact, with regular exercise (greater than 150 minutes a week), you may hasten your recovery, improve heart function and even get off of some of the medications you're on.

Cardiovascular benefits of exercise include:

  • Strengthening your heart and cardiovascular system

  • Improving your circulation and helping your body use oxygen better

  • Improving your heart failure symptoms

  • Lowering blood pressure

  • Improving cholesterol.

It's never too late to increase your physical activity or start an exercise program. Get an "OK" and some guidelines from your doctor before you start.


Getting Started: Things to Discuss with Your Doctor

Always check with your doctor first before starting an exercise program. Your doctor can help you find a program for your level of fitness and physical condition.

Here are some discussion questions:

  • How much exercise can I do?

  • How often can I exercise each week?

  • What type of exercise should I do?

  • What type of activities should I avoid?

  • Should I take my medication(s) at a certain time around my exercise schedule?

  • Do I have to take my pulse while exercising?

Your doctor may decide to do a stress test or an echocardiogram, or to modify your medications. Always check with your doctor first before starting any exercise.


General Workout Tips and Caveats for People with Heart Failure

  • Avoid too much isometric exercises such as pushups and situps. Isometric exercises involve straining muscles against other muscles or an immovable object.

  • Don't exercise outdoors when it is too cold, hot or humid without checking with your doctor first. High humidity may cause you to tire more quickly. Extreme temperatures can interfere with circulation, make breathing difficult and cause chest pain. Better choices are indoor activities such as mall walking or a treadmill.

  • Make sure you stay hydrated – within reason. It is important to drink water even before you feel thirsty, especially on hot days. But, be careful not to drink too much water. Check with your doctor first!

  • If your exercise program has been interrupted for more than a few days (for example, due to illness, vacation or bad weather), make sure you ease back into the routine. Start with a reduced level of activity, and gradually increase it until you are back where you started.

Warnings During Exercise

There are some precautions you must keep in mind when developing an exercise program:

  • Stop the exercise if you become overly fatigued or short of breath. Discuss the symptoms with your doctor, or schedule an appointment for evaluation.

  • Do not exercise if you are not feeling well or were very recently ill. You should wait a few days after all symptoms disappear before restarting the exercise program. If uncertain, check with your doctor first!

  • If you have persistent shortness of breath, rest and call your doctor. The doctor may make changes in medications, diet or fluid restrictions.

  • Stop the activity if you develop a rapid or irregular heartbeat or have heart palpitations. Check your pulse after you have rested for 15 minutes. If it's above 120 beats per minute at rest, call your doctor.

  • If you experience pain, don't ignore it. If you have chest pain or pain anywhere else in the body, do not allow the activity to continue. Performing an activity while in pain may cause stress or damage to the joints.

  • If you pass out, call your doctor or seek urgent care as soon as you awake.


Stop Exercising and Rest if You Have Any of the Following Symptoms:

  • Chest pain

  • Weakness

  • Dizziness or lightheadedness

  • Unexplained weight gain or swelling (Call your doctor right away.)

  • Pressure or pain in your chest, neck, arm, jaw or shoulder, or any other symptoms that cause concern.

  • Never exercise to the point of chest pain or angina. If you develop chest pain during exercise, call 911 right away.


Exercise: Only One Part of the Equation

In order to maintain optimal cardiovascular health, eating a heart healthy and mostly plant-based diet, along with stress reduction, in combination with exercise as outlined above is critical for success.