After Your Heart Attack

You’ve survived a heart attack. Now it’s time to make changes for a healthier future. “We recommend cardiac rehabilitation,” says Thomas H. Cawthon, Jr., M.D., a cardiologist in Birmingham, Ala. “It is vital for long-term prevention of a recurrent heart attack and stroke.”

Rehab is the Key

Cardiac rehabilitation is a supervised program that typically includes an exercise plan, nutrition counseling, smoking cessation, and much more. Cardiac rehabilitation is essential if a heart attack survivor is to live the best life possible after the attack. These programs reduce the risk of death and the risk of subsequent heart attack. Although patients who have a heart attack are referred to cardiac rehabilitation, studies show that only 15% of patients who’ve been hospitalized for heart attack actually participate in any type of rehab after being discharged.

Dr. Cawthon says one of the biggest challenges for those who’ve had a heart attack is the simple acceptance that they have a disease that needs treatment. “Once the patients have gotten past this, they are able to become much more involved in the recovery process,” says Dr. Cawthon.

Let the healing begin with a proactive approach to your recovery. Here are three key components to improve your heart health and help prevent future problems. (Consult with your physician before starting any exercise program.)

Active Lifestyle

Exercise is one of the best ways to make your heart stronger. Improving your cardiovascular fitness offers multiple benefits that include boosting levels of HDL (the good cholesterol), reducing the amount of LDL (bad cholesterol), improving circulation, lowering blood pressure, and much more. “Anecdotally, exercise seems to greatly improve one’s self esteem and helps prevent depression,” says Dr. Cawthon. “This is especially true for those who participate in a supervised cardiac rehab program.”

In addition, exercise is essential for weight loss and healthy weight maintenance. Once your doctor gives you the all-clear for physical activity, make it a priority to find a fitness regimen that suits your needs. Most heart attack patients need to exercise three to five times a week.  


Walking is the most accessible (and easiest) form of exercise to jump-start your fitness program. Start slowly and gradually increase your walking speed and distance as you get stronger.

Follow the 10-20-5 Plan

Start your fitness activity with 10 minutes of warm-up (light walking, cycling, etc.) and then increase your intensity for 20 minutes. Finally, spend at least 5 minutes cooling down (light walking, cycling, etc). As you build up strength, increase your plan to 10-30-5.

Check Your Pulse

Exercising at the right intensity level is important for maximizing the cardiovascular benefits. Check with your doctor to see what your target heart rate should be when you work out.

Add Strength Training

Resistance training—free weights, weight machines, elastic bands—increases stamina and builds muscle mass, which are important components for lowering the risk of heart disease. 

Find a Partner

You may be more likely to stick with a workout if you have a fitness buddy. Scheduling exercise time with a friend or family member may make you more accountable. Involve the entire family if they are willing. If there is resistance (which could be frustrating and stress-inducing for you), get fit with supportive partners only. 

Healthy Eating

Regardless of what food plan you follow, consider it a healthy diet makeover, not a temporary fix for your heart attack. Revamping what and how you eat plays a huge part in improving or even reversing heart disease. A heart-healthy plan can reduce your blood pressure, reduce LDL and triglyceride levels, raise HDL cholesterol levels, improve your digestive system, and much more.

“Clearly diet is crucial for prevention of both primary and for secondary cardiac events,” says Dr. Cawthon. “Often I will recommend the Hilton Head diet. It is a simple and safe diet for post-myocardial infarction patients.” In general, any diet that emphasizes whole grains, fruits and vegetables, leans meats, and low fat dairy will be appropriate for post-heart attack patients.

Your diet doesn’t have to be complicated. With portion control in mind, eat fruits and vegetables, lean cuts of meat, fish, whole grains and legumes, healthful fat, and high calcium foods. Also consider these tips when developing a heart-healthy eating plan that’s right for you.

Go Easy on the Salt

Research shows that reducing salt intake (a half teaspoon a day) could significantly reduce the number of new cases of coronary heart disease, high blood pressure, and stroke. Flavor your recipes with spices, not salt. Look for low-sodium canned goods and consider rinsing beans before cooking them. Do not be fooled by “reduced sodium” labels; they may just mean ‘reduced from our usually incredibly high in sodium option’. When in doubt, choose no-salt-added products. This is particularly true for process foods; they tend to be packed with salt.

Choose Calories Wisely

Limit processed and refined foods. They may be convenient (frozen meals, canned biscuits, fast food, cookies), but they are packed with empty calories and, for the most part, offer little or no nutritional value.  

Know the Skinny on Fats

Not all fats are created equal. Good fats include monounsaturated fats (olive oil, canola oil, avocados), polyunsaturated fats (most vegetable oils), and Omega-3 fatty acids (walnuts, flaxseed, and fatty fish such as salmon). Bad fats include saturated fats (fatty cuts of beef, pork, lamb) and trans fats (found in fried foods and commercially baked goods).

Indulge Occasionally

Every now and then, savor your guilty pleasure (cupcake, chips, French fries) without remorse. If you make heart-healthy food your daily norm, treating yourself once in a while shouldn’t be a problem.

Reduce Your Stress

Countless studies show that stress can have a negative impact on your heart. Both chronic stress and acute stress can increases your risk of heart attack, arrhythmias, and stroke. Many patients may feel additional stress and anxiety because of the heart attack itself. Talk with your doctor if you are feeling overwhelmed and consider counseling.

Reach Out to Others

Having supportive family and friends can improve your overall well-being. In fact, research shows that women more so than men need this social interaction to fare better during the first year after a heart attack.

Keep Your Hands Busy

Engaging in activities like knitting, sewing, woodworking, painting, and crocheting helps relieve stress and calms the fidgety feelings.

Focus Your Breathing

Sometimes a few simple long, deep breaths will calm a stressful feeling. Inhale into your abdomen, through your rib cage, and into your diaphragm. Exhale slowly.

Take Five

If you find yourself in a stressful situation, take a walk for at least five minutes or longer. If you’re where you can’t walk (say in a car or the line at the DMV), then try smiling. It’s amazing what a small change in attitude can do for your stress levels.