Frequently Asked Questions About Heart Attack
Q: Was my heart injured, and how will this affect the way it works?
A: When a heart attack occurs, a part of the heart dies because its supply of oxygen-carrying blood is cut off. But the heart is a remarkably tough organ. Even though a part of it may have died, the rest still keeps working.
Your situation is much like that of an athlete with a torn leg muscle. Until the muscle heals, his or her effectiveness is reduced. Because your heart has been damaged, it's weak and can't pump as much blood as usual.
During the first few days after a heart attack, rest is essential. But even after that you should limit your activities until your heart has had time to heal. When your heart is healthy again, you can return to your usual lifestyle.
As the damaged part of your heart heals, a tough scar forms. This takes time; it's still forming after you've begun to feel good again. Usually in a month or six weeks your heart has repaired itself. The length of time depends on the extent of your injury and your own rate of healing. That's why doctors recommend different amounts of activity for each heart attack patient.
Q: Why do I feel weak now that I'm home? Is it heart damage?
A: If you rested a lot in the hospital and stayed in bed, you'll feel weak when you get home. Damage to your heart isn't the reason. You feel weak because inactive muscles lose their strength very quickly. Without activity muscles lose 15 percent of their strength in just one week.
Muscles regain strength only through exercise. That's why your doctor has given you a program of gradually increasing activities you can do at home. But even with regular exercise, it normally takes two to six weeks to get muscles back into shape.
Q: What are my chances for leading a normal life again?
A: Most people who've had a heart attack can resume their former activities in a few weeks or months. When your heart has healed, the scar usually isn't big enough to interfere with your heart's ability to pump blood. That means you won't need to reduce your activities very much, if at all. You may need to make some lifestyle changes. Most heart attack victims survive their first heart attack. Most fully recover and enjoy many more years of productive activity.
Q: When can I go back to work?
A: Between 80 and 90 percent of heart attack survivors return to work in two to three months. Usually they can return to their former jobs. Of course their return depends on two things: how badly their heart was damaged, and how demanding their job is. Some people switch jobs and take a new job that's less taxing on their heart.
Cardiac Rehabilitation Units like the one affiliated with St. Mary's Heart Institute are available in many communities. Your doctor may send you to one to find out how much and what kind of work you can do. Most communities have some type of rehabilitation program for vocational guidance, training and placement of heart patients who can't return to their former jobs. For more information about these programs, talk to your doctor or contact your nearest American Heart Association.
Q: Will I still need to rest when I go back to work?
A: You'll need a reasonable amount of rest, of course. But recreation, physical activity and social life are as good for you as they are for everyone else. Many times doctors recommend that heart attack survivors get even more physical activity than they got before their event.
Getting a good night's rest is important for everyone, but it's especially important for heart attack survivors. Sometimes a nap or short rest period during the day is helpful, too. Heart patients should rest before they get too tired. Your doctor can tell you what he or she thinks will best fit your needs. Most heart attack patients find they have plenty of energy for both work and leisure activities.
Q: How do I recognize serious depression?
A: Several warning signs indicate that a serious depression has developed. These include:
- Sleep problems. You have trouble sleeping or you want to sleep all the time.
- Appetite problems. Food doesn't taste good anymore, you've lost your appetite or both.
- Fatigue. You tire easily and have no energy.
- Emotional stress. You're tense, irritable or agitated, or you feel listless and apathetic.
- Loss of alertness. You have trouble concentrating.
- Apathy. You lose interest in your old hobbies (movies, reading, sports, etc.).Low self-esteem. You feel worthless or inadequate.
- Despair. You have repeated thoughts of death or suicide.
- Sloppiness. You don't keep up your appearance or clean up after yourself.
If you have any of these symptoms, tell your doctor. He or she can decide whether your symptoms are normal, or whether you're slipping into a depression. If your doctor thinks you may be depressed, he or she may prescribe medication to help you feel better.
Q: What kinds of exercise can I do?
A: Most people who recover from a heart attack can take walks, play golf, fish, swim and enjoy similar activities with no trouble. In fact, physical activity is healthy and recommended for most heart attack survivors. Still, don't exercise until you first talk to your doctor to find out how much exercise is right for you.
By giving you special tests on a treadmill, exercise bicycle or steps, your doctor can find the right amount of physical activity for you. You may be tested in a Cardiac Rehabilitation Unit as part of a program or in your doctor's office.
Q: Am I likely to have chest pain?
A: Not everyone has chest pain (angina pectoris) after a heart attack. In fact, many people don't. But it's possible that you will. Angina is a light pain or pressure in the chest that occurs when part of your heart muscle doesn't get enough blood (oxygen) for the work it has to do. That's why angina usually occurs during or right after physical exertion, intense emotion or eating a heavy meal. If you do have angina attacks, tell your doctor. He or she can prescribe medication or an exercise program to help you.
Q: Is sexual activity allowed?
A: Most people can continue their same pattern of sexual activity after they recover from a heart attack. If this question worries you or your sexual partner, talk to your doctor. If you get angina when you exert yourself during sex, your doctor may prescribe nitroglycerin for you to take before having sexual relations.
Q: Should I stop smoking?
A: YES! Smoking is unhealthy for everyone! And it's an even bigger risk for people who have coronary disease. In fact, if you resume smoking after your heart attack, your chances of having a second one are doubled.
