Exercise & Fitness

Exercising with Heart Conditions

By Phoebe Chi, MD, MPH

Getting enough physical activity is important for your health and is particularly important when you have chronic conditions. However, many people with heart problems or chronic pain are often hesitant or apprehensive when it comes to exercising, as they fear that it will trigger their symptoms or make them feel worse. If you currently have concerns about exercising or have not been physically active for a long time, there is no need to worry! It is never too late to increase your physical activity. The key is knowing how to do it safely and effectively. In this post, I will equip you with the tools you need to confidently plan and achieve your personal fitness goals.

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Why is Exercise Important?

When living with a heart condition, it can be a real challenge to remain physically active. But physical activity is crucial–especially when you have heart disease. This is because exercising not only helps strengthen the heart muscle, but it can, among its other benefits, actually improve the symptoms of angina (chest pain) or heart failure that you experience on a day-to-day basis.

Some people may have the desire to increase their level of physical activity–but they just don’t know how to take the first step. Sometimes, fearing that exercise will worsen symptoms, one may become even less active, which then starts the vicious cycle of pain where inactivity leads to deconditioning, which leads to more pain and fatigue, which then makes the thought of physical activity even more impossibly daunting!

If you happen to find yourself caught in this cycle, be encouraged! As you will see, breaking this cycle can be easily done once you have the right tools, some of which can be found in this guide.

The Many Benefits of Exercise

There is no question that physical activity benefits the mind and body. Here are just a few ways it does that.

Heart Benefits of Exercise

  • It strengthens your heart (especially aerobic exercise)
  • It improves circulation and helps your body use oxygen more efficiently
  • It can improve your angina as well as heart failure symptoms
  • It improves your blood pressure and cholesterol

Other Benefits of Exercise

  • It improves chronic pain
  • It improves blood sugar and diabetes
  • It lowers your chance of injury (such as back strain and pulled muscles)
  • It increases your energy level
  • It improves your mood
  • It improves your overall quality of life

3 Steps to Safe and Effective Exercising

The key to becoming more active when you have a heart condition is to plan ahead and know what to expect. The following steps will help guide you each step of the way.

Step 1
Pick an Activity

♦ Aerobic activities are very beneficial for the heart. Walking (anywhere…in the house, the park, the mall), bike riding, swimming or water aerobics, elliptical machines, and Zumba classes are just some of your options.

♦ Choose something that you will enjoy and will look forward to doing.

♦ Don’t think you can do an aerobic activity? No worries! Start with seated exercises  and go from there.

Step 2
Decide on a Starting Point

♦ Hesitant about exercising? Set your goal at 5 minutes a day of walking (total walking–which you can accomplish just by walking to the restroom a few times!). This may not seem like much, but it is still a good starting point.

♦ Go slowly. Plan to move at a pace that is comfortable for you. Do not challenge yourself too much at first (regardless of how motivated you feel) as this can lead to frustration or injury.

♦ Look into the future. The general recommended goal is to accumulate at least 30 minutes of total activity per day, 4-5 days of the week.

Step 3
Exercise Wisely

Before Your Activity:

  • Check that you have your nitroglycerin with you, just in case you need it.
  • Have a loved one with you the first time you try something new, so they can cheer you on and assist as needed.

During Your Activity:

  • Spend 5 minutes warming up and cooling down before and after your activity.
  • Stopping abruptly can lead to fast drops in blood pressure and make you feel dizzy or lightheaded.

Knowing When to Slow Down or Stop:

  • Shortness of breath that prevents you from completing a sentence
  • Dizziness or lightheadedness
  • Chest pain, tightness, or irregular heartrate
  • Pain in your arms, shoulders, neck, or jaw
  • Unusual or extreme fatigue
  • Severe sweating, nausea, or vomiting

If you start experiencing these symptoms, stop and rest. Take a nitroglycerin if necessary.

If the symptoms do not improve or worsen after 10-15 minutes, seek medical attention.

Finally, Some Practical Tips

♦ Don’t exercise outdoors when it is too cold, hot, or humid. High humidity tires you out more quickly. Extreme temperatures can interfere with circulation and make breathing difficult or cause chest pain. On these days, do an indoor activity (such as mall walking).

♦ Stay hydrated. Drink water even before you feel thirsty, especially on hot days. If you have heart failure and are on fluid restriction, take frequent small sips of water to stay hydrated without overdoing it.

♦ Skip extremely hot and cold showers or sauna baths after exercise. These extreme temperatures make your heart work harder.

♦ Avoid exercising in hilly areas. If you must walk in steep areas, slow down when going uphill to avoid working too hard.

♦ If your exercise program gets interrupted for a few days (due to illness, bad weather, etc), start at an easier point, and ease back into your routine.

♦ Write it down. Document your progress each day as well as any symptoms you experience, and acknowledge the progress that you make, knowing that the important thing is to take it one step at a time.

Here’s to moving your way to health!

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Want this information for handy reference?
Below is a printable PDF handout for your convenience. 

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