Exercise. What intensity is acceptabl... - British Heart Fou...

British Heart Foundation
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Exercise. What intensity is acceptable in the long term after MI?


Firstly, my background. Age 56 with no risk factors then had an unexpected heart attack with a single stent inserted in January of this year. Since then it has been a very steep learning curve. I am on all the usual post MI medications and thankfully everything has gone as well as can be expected. I followed all the advice given and attended cardiac rehab. The rehab was difficult to come to terms with at first. I have always been a keen exerciser, attending circuit training and boxercise sessions. I had to learn to take it easier to allow the heart to heal. But I got there and was allowed into the gym on a reduced heart rate level. I had never bothered to measure heart rate so this has again been been something new to learn. This is where I am now having a problem. I am now in the wilderness of being left on my own, having been discharged by the healthcare system. Last week I attempted a return to my circuit training class with the support of the instructor. How the mighty have fallen!

I am having difficulty coming to terms with the loss of physical fitness. Having spent several months keeping my heart rate at very low levels and taking medications to keep it at a lower level, I was horrified at how quickly, even with just the warm up, my heart rate shot up to a very high level.

I am unsure whether I should continue to exercise at a much reduced level or endeavor to return to what I would have regarded as “normal” for me previously. Will I damage my heart by exercising more intensely or will it do it some good to be pushed a bit harder? I would appreciate the views of members who have exercised intensely prior to a heart attack. I am particularly interested to know what you are all doing now. I understand that we are all individuals, so the responses are likely to be diverse. Having travelled this far safely, I wish to continue the journey even if it’s on a path that I would not have chosen previously. Good luck to everyone out there on the same journey, I look forward to reading the responses.

13 Replies

Hi I'm also at that stage. I had HA February and have done rehab. After being hospitalised a few weeks ago I was put on drugs to lower my heart rate I had to start rehab again. Thing is I feel I want to up exercise now. I'm currently walking bout 5/6 km a day and I find it doesn't raise my heart rate too high but on returning to rehab and doing circuits HR shoots back up to 168. Was told to slow down but I find it really hard to do this as I don't feel I'm really working at a slower rate. Not much help to you I know but just know your not on your own. It's very frustrating and I don't have the answer sorry

in reply to Shoshov

Knowing that I’m not on my own is some help. Thanks.

I had similar experience but found the initial rehab set some reasonable objectives and boundaries in terms of what I should and should not do. Having been involved in sport all my life I too wanted to push things along and it took quite a while to “settle down” and accept that recovery was a long haul.

I have not experienced the raised heart rates you describe, mine is almost the opposite in that it takes quite an effort to get to anything like the level you describe. That may be the result of different drugs but my recovery over 18 months has been one of steady progress. I stress the “steady”!

Once I left the hospital system I joined, and still attend, “Level 4 Cardiac Rehabilitation” classes at my local leisure centre. It continues from wher the hospital process left off - basically circuit training with some supervision. Over time I have passed tests to resume scuba diving and recently did the London to Brighton Cycle ride so progress is feasible - I couldn’t walk to the end of my road at the start!!

Maybe speak to the rehab team or you doctor and get some concrete advice they will have evaluated you and will know what you are capable of?

All the best - don’t rush it :)

in reply to NathanBlau

Thanks. I intend to discuss with my GP at my next visit. I suspect that I am being a little ambitious. First day home I could just about peel a potato! The trouble is now that I feel “normal”. To any newbie all I can advise is listen to cardiac rehab and you will be fine. I can function perfectly well on a day to day basis. Circuit training however is my utopia. BHF and this blog is a fantastic source of support. Thanks for the reply.

Hi MrNT. I really feel for you. Wanting to get straight back to the ‘old’ you: but logic telling you to build up steadily.

The psychologists would say you are emotionally suffering a sense of loss, of the old, fit energetic you...and just want to jump back into being who you were.

But the logical brain says you need to listen to well researched advice which says build up steadily. How difficult it must be for you,

All I’d say is take some heart from steady progress, each little achievement will build up to lots, and you’ll find a new way of doing things...possibly very like your old way. But you need to take a steady journey to get there.

Hope this makes some sense?

Let us know how you get on,


I have AF and Heart Failure which started 4 years ago. I couldn’t walk to the end of the road to begin with but I just completed a 15 mile high walk in the Lake District. The problem is I now don’t enjoy the walking. I find it more of a challenge than a enjoyable hobby it used to be. I can walk up any hill as long as I do it in my own time, and there lies the problem. I am 58 and was very fit but now pensioners, (I know some pensioners are extremely fit), and people who look a lot less fitter than me are catching and passing me on the routes. It’s very frustrating and hard to except.

