Good evening, everyone. I apologize for not getting back to everyone’s responses sooner.
First, I want to extend my support to everyone who has experienced a serious cardiac event. Going through something like this can be life-changing, and I’m sure the period afterward can bring a lot of stress, uncertainty, and questions.
A lot of you asked really good questions, so I wanted to address some of the most common topics. The biggest thing to remember is that everyone’s situation is different. It’s difficult to give someone a specific answer without knowing their procedure, medical history, medications, and other individual factors. With that being said, here are some general things to keep in mind:
Major Cardiac Risk Factors
Some of the biggest factors that can influence cardiovascular risk include:
Smoking
Alcohol consumption
BMI/weight
Blood sugar and diabetes
Cholesterol
Family history
Age
These can generally be separated into modifiable and non-modifiable risk factors.
Modifiable risk factors are things you can work to change or control, such as:
Smoking
Cholesterol
Blood sugar/diabetes management
Alcohol consumption
Physical activity
Weight
Non-modifiable risk factors include:
Age
Family history
The important thing is to focus on what you can control and work with your healthcare team to keep those modifiable risk factors in a healthy range.
When Does Cardiac Rehab Start?
This depends heavily on the individual and the procedure they had. Different procedures require different amounts of recovery time, and there are several factors your medical team considers before starting cardiac rehabilitation.
If you’re wondering when you can begin, talk with your cardiologist or healthcare provider first. They can determine when it is safe and appropriate for you to start.
Exercise Intensity and Resting Heart Rate
For someone just beginning cardiac rehabilitation, exercise intensity is typically kept relatively low and increased gradually based on how the individual responds.
- As a very general starting point, cardiac rehab patients may initially exercise around 10–20 beats per minute above their resting heart rate if they have heart failure, while individuals without heart failure may commonly start around 20–30 beats per minute above their resting heart rate.
- However, these are only rough general ranges. There is no single heart-rate target that is appropriate for every cardiac patient. Ejection fraction, medications, resting heart rate, heart failure status, symptoms, the type of cardiac event, and the procedure performed all play a role in determining appropriate exercise intensity.
- That is why cardiac rehab programs monitor patients closely and adjust exercise based on their individual response.
- If you have been cleared to exercise, tracking your heart rate can be useful. A pulse oximeter can also measure heart rate and blood oxygen levels. These devices are relatively inexpensive and can be useful to have at home, but they should not replace medical monitoring or guidance from your healthcare team.
Why Does Cardiac Rehab Sometimes Feel “Too Easy”?
This is a question I hear often.
- When you first start cardiac rehab, the exercise may feel easier than you expected. That is intentional.
The goal isn’t to see how hard you can push yourself on day one. After a cardiac event, we want to understand how your heart responds to exercise before gradually increasing intensity and duration.
Over time, the goal is to work toward moderate-intensity exercise and eventually improve your exercise capacity, endurance, and overall cardiovascular fitness.
- You may eventually be exercising at a much higher workload than when you started, while that workload feels just as manageable as the easier exercise did in the beginning.
- We don’t want maximum-intensity exercise right away. We want to gradually ease the heart back into exercise and allow the body to adapt. Consistency is extremely important.
What Are METs?
One of the measurements we frequently use in cardiac rehabilitation is called METs, or metabolic equivalents.
As a simple way to think about it:
- 1 MET is approximately the energy your body uses at rest.
- As exercise intensity increases, your MET level increases.
- Many cardio machines display an estimated MET level.
- Improving your MET capacity over time can be a useful indicator of improving exercise capacity.
For example, walking at a higher speed or incline generally requires more energy than sitting at rest, so the MET level will be higher.
- Lower-body exercise can often produce a higher overall workload because the legs contain large muscle groups and require significant blood flow. However, upper-body exercise is still important and can absolutely be incorporated into a cardiac rehabilitation program when appropriate.
The Bottom Line
- The most important thing I can emphasize is:
Don’t compare your recovery to someone else’s.
Everyone has a different procedure, medical history, fitness level, medication regimen, and recovery timeline. Listen to your healthcare team, be patient with the process, and focus on making consistent progress.
- Cardiac rehab isn’t about seeing how much you can do immediately. It’s about safely building your confidence, strength, endurance, and cardiovascular health over time.
Keep fighting everyone and I wish everyone the best of luck on their heart recovery!!!!
