I am new to the site and have started my recovery program. I have been discharged by the cardiac nurses without any advice on what my target heartbeat should be and how quick the heart should go back to resting heart beat after exercise.
Can someone give me any advice on this?
Hi, and welcome. So, everyone is different (ish) Try not to worry about your pulse, yours will be different from mine and the next person. Go by perceived physical exertion and judge it that way, try the "talk test". Your pulse will "go back" to "normal" faster once your cardio vascular function becomes more efficient. All that said, you asked a question, so from a random internet stranger, dont let your pulse go over 126 and give yourself 7 mins rest give or take 
HTH (yes, they are randomish numbers - and you should really speak to your cardiologist and cardiac rehab nurse)
Welcome to this great forum. The answers to your questions are not straightforward and you will need to get back to your cardiac nurses for informed advice. You don't say what you are recovering from, how long ago, what medication you are on, how old you are, whether you have any other relevant medical history and how active you were before your operation/procedure. All these things will affect what exercise you should and shouldn't be doing and the cardio rehab nurses will take all this into account.
The formula that "normal" healthy exercise-enthusiasts use is to calculate their maxiumum heart rate (which is 220 minus their age) and then take a percentage of that to set a target heart rate for moderate (eg, 60%) or strenuous (eg. 80%) level of exercise. But using this is unlikely to be right for you. For example, if you are taking a beta-blocker (eg. bisoprolol) then this med slows your heart rate and so your target heart rate for exercise will also be lower.
In my case, I'm recovering from a bypass operation 3 months ago and I'm taking 2.5mg bisoprolol a day. My resting heart rate with the medication is about 65 bpm. My cardio nurses have told me that 100 bpm is a good target for my exercise. In fact I find have to work quite hard to get my HR above 100 bpm anyway and then I get puffed out and fail the "talk test" (as mentioned in Sparticus's reply).
I hope this helps you have a good discussion with your cardio rehab nurses. Good luck!
Hi Mart,
Here are some of the questions answered:
I am female, 60 yrs old and had a quadruple CABG on 23 November 2020. A was put on Clopidogrell, Atorvastatin, Asperine, 12.5 mg Atenelol, Lansoprolol, Ferrous Sulphate, Levothyroxine and Vit D. 5 Days later I was back in hospital with Pulmonary Emboli. They changed the Clopidogrell to Apixaban 5mg. As you might see from the medication, I am hypothyroid and my haemoglobin was so low before release from hospital that I needed a blood transfusion. I wasn't able to walk properly until 3 weeks ago, and that is when I started my outside walks...... 100 meters at a time. I have now worked it up to just below 2k.
So, going from your explanation I should have a 60 - 80% of heart beat of 160 = 96 - 128 minus the impact of the beta-blocker. My resting heart beat is around 70. So if I aim to be between 80 and 110 I should be okay. I will definitely have a good discussion with the cardiac nurses today.
I was quite fit before this all happened and was cycling around 20k every other day, fast walking for 30 min and weights on the other days and going on 2-3 hour walks in the weekend before the angina started. Within 3 months I was not able to walk to the end of the street anymore without getting angina. How can it progress so quickly???
As we have all said, please get advice from an expert. That said, your 80 - 110 range feels sensible to me (as a non expert) as a good starting point for a discussion with a cardio nurse. I'm sure you will have been told about the talk test - ie, you should be able to hold a reasonable conversation with someone while you are exercising.
Given your past activities I guess you are impatient to get back to doing all the things you were doing before. I am an impatient patient too! Happily, everything I have read and been told suggests that it should be possible. I was also pretty active before my bypass and now, at 3+ months, I'm feeling increasingly confident.
Your comment about "How can it progress so quickly?" is interesting. I don't understand this myself and I would like to. In my case it almost happened overnight. Sudden onset of chestpains with gentle exercise...nothing the day before. Within a month I couldn't walk 200 yards on the flat without angina pains. Puzzling. I still in shock and feeling rather cheated because I was quite active before, not overweight and my diet was also OK-ish.
I think you need advice from a doctor, ideally from your cardiac team. It depends so much on your condition and your general health. I was reasonably fit without being remotely an athlete, recovered well from my bypass apart from a big issue with an infection, and pushed myself a little (not too much) in the physio sessions. I alarmed the nurses a bit, and they kept telling me to hold back, but in fact I don't think they had a proper baseline measurement, as they were being extra cautious when they took that - I wasn't too long out of hospital.
