CAD and exercise: hi everyone. I had a... - British Heart Fou...

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CAD and exercise

Spedyrecovry50 profile image
30 Replies

hi everyone. I had a ct angiogram which showed i have partly blocked arteries. not bad enough to have it unblocked but bad enough to have a high dose of statins and the symptoms of CAD.I was wondering what kind of exercise I can do?

so far any exercise i do especially cardio gets me really out of breath and brings on chest pain. I don't wont to put myself at risk.

my gp says anything just do go crazy. that was also what the cardio nurse said. I havent spoken to a cardiologist yet so I don't know what to do.

any ideas would be great. I am already looking at cutting calories. I just want to know what exercise is safe. thanks.

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Spedyrecovry50
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30 Replies

Chest pain brought about by exercise can be a symptom of stable angina. Have you discussed this with your GP? If so are you prescribed medication e.g a GTN spray and advised to use it? Otherwise I suggest you try brisk walking to start with, say a daily brisk walk for 10 minutes gradually increasing to 30 minutes or so. Or buy an exercise bike and slowly build up daily sessions. That will get your heart rate up and may do you just as much good as a twice weekly rigorous gym session or a 5k run. The late Michael Moseley did a series of BBC podcasts headed Just One Thing, some in exercise, and the one dated 3Jan24 with Prof Marie Murphy is a good start. But whatever you do it regularly, listen to your body and certainly don't overdo it.

Happyrosie profile image
Happyrosie

just to confirm what Lowerfield says . Start small, work your way up. You know the sort of exercise you could do fairly easily before you started to have these problems: start with this sort of exercise but not heavy gym work.

For instance, if you could do a brisk thirty minute walk three years ago and only twenty minutes now : Start with a ten minute brisk walk twice a day, then fifteen minutes twice a day after two days and so on. You probably know what exercise brings on cardio pain so keep it just below that level. As GP and cardio nurse have said, probably.

This is just an example.

Make sure you are well-hydrated.

Have a look at the website of Blood Pressure UK for diet ideas.

AAJJTt profile image
AAJJTt

Hi,

Do you have any cardio rehabilitation programs in your area? Maybe ask your GP or nurse .

In my area we have;

Phase 3 - Referred on discharge. This is run by the NHS with cardiac nurses and some trainers from a local charity. It was a 12 week program, starting and finishing with a walking/jogging beep-test; to show progress. Predominantly this was low intensity circuit program designed to get you moving again after discharge and build confidence. The group was mixed (sex and age) and while I found it relatively easy, I did welcome the slow build up. There was a lot of uncertainty and trepidation in mind about the position I was in. This gave me the confidence to exercise again without feeling I was going to keel over. You also had the opportunity to discuss things with the staff, emotional support is important too. The psychological effects can sometimes be more debilitating than the problem itself. This was run in conjunction too, with some educational seminars covering things like diet, medication, etc.

Phase 4 - NHS or self referral. This is run by a local charity with their trainers. This was a 9 month program starting and finishing with full CPET tests (treadmill/Bruce protocol). On completion of the tests, the results are analysed and you are given a target heart rate to work to. You then follow the program, twice a week, circuit training or gym, working to your target. The staff are there (to monitor, support you and to show you how to work safely to your desired intensity.

After my heart attack, they got me up and running again and I’ve not looked back. I still attend phase 4 weekly, regularly running and rowing.

Spedyrecovry50 profile image
Spedyrecovry50

thanks everyone. I will ask my gp about the rehabilitation.

sandandkev profile image
sandandkev

I have mild cad,but I walk a lot,the pain is where your blood is being pushed harder through arteries and where on is slightly narrowed it causes cramp like pain-angina, so I would do what you like but stop if you get pain,you will soon find out how much you can do,then you know the amount to do without pain-- good luck

Drummer20 profile image
Drummer20

I’ve just been doing cardio rehab and the thing they told me is very important is to warm up gently for 15 minutes before exercise and cool down for 15 minutes afterwards.They said it’s important with any heart conditions to give your heart a chance to adjust.If someone could give you an idea of what a safe heart rate would be for you that would help too.There might be cardio rehab available in your area too.

