What happens when I get home from hospital after a heart attack?

For the first few weeks, it may be helpful to have someone close by to support and help you.

If you live alone, someone may need to stay with you during this time, depending on how serious your health condition is. If you don’t have family or friends who can be with you, you can get help from a home care agency.

If you need extra community services, such as Meals on Wheels, ask your doctor or cardiac rehabilitation team for information.

You will need lots of rest, but try to get back into a normal routine as soon as possible, including:

• get up at a normal time
• have a bath or shower if possible
• get dressed for the day – don’t stay in your sleeping clothes during the day
• rest at mid-morning, mid-afternoon and after any physical activity.

You should be able to:

• do light work around the house
• go to places, such as a theatre, restaurant or church
• visit friends
• travel in a car but not drive a car until your doctor has given you approval to do so
• climb stairs slowly.

You may feel weak at first, but this isn’t usually serious. It is normally because you didn’t use your muscles very much when in hospital.

Be physically active

Keep up any physical activity program you started while you were in hospital.

You should be able to return to your usual activities a few weeks after your heart attack or other heart problem. Talk to your doctor or cardiac rehabilitation team about when you can start different activities again and how to pace your program.

Do regular activity

Regular, moderate-intensity physical activity is good for you, especially if you have coronary heart disease.

It will help you:

• recover better from a heart attack or other heart problems
• reduce your risk of more heart problems
• improve your long-term health
• feel more confident, happy and relaxed
• have more energy
• manage your weight more easily
• improve your cholesterol
• have lower blood pressure
• have stronger bones (and lower your risk of osteoporosis)
• manage your blood glucose levels if you have diabetes.

You won’t get all of these benefits at once, or all of the same benefits. But doing regular physical activity will improve your health – even if you have coronary heart disease.

The Heart Foundation’s recommended activity goals

Aim to build up to doing at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. You can do this in three lots of 10 minutes each if it’s easier.

For example:

10 minutes of walking, 10 minutes of gardening and 10 minutes of light housework.

Keep on walking

Walking is a good type of physical activity for people with coronary heart disease because:

• it is gentle on your body as it is a low-impact activity
• you can go at your own pace
• you can walk and talk with other people which can help with motivation and  confidence
• it doesn’t cost anything.

Start slowly

• Do some easy walking around your house and garden, or out on your street.
• Start by walking on flat ground each day.
• Have a destination in mind, such as the local shop or the end of the block.
• Walk at a pace you find comfortable (a good guide is a pace at which you can still have a conversation).
• Build up gradually – over a few weeks, walk longer distances and then uphill. Join your local Heart Foundation Heartmoves program or Heart Foundation Walking group.

This will help you to keep fit and make new friends.

Guidelines for walking after you leave hospital

Build up your walking gradually over time. Start by walking up to 10 minutes twice a day. Do this at least two days in a row. If you find this tiring, keep walking 10 minutes twice a day until you feel stronger. You may need to do this for a few weeks.

Talk to your doctor or other health professional if you aren’t sure whether you are doing too much or too little walking.

Only move to the next stage when you meet your walking target without discomfort.

As you advance and are doing more walking, you may take longer getting used to how much walking you need to do before you move to the next stage.

If you don’t feel well enough to walk one day, miss walking that day – or at least drop back one or two stages – so your body gets some rest.

Take the stairs?

If there are stairs where you live, you can climb them slowly as soon as you come home.

As a general rule, if you can walk normally at your usual pace, you can also climb two flights of stairs at your usual pace.

Gradually increase how many stairs you can climb, and how fast you climb them.

Do sport and other recreational activities

Do the sort of activities you like to do regularly. Start with walking and everyday tasks, like light gardening and housework. Aim to limit the amount of time you sit each day. Gradually add other activities such as cycling and swimming that need more effort.

You can usually start cycling, swimming, tennis, golf and bowls again after six weeks, as your fitness and confidence increases. Ask your doctor or cardiac rehabilitation team about specific sports.

The strain of lifting heavy weights and some other activities can raise your blood pressure, so don’t do these in the short term.

You may later include resistance (weight) training with light weights in your activity program. But talk with your doctor or cardiac rehabilitation team before you start this sort of training.

