Heart attack - Living with the effects

People who have had a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. often have a number of questions on the path to recovery. When will I be able to return to work? When will I be able to drive again? Is it safe for me to have sexual intercourse? What steps can I take to make sure this doesn't happen again?

Measures to reduce the risk of a repeat attack - known as secondary prevention - are usually recommended after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. It's important to remember that short-term approaches are unlikely to bring about long-term benefits; making lifestyle changes is a lifelong commitment.[1]

This section will discuss the following issues to be considered after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.:

If you recover well from your heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. without any complications, and your symptoms have cleared up, the general advice is that you will be able to drive again within 4 weeks. Still, you will need to tell your insurance company to ensure that your policy is still valid

Mobilisation

After a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., it takes a little time for the damaged heart muscleTissue made up of cells that can contract to bring about movement. to be replaced by scar tissueA type of connective tissue that forms after a wound heals.. Until this process is complete, some doctors believe that it is best not to overexert yourself too much: people are usually advised to take things easy for about 4-6 weeks after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. It's best to increase activity gradually rather than pushing yourself too much all at once.[2,3]

Returning to work

The best time to return to work varies from person to person. Often, the aim is to return within 4-6 weeks after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction..[2] However, some people have more severe heart attacks than others, and some are more significantly affected, both physically and emotionally.

The best time to return to work after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. will depend very much on the individual and his or her personal circumstances. If you are unsure whether or not you are ready, you might find it helpful to discuss this with your doctor.[4]

In some countries, such as Japan and the USA, many people who have had a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. return to work early afterwards - within the month. Often, they return to working conditions that are the same as those they had before the heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction..[5]

It is generally advised that if your recovery is uncomplicated and your symptoms have cleared up, you can safely have sexual intercourse again within 2-3 weeks after having the attack

Driving

If you recover well from your heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. without any complications, and your symptoms have cleared up, the general advice is that you will be able to drive again within 4 weeks. Still, you will need to tell your insurance company to ensure that your policy is still valid.[3]

In many parts of the world, people who hold vocational driving licences - for example, for heavy goods or public-service vehicles - will need to be assessed and deemed safe to drive after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction..[2]

Sexual intercourse

If you've had a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., you may understandably feel some concern about whether it is safe to have sexual intercourse again. It is generally advised that if your recovery is uncomplicated and your symptoms have cleared up, you can safely have sexual intercourse again within 2-3 weeks after having the attack.[3]

Some doctors advise that if you can walk briskly up two flights of stairs without feeling breathless or getting chest pain, then it is safe for you to start having sexual intercourse again.[3]

Secondary prevention

On the road to recovery after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., there are a number of measures that you can take to lower your risk of having a repeat heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. These measures range from lifestyle modifications - including diet, exercise and smoking - to drug therapy such as cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy.-lowering medication.

Preventive measures after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. have the same aims as those that may be recommended to prevent a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. in the first place.

Stopping smoking is the single most effective measure a smoker can take to reduce the risk of a repeat heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. Other steps that may help include modifying your diet, and lowering your cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy. through diet or medication. Adopting a more active lifestyle is also important. Finally, although less well understood, lowering stressRelating to injury or concern. levels may have a role in protecting the health of the heart.[6]

Sometimes, cardiac rehabilitationA staged programme of exercise and lifestyle changes to help recovery from a heart attack and help to prevent a repeat heart attack. programmes are available that tackle all these elements in a structured manner. It is worth finding out if such a programme is available in your area as those who attend them seem to have a better outcome.

Learn more about preventing a repeat heart attack and cardiac rehabilitation programmes.

References: 
  1. Global secondary prevention strategies to limit event recurrence after myocardial infarctionDeath of an area of heart muscle due to poor blood supply.. Giannuzzi, P Temporelli PL, Marchioli R et al. Arch Intern Med 2008;168:2194-204.
  2. Boon NA, Colledge NR and Walker BR. Davidson's Principles and Practice of Medicine. Churchill Livingstone Elsevier. 2006; 20th edition.
  3. Heart attack: including information on acute coronary syndromeA range of clinical conditions caused by coronary artery disease: it encompasses the full spectrum from unstable angina to heart attack.. Heart Information Series Number 7. The British Heart Foundation.
  4. Return to work after acuteHas a sudden onset. myocardial infarctionDeath of an area of heart muscle due to poor blood supply. - Listen to your doctor! Farkaš J, Černe K, Lainščak M et al. International Journal of Cardiology 2008;130:e14-6.
  5. Effects of phase II cardiac rehabilitationA staged programme of exercise and lifestyle changes to help recovery from a heart attack and help to prevent a repeat heart attack. on job stressRelating to injury or concern. and health-related quality of life after return to work in middle-aged patients with acuteHas a sudden onset. myocardial infarctionDeath of an area of heart muscle due to poor blood supply.. Yonezawa R, Masuda T, Matsunaga A et al. Int Heart J 2009;50:279-90.
  6. Cardiac rehabilitationThe treatment of a person with an illness or disability to improve their function and health.. Gohlke H and Gohlke-Bärwolf C. European Heart Journal 1998;19:1004-10.