Exercise for the Heart Patient, for Postop Patients, and for the Hospitalized - Caveats

Even after he has reached a satisfactory fitness level the heart attack victim may have to be careful. He may, for example, avoid exercising at higher altitudes. At elevations over 4,000 or 5,000 feet, the oxygen pressure in the air sacs of the lungs decreases. The oxygen content in the circulating blood is correspondingly reduced.

The postcoronary patient should also watch for signs of overtraining, or staleness. This condition is characterized by chronic fatigue, irritability, susceptibility to minor infections including colds, insomnia, loss of appetite, and loss of concentration. The answer in such cases is to rest for a week or two. The body can then recuperate and adjust.

In many other situations the postcoronary program may have to be modified or suspended temporarily. Exercise types, times, and places may have to be chosen carefully. No recuperating patient should exercise heavily after a heavy meal; a wait of two hours is usually suggested. Outdoor exercise in very cold weather may have to be ruled out. The cold air may act as an irritant on the large air passages in the lungs—or exposure to cold may cause a sharp rise in blood pressure. Many physicians believe that a heart attack victim should never do isometric exercises.

Finally, patients on medication should consider the effects of exercise-plus-medicine on their heart rates. Small doses of some medications may not affect the heart rate, but larger doses may do so. Medication may also affect the individual's endurance levels; fatigue may set in more quickly where a patient is taking medication.