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Guest post by Laura Raymond, manager of the Cardiac Rehab and Prevention program at St. David’s Medical Center; Evan Weese is an exercise physiologist in the Cardiac Rehab and Prevention program at St. David’s Medical Center

We hear it all the time—exercise can help prevent a heart attack. But what if you’ve already had a heart attack? How soon is too soon to get back in the game?

February is American Heart Month, and it’s also the perfect time to kick start an exercise program. Not only can exercise improve heart muscle function, but it also helps keep off excess weight—and can reduce the devastating effects of heart disease.

Exercise can begin as early as one week after suffering a heart attack. However, patients should always seek medical clearance from their physician before starting any exercise program.

Once a person has been cleared for physical activity, cardiac rehabilitation experts suggest patients choose activities that are fun and suit their needs, but can also be done year round. Walking, swimming, cycling, jogging, skiing, rowing, arm ergometry and aerobic dancing, along with many other forms of cardiovascular exercise, are great for improving your heart’s function.

Start exercising at a low intensity (especially if you’ve been sedentary for much of your life). From there, patients can progressively increase the duration to 150 minutes a week (30 minutes, five times a week), which may take a couple of weeks.

Also, use the Borg Rating of Perceived Exertion Scale to progress your activity. According to the Centers for Disease Control and Prevention, the Borg Rating of Perceived Exertion is a way of measuring physical activity intensity level. Perceived exertion is how hard you feel like your body is working. It is based on the physical sensations a person experiences during physical activity, including increased heart rate, increased respiration or breathing rate, increased sweating and muscle fatigue. Although this is a subjective measure, a person’s exertion rating may provide a fairly good estimate of the actual heart rate during physical activity. We recommend patients try to stay between 11 and 13 (fairly light to somewhat hard) on the Borg Rating of Perceived Exertion Scale when exercising.

Also, incorporate strength-training and flexibility exercises into your workout to maintain muscular strength and endurance, as well as full range of motion in your joints. Flexibility can also improve your balance. Make sure you stretch slowly and hold for a minimum of 15 seconds per muscle (and do not bounce).

Remember to take time to warm up and cool down—three to five minutes for each. The warm up prepares your body for exercise through increasing blood flow to the working muscles and steadily increasing your heart rate and blood pressure. The cool down slowly decreases your blood pressure and heart rate to ensure you do not become light-headed, dizzy, or faint.

Patients are commonly referred to an outpatient cardiac rehab program to begin their journey toward a more rigorous workout regime and a healthier lifestyle (if your doctor has not referred you to an outpatient cardiac rehab program, you should inquire about it). Cardiac rehab programs, which are recommended by the American Heart Association and the American College of Cardiology, can increase a patient’s chance of survival. Most patients remain in cardiac rehab for approximately 12 weeks.

If you still need some extra incentive to inspire you to have a change of heart, consider this—research shows many patients who go through cardiac rehab show almost no signs that they ever had a heart attack if they commit to an exercise program and adopt a long-term healthy lifestyle. So after about three years, it’s as if they never had one.

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