How much activity should you do?

How you feel is your best guide to doing physical activity at a safe level.

It is normal to worry about what you should and shouldn’t do. Slowly build up your activity level based on what your doctor or health professionals tell you. You may feel more comfortable exercising with a friend or family member for increased motivation as well as confidence or safety concerns.

Increase your physical activity slowly. Your doctor will advise you about this when you leave hospital.

How to stay safe during physical activity

• Do the activity gradually and at a low level of intensity.
• Find the level of activity that suits you.
• You should be able to talk without getting short of breath while you’re doing physical activity.
• If you want to do more intensive physical activity, build up slowly over a number of weeks. 
• As you start to feel better and fitter while being active, increase the intensity so you start to ‘puff’ a little during the activity.
• Be active when you’re feeling well.
• Don’t overdo it.
• Don’t do physical activity if you feel unwell, tired or sore – take a day off to recover.
• Don’t do physical activity straight after meals or alcohol.
• Stay comfortable while you are active – you should never find the activity very hard.
• Drink lots of water before, during and after the activity (you will lose water through sweating).
• Share the activity with a friend – you may feel more confident and motivated, and enjoy it more too!
• Carry a mobile telephone with you while walking, if you have one.
• Talk with your doctor if you want to do more intensive activity or competitive sports.
• If you need to take angina medicine, keep it with you when you do the activity.

Having sex again?

Most people can have sex again soon after a heart attack or other heart problems.

If you can walk up two flights of stairs without getting chest pain or feeling short of breath, you are probably well enough to have sex.

If you have had heart surgery, wait until your breastbone has healed (about six to eight weeks after the operation). Do not put any pressure or stress on your chest. Some positions may be more comfortable than others.

Stop if you feel any pain or discomfort in your chest.

Try not to have sex after eating a large meal, drinking alcohol or when you are very tired.

Take things slowly – it can take time for a sexual relationship to get back to normal. It’s common to lose interest in having sex for a little while. Some heart medicines can also reduce your interest or capacity for sex.

Talk with your partner or doctor about your feelings and worries about having sex.

Travelling again

You can travel straightaway by train, tram or bus, or as a passenger in a car, but make sure that you have a seat, so that you do not get too tired.

Long trips may make you feel tired, so try to have regular breaks. You may also get car sick more easily than usual.

Check with your doctor if you can travel by plane. You may also need to get a medical clearance form. Ask the airline about any air travel requirements if you are unsure.

Driving again?

Talk with your doctor about when you can drive again as you will need your doctor’s approval. If you’ve had heart surgery, or drive a commercial vehicle, it may take longer and you may need to follow specific instructions. This may be within two to four weeks, but it depends on your recovery.

The following are suggested times to wait before you begin driving again:

• cardiac arrest – at least six months
• coronary artery bypass graft (CABG) surgery – at least four weeks
• heart attack (myocardial infarction) – at least two weeks
• cardiac pacemaker – at least two weeks
• coronary angiogram – at least two days.

Check with your car insurance provider, as you may not be covered for a specified time after a stay in hospital.

If you feel insecure or your family is worried about driving:

• don’t drive alone
• only drive routes you know
• avoid peak hour traffic.

It’s the law that all drivers must report a permanent or long-term medical condition that might affect their driving. To check if you should report your condition, contact the Transport Authority in your state or territory.

Going back to work?

Returning to work is a very important part of your overall recovery.

Decide with your doctor, cardiac rehabilitation team and other health professionals when to go back to your job. They will tell you how to best prepare for returning to it.

You can usually go back to work a few weeks after you go home from hospital. But this depends on how fast you recover and how physically active your job is.

If you do physically demanding work, you may need to build up your strength first. Think about asking your workplace for lighter work or shorter work days.

Whatever your job, make sure you are ready to go back to it. Give yourself time to settle into your work routine again.

Where to get help

• See your doctor.
• Ring healthdirect on 1800 022 222.
• Phone the Heart Foundation’s Health Information Service number on 1300 362 787.

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The above information is extracted from My heart, my life: a manual for patients with coronary heart disease, and is used with the Heart Foundation’s permission. © 2012 National Heart Foundation of Australia.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.