Anyway, the long and the short of it is that my notional rate is about 160, my HR is consistently lower than expected, I've never got it above about 145, even going flat out, the nurses thought I shouldn't be going to or above 130, and the surgeon who discharged me said I could push as hard as I liked, given my general condition and recovery - which of course would not apply to everyone, as I've been fortunate. And it drops back below 90, sometimes lower, within a couple of minutes of any exercise.
But these numbers are to illustrate the different considerations and advice, rather than as comparisons for anyone else. Medical advice is what you need. And you don't really need to get to maximum to be doing yourself good.
Best advice I received was to go "by feel".
In other words, if it doesn't feel right or you're getting chest pains, ease back on the exercise. Also, if you're excessively tired the following day, that's another sign that you've overdone it and need to reduce your exercise a bit.
That is so not good. Recovering heart patients need guidance. But step by step is how to go. BHF have some videos. I have my Harefield link but I'm not allowed to share because everyone will be at a different stage. I have carried mine on after my rehab discharge and do check my pulse...not over 130. Good luck.
The cardio rehab folks gave me a target heart rate band to work to. Based on resting heart rate data that I gave to them.
Interestingly though my surgeon said he didn’t put much weight on heart rates. His advice to me was “when you exercise, don’t go too intense. You should still be able to just about have a conversation whilst you are doing your exercise”
Everyone’s heart and medical circumstances differ to no one heart rate, or even method of calculating a heart rate is right for everyone.
Welcome to the Hearties! Not somewhere you ever wanted to be but now you are, you'll find us a welcoming and generally quite helpful lot
You need to contact the cardiac nurse and specifically ask what your 'target' heart rate is - none of us are medically trained and we've no access to your medical history so we cannot give any advice regarding your specific case.
Every single one of us is different - what is right for me will not be right for you.
Only your medic can advise something like this.
Let us know how you get on.
Hi all,
Thanks for your replies. I felt really let down by the surgeon and the cardiac rehab team this week when both of them discharged my without giving clear guidance on what to do next. I will get back to the cardiac nurses to get some clarity though. Thanks again for your support.
if you can measure your heart rate during and after exercise , and keep a diary, it will give you an idea of what your trends currently are, particularly your resting heart rate is. Please note that I am not a qualified medical person and these comments are based on my experience.
From what I can gather, on a very general basis, there are problems with stenosis, usually causing difficulty with valves that have to be operated, repaired or replaced as required. Curiously quite a lot of people with this sort of problem do not have clogged arteries. When I comment on this as I was going down to have my valves repaired one of the surgeons said that it was not unusual for this to happen.
What about Angina and clogged arteries I asked. "Usually too much sugar washing around your arteries, forming plaque and jamming things up" , he said . A man with a mask came along and that was the end of the conversation
I was advised by my heart failure nurse not to be surprised if I have trouble raising my heart rate during exercise, because I am on a beta blocker, Bisoprolol, and of course one reason why beta blockers are prescribed is to lower heart rate. I had noticed that the longer I had been taking Bisoprolol, the more difficulty I had been having with this, so good to be given this advice. Just something to bear in mind. Cardiac nurses (no cardiac rehab here due to you know what...) gave me no advice at all about this.
Hi Honeybee,I had a long chat with the caediac nurse on Friday and she now gave me a detailed training program to start with and I was asked to give them a call with an update in 2 weeks time. It feels a lot better to have the regular contact even if it is by phone.
Good you found a supportive cardiac nurse, fit4walks. Phone support is better than no support at all. I was promised weekly phone calls for 8 weeks, which never materialised. I had two telephone conversations, which were helpful, but was then discharged back to my GP.
I'm sorry to hear that you had a similar experience. Although the cardiac nurses here are helping out on Covid wards, they will pick up messages when you call them. I have the feeling that most of us are left hanging without much support during this pandemic. Not a nice position to be in....
I think this is true, I definitely feel I am not getting adequate support from the NHS, and this together with lock down and so not being able to see family and friends is becoming increasingly difficult to cope with. I’m sure this must be the case for a lot of us here.
Yea ,I was in the fitness industry for years ,think someone mentioned it here but I’ll echo it,220 minus age, take that figure work out 60-80 percent of it then that’s a good idea of what u should be aiming for if u feel up to it of course
Heart rate post surgery (especially during exercise) 
IRREGULAR HEART BEAT 
Irregular heart beat 
heart suddenly beats really fast for a few seconds during the night