I’m on 10mg Bisoprolol which makes me constantly tired but is suppose to keep my heartbeat under control. I find if I make the heart work to much I feel sick. I haven’t experienced a real good workout, one that really pumps the heart, for 4 years, I miss that level of training. I can’t really do walking holidays anymore because everyday I walk drains energy which I cannot replace. At the moment I feel like a battery slowly draining but with very little recharging.

It’s impossible to get used to but try and keep interested. Listen to your body and except that although not official, we are now a little disabled.

in reply to Howardl

Hi Howard,

I sometimes think the medical profession considers preserving life is more important than the quality of life.

Beta blockers are great for restricting the amount of work the heart can do, but conversely they restrict energy levels....that's where a balance must be struck.

After my heart attack I was put on bisoprolol which dramatically slowed my heart. To cut a long story short I finally got the dosage down to 1.25mg where it does its job but I still have plenty of energy left.

Maybe you could try reducing the dosage bit by bit until your energy levels are restored?

Hi, your background seems similar to mine.

I was 64, always been very fit, gym twice a week where my heart rate would routinely reach 180, resting HR of about 50. Ran 5 miles every Sunday morning since I was in my mid 20's, played squash every week and took a brisk walk every lunchtime at work.....I had a very stressful job which I loved, but ultimately that was probably where my problems lay.

That was over 5 years ago.

I have now retired and have built back up to taking regular exercise, my HA is now history, but still there in the background.

I go to the gym twice a week and always wear a HR monitor. Medication (beta blocker) now regulates my HR to about 125, no matter how hard I try. sweat pouring off me on the cross trainer, I can't get it much higher. I jog, row, play golf (squash sadly is history), walk and cycle a LOT, and have a regular morning exercise regime which takes about 15 mins.

The important point is that I have come to terms with my ageing body. I loved my job and really miss it but I know that lying awake a 4am thinking and planning all the things I had to do the next day, spending half my life rushing to the airport or in a jam on the M25 had taken its toll.

As we get older we must accept we can't do at 60 what we used to do at 40 or 50, that's the reality, don't push too hard, keep working out but work within yourself, eat well and don't get overweight and the future is bright.

Good luck

Post HA and stent is a new mental game. A readjustment is needed and your progress will be steady. If very lucky and in good time you’ll get back to good fitness levels but I think you have to appreciate how lucky you are and are not incapacitated . Set New horizon and go for it with an appreciation and expectation.

A lot of good advice in the previous replies. I am 70 and had my HA last December, prior to that cycled a lot, hill walked and swam every week. On getting back after my HA and stent fitted I just slowly increased my walking distances over the first few weeks and then back to swimming then progressed to cycling gradually building up the mileages and hills. I am more or less back to where I was previously but struggle on some of the steeper hills but this may be my age or loss of previous fitness. My advice would be to gradually increase what you do and listen to your body and do what you are comfortable with. And over the next few months I am sure you will get back to normal.

I had 4 stents put in 5 months ago, 3 in my LAD.

Off all meds except the prasugel (blood thinner) and aspirin. I keep my heart rate between 130-140. Elliptical and weights 5 days a week. Exercise is harder now but it seems I’m working at the same level with a lower heart rate so I have to push harder. Statins were killing me so doctor has given me a 6 week vacation from taking them to see how my cholesterol levels respond. I’m afraid I’ll have to be put on them again and keep trying until I find one that’s tolerable. I guess we all have mental issues after our procedure. Mine is second guessing myself on stents versus bypass. Bypass seems to be a more permanent fix but I have to come to grips with my decision and move on.

Good luck!

I had a heart attack and cardiac arrest 14 months ago and kept fit before then . I love swimming and cycling for great work out and helps with the anxiety side as well . good luck you will get there

Thankyou to everyone who has replied. It has been interesting to read the comments and advice. I’m sure that the replies will be useful to many people.

I always believed that keeping myself physically fit would protect me from cardiac disease. It was therefore a very unpleasant surprise to then have a heart attack. I choose to agree with the view of the cardiac staff that my acquired fitness was not wasted since it has contributed to aiding my survival and recovery. Therefore my intention is to continue as previously and to regain as much of my previous fitness as possible. However there is no rush and I will do it carefully. It may or may-not happen, it’s not so important now. I’m alive and it will be fun trying.

Good luck everyone.

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