Thisishappening profile image
Thisishappening in reply to Drummer20

Re max heart rate. Rough calculation: 220 minus your age and take 85% of thisas your safe max. Mine is 132. Cardio says use this as a guide. Listening to pain threshold is more important.

Sb1171 profile image
Sb1171 in reply to Thisishappening

Would definitely agree with paying attention to your perceived exertion as HR can vary, especially if you are on a beta blocker. My HR used to truly max at 185, but now 165 with beta blocker. My calculated max is bang in the middle of those!

Spedyrecovry50 profile image
Spedyrecovry50

thanks for the replies. I am talking to my gp on Monday so I think I will ask about rehab

Rabbit55 profile image
Rabbit55

Dear speedy recovery50, I am still waiting my results from having an angiogram. The canula going into your arm is the worst part of it. Walking is the best exercise. Best of luck. Rabbit55.

Thisishappening profile image
Thisishappening

I'm same as you. I take Ranolozine 500mg x daily plus statins and BP meds. They didn't stent me as diffuse blockage, so tricky. Cardiologist says I must exercise daily, v important. But how much? Listen to your body he says. If it hurts or you're wiped out cut down. If OK go for it. I bought fitbit and can monitor pulse, I keep to about 120bpm at vigorous exercise, sometimes goes higher and with warm up etc don't get angina. Right now I've built up to three, mile swimming sessions per week, 64 lengths, plus good walks each day. I told cardio about this and he said great, if no pain, no problem. I do keep my gtn spray with me at all times in case I have a problem.

Main thing i think is not to sit around all the time. The heart is a muscle and needs exercise. You can do this! Good luck

Ps listen to your body. Pain is bad, it needs treating if brought on by exercise. Otherwise keeping moving is vital for all sorts of reasons.

dlowell profile image
dlowell

I would get a second opinion to determine why a stent isn’t being advised, since the stenosis or plaque build up will likely continue.

Thisishappening profile image
Thisishappening in reply to dlowell

Not necessarily. If the cholesterol is brought right down and with good lifestyle, it's possible to reverse the calcification in some cases. I didn't have stents partly because I have diffuse blockages over long sections. This makes stenting much more problematic. This is why I've been working so hard on weight, lowering LDL, and keeping as fit as possible.

Gigi70 profile image
Gigi70 in reply to Thisishappening

are you being put forward for bypass?

Spedyrecovry50 profile image
Spedyrecovry50 in reply to Gigi70

no. at the moment I have been discharged with no help but the statins which I am having problems with. they are making me so tired I cant hold my head up. I am talking to my gp tomorrow and I have written to my cardiologist. so hopefully I will get some help.

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Thisishappening

Where is your evidence that plaque calcification can be 'reversed in some cases' . My understanding is that once plaque is laid down that's it. It either subsequently calcifies either naturally or by medication, e.g. statins, or removed mechanically by drilling. If calcification could be reversed there would be a complete shift in medical practices to assist the millions with blocked arteries rather than just trying to stabilise plaque, and/or undertake mechanical interventions such as stenting, bypasses, drilling etc etc.

Thisishappening profile image
Thisishappening in reply to Lowerfield_no_more

That is what my cardiology consultant told me explicitly. I assume he was basing this on some evidence.

Thisishappening profile image
Thisishappening in reply to Lowerfield_no_more

How about a quick Google? webmd.com/heart-disease/fea...

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Thisishappening

Google came up with this too closer to home from our very own BHF sponsor which says "(Arteriosclerosis) is progressive and unfortunately current treatments cannot melt it away. "

bhf.org.uk/informationsuppo...

However medical opinion seems to widely support the view that you can slow down or even stop plaque lay down as well stabilise what has been layed down.

No doubt in years to come with advances in medical science some treatment will become widely available to mankind to prevent and reverse arteriosclerosis, and significantly reduce heart health risk, but in my view it ain't here yet.

Thisishappening profile image
Thisishappening in reply to Lowerfield_no_more

Which goes to show that knowledge is currently imperfect and there are different perspectives. I made my comment in good faith on basis of what my cardiologist advised. I'll go with that for now since apart from anything else it's a message of hope not despair, which is important in the healing and recovery process. BTW I'm a psychologist, not a medic :-)

dlowell profile image
dlowell

Fair enough. I have six stents and try and exercise 4-5 times a week - cardio, weights and flexibility. My cardio includes high intensity workouts to get my heart rate up to about 155-160 with encouragement from my cardiologist. I’m 64 and now in good shape with an EV around 60%+. My cholesterol medication includes Rosuvastatin and Nustendi. My LDL is so low that BUPA couldn’t measure it (!)