Smoking increases the strain on your heart because it causes blood vessels to constrict and some of them are already narrowed and damaged. Smoking also causes your heart to beat faster and raises your blood pressure. Finally, smoking increases the level of carbon monoxide in your blood and thus deprives your heart of the oxygen it needs. If you smoke, QUIT.
Q: Do I have to watch my weight?
A: It's important for people with heart disease to keep their weight in a healthy range. It's also important to eat a well-balanced diet that contains healthy amounts of protein, vitamins and minerals. Your diet should also be consistent with the American Heart Association Diet, which is low in saturated fat, cholesterol total fat and sodium.
Q: What's a fat-controlled diet, and why is it recommended?
A: The goal of a fat-controlled diet is to reduce your blood cholesterol. This lowers your risk of heart attack. The diet will help you cut down on calories from fat, particularly from meat, high-fat dairy products and saturated fats. You need to focus on reducing your saturated fat intake, which will help lower your dietary cholesterol intake at the same time.
Q: What about carbohydrates?
A: You'll probably be reducing the fat in your diet to less than 30 percent of total calories. (Right now, if you're like most Americans, your diet contains about 34 percent fat.) To make up for the decrease, you'll need to eat slightly more carbohydrates. Ideally your carbohydrates should come from fruits, vegetables and cereals.
Q: Can I still have an alcoholic drink?
A: If you didn't drink alcohol before your heart attack, don't start. Because alcohol can raise blood pressure, the American Heart Association recommends no more than one drink a day for women and two drinks a day for men. If you're trying to lose weight, remember that alcoholic beverages are high in calories.
Q: Will I have to take medicines to keep my blood from clotting?
A: It's possible. Your doctor may decide to prescribe anticoagulant drugs depending on the circumstances surrounding your heart attack. In most cases these drugs are beneficial; in others, they're not needed. Only your doctor should decide if anticoagulants are right for you.
Anticoagulants interfere with the normal clotting of blood. They're prescribed to prevent blood clots that may occur in a coronary artery or leg vein. There are two main groups: direct-action (injected into a vein or beneath the skin) and indirect-action (taken by mouth).
If your doctor prescribes anticoagulants, you'll need blood tests to ensure that the proper dosage is maintained. You should also carry a card stating the anticoagulant drug and dosage, in case you're involved in an accident. Talk to your doctor about other medications to avoid and to get a medication card.
Q: What about taking aspirin?
A: Taking aspirin regularly may help patients who've had a heart attack. Talk to your doctor about whether this is right for you.
Q: Can coronary artery surgery be helpful?
A: Whether or not you need surgery is a question only your doctor can answer. Right now your heart is healing on its own. In some cases surgery can be helpful, particularly when certain complications result from the heart attack.
Q: Since I've had one heart attack, will I have another one?
A: Not necessarily. Of course, no one can say for sure whether you'll have another heart attack. But if you follow your doctor's recommendations about your weight, diet, exercise, work, medicine and rest, you'll have a better chance of living comfortably and avoiding future attacks.Research into coronary disease is uncovering new insights into heart attack every day.
Research into coronary disease is uncovering new insights into the causes of and prevention of another heart attack every day. The outlook for coronary patients is better today than it was only a few years ago. And it will keep improving. There's a lot to be hopeful about.
Q: What feelings are normal after a heart attack?
A: After your heart attack you'll probably have a wide range of emotions. Three of the most common are fear, anger and depression.
Fear may be the most common emotion and the most understandable. If you're like most people, you've probably had thoughts like, "Am I going to die? Am I living on borrowed time? Will my chest pain (or shortness of breath) come back?" These are troubling thoughts, but as time passes your worries will go away.
Physical symptoms may cause fear, too. For instance, before your heart attack, you probably never gave small, fleeting pains a second thought. Now the tiniest twinge in your chest worries you. That's normal. The passing of time will ease these fears, too.
Anger is another common emotion. You've probably thought, "Why did this have to happen to me? And why did it have to happen now, at the worst possible time?"
Bitterness or resentment is common after a heart attack. You may lose your patience; your friends and family may irritate you. But before you snap at them, remember that it's normal to resent a heart attack. Your misfortune isn't their fault. Being angry is one stage in your recovery, so accept it. There's no reason to take it out on your loved ones. Finally, you may be depressed or have "the blues." You may feel down in the dumps and think you're hopelessly damaged or crippled. You may even have thoughts like, "What's the use?" or "Life is over." This, too, is normal.
One of your biggest fears may be that you won't be the same person you were before your heart attack. You may be afraid you won't be able to work as hard, be as vigorous, or be a helpful spouse or parent. You may even think that now it's too late to do all the things you've dreamed of doing. To some extent everyone in your situation feels this way. But try not to anticipate the worst. Be patient, and give yourself a chance to recover.
Finally, you may be worried about sex. Perhaps you think others will think you're a weak, incomplete person. Again, your fears are normal, but they're not necessarily true.
Your moods will vary widely from day to day, and your thought will reflect your moods. Don't take them too seriously. If things do start to bother you, tell someone you trust how you feel. Don't just pretend nothing is wrong. Time will cure most of your unpleasant feelings, but you don't have to suffer. It's very common to feel the way you do.