AAJJTt profile image
AAJJTt

There are a few comments about target rates and intensity.

This the advantage of a CPET, it is a clinical examination of your exercise tolerance. Your heart (via ECG), respiration and BP are monitored, while you are ‘stressed’ (Bruce protocol on a treadmill) in a controlled manner. The analysis gives you a very personalised target HR.

I always remember the Doctor’s words at the end of my first test, ‘I think we can afford to be aggressive with you’. I had a very good result and my target heart rate was set at 90% of my maximal; my result was even better on the 2nd test. This was 5 years ago and I still exercise to this target, though my maximal decreases with age. It’s quite convenient too, that the zoning on a lot of sports watches (I use Polar) usually has 90% as the top of zone 4. I don’t have to do much thinking and exercise to the data on the watch. Of course, it goes without saying too, that I do listen to my body as well.

I am not sure if all cardiac rehabilitation services around the country provide this examination but it’s worthwhile if they do.

Hi,

Like you I have CAD, and on statins and low dose Aspirin only.

I do cardio 4-5 sessions/week (rowing) - can easily get near 90% my max HR with no issues/pain whatsoever. However, I am a bit hesitant to push myself harder and for longer and near my max HR. Typical session is 10mins at 90% of max HR.

Stressing your heart for longer and harder, personally I would not do. Not sure what the marginal benefit is of doing so.

In short - listen to your body and try to enjoy it and not suffer from it. If you do it this way, you will stick to it for longer.

Just to add, I also try to hit 10k steps on most days too.

Best

Spedyrecovry50 profile image
Spedyrecovry50

hi all. thanks for all the advise. I talked to my gp today. they have upped the statins to 40mg a day. she said to take them at night. she said that I could do the exercise but to take it easy. even though I said that exercise brought on chest pain. she just said to keep my gtn at had and stop if its bad. no rehab or to be able to talk to a cardiologist. I am going to try some exercise tomorrow.

Lowerfield_no_more profile image
Lowerfield_no_more in reply to Spedyrecovry50

BHF do an online cardio rehab course. Might be worth checking it out to see if it suits you.

bhf.org.uk/informationsuppo...

Spedyrecovry50 profile image
Spedyrecovry50

I did some strength training this morning. it went ok. its weird building up my strength and stamina from scratch again. no chest pain which was good.

Spedyrecovry50 profile image
Spedyrecovry50

OK. so a little bump in the road. I had 40mg atorvastatin last night at 8pm. I did my strength training in the morning. it was lunch time and I noticed what I thought was a eye floater. as time progressed so do the floater. it became a squiggly line that was effecting my vision. it then got so bad I couldn't see out of the left side of my vision. it was in both eyes. it took 20 minutes to get to its peak. I got my lunch and drunk a pint of water. in the next 20 minutes u was OK. I phoned my gp and told him. I was worried it was the statin. the gp sent me to the eye clinic to get checked out. they said my eyes where clear and it was probably a migraine. so now I don't want to exercise or take statins ever again. not sure what to do now.

Spedyrecovry50 profile image
Spedyrecovry50

update.they think I might have had a mini stroke. I have a ultrasound on my neck on Wednesday then I am talking to the dr on Friday. I havent been able to do anything. I also woke up in the night because of tinnitus. it was very loud and it hurt my ears. everytime I try the high dose of statins I get some nasty side effect. I am going to ask to try a different one.

bluemoon572 profile image
bluemoon572

Did a treadmill stress test bring on chest discomfort and EKG changes diagnostic of ischemia? If so, perhaps your GP will recommend a second opinion about treatment. Are you taking a longacting form of.nitroglycerin as a preventative? Walking on level ground probably is your best & safest form of exercise with a distance that just won't bring on chest discomfort.

Spedyrecovry50 profile image
Spedyrecovry50 in reply to bluemoon572

I havent done a treadmill test yet. all they did was a ct angiogram. I only have the spray. I try to walk on flat ground but I live in a hilly area so it is difficult. thanks.

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