How to recover from a heart attack

Though the prospect of a heart attack can be terrifying, there’s good news: The vast majority of people who receive prompt medical care survive them.

“But time is of the essence,” says Frederick Funke, MD, an interventional cardiologist in Ladson, South Carolina. People who recognize the signs and get to a hospital quickly are significantly more likely to survive and less likely to have long-term complications, Dr. Funke explains.

After you’ve been treated for a heart attack, your physician or other healthcare provider (HCP) will work with you to prevent another, and to avoid other heart conditions. “As you get further away from the time of the heart attack, the patient and physician gain more confidence that things are treated adequately,” says Funke.

Here’s what to know about recovery, along with life after a heart attack.

Potential for heart damage

While survival rates for heart attacks have improved greatly over time, they can still cause long-term heart damage. “The longer the heart goes without oxygen-rich blood, the more likely it is for that part of the heart to essentially die,” Funke says.

One serious potential consequence of a heart attack is called congestive heart failure (CHF), which occurs when the heart has problems pumping blood to the rest of the body. “Once a part of the heart is permanently damaged, it’s no longer able to contract so the heart becomes less efficient,” explains Funke.

Cardiologists frequently say that “time is muscle” when it comes to a heart attack. “The quicker a patient recognizes the signs and symptoms of a heart attack, the less likely he or she is to suffer permanent, irreversible damage to the heart, which is what usually leads to heart failure,” says Funke.

Cardiac rehab

After your heart attack, you may be placed on a program of cardiac rehabilitation. That’s good news for you. Research shows that people who attend cardiac rehab are significantly more likely to still be alive years after the event.

Cardiac rehab is a multi-pronged program, usually consisting of education, exercise, stress reduction, and advice on reducing heart disease risk factors. People who have a heart attack and get a stent or a bypass should be considered for cardiac rehab when they leave the hospital, according to Funke. He notes that it’s usually three times a week for up to 12 weeks, and the patient is monitored throughout.

“There’s a graduated exercise program where patients are monitored by EKG so we can see the heart rhythm,” Funke says. “Blood pressure is monitored, as well. Every few weeks the patient is graduated to a more intense exercise regimen. It’s important to condition the heart after a heart attack—the more exercise you do, the stronger your heart gets.”

Lifestyle changes

Even if you’re not put on a cardiac rehab program, your HCP will monitor your recovery, provide education, clear you for exercise (or not), and recommend lifestyle changes to strengthen your heart. If you smoke, it’s best to immediately and permanently quit.

A proper diet and exercise are both crucial components of heart attack recovery. “Regular exercise gives cardiologists a fuel gauge of the body’s ability to deliver blood to other parts of the body,” says Funke. “There might be another blockage in your arteries that wasn’t fixed during your heart attack treatment and exercise may help reveal it.”

Even light exercise has a significant protective effect. Research suggests that people who are sedentary are more likely to have an additional heart attack—or die of one—compared to those who regularly get almost any level of physical activity.

Recovery challenges

Taking medication is something many people recovering from a heart attack find a challenge, according to Funke. People may forget to take their pills, may not be convinced they need medication, or fear the side effects. Medication can include aspirin, blood thinners, beta-blockers, nitrates, ACE inhibitors, and statins.

“The biggest problem we have is making sure patients understand that their medications are likely going to be needed forever,” Funke says. Your HCP will likely want to see you one to two weeks after you leave the hospital and then on an ongoing basis to make sure you’re taking your meds and you haven’t fallen into old lifestyle habits, he explains.

It’s also important to understand that mental health issues like anxiety, depression, and post-traumatic stress disorder (PTSD) are common after a heart attack. For example, about one-third of heart attack survivors develop depression, according to the American Heart Association.

For many people, a heart attack is a reminder of mortality. “It’s often the first time someone’s been seriously ill. It’s their first brush with what could have been a life-threatening or -ending event,” he says. “People realize they’re getting older, especially when their lifestyle choices haven’t been the best.”

People with mental health difficulties may not be motived to stick to their medication or keep appointments with their HCP, Funke adds. This can have consequences. The AHA has found that, compared to people who aren’t depressed, people with depression after a heart attack are about twice as likely to have another one—and about twice as likely to die.

While many HCPs are trained to screen for mental health issues associated with heart attacks, if you’re having symptoms of anxiety or depression, tell your HCP right away. They can recommend medication, lifestyle changes, or counseling, or refer you to other HCPs who can help.

Returning to normalcy

On the bright side, most people can return to daily activities fairly quickly after a heart attack. A lot depends on the severity of the heart attack, your previous lifestyle, and what adjustments are necessary. You’ll likely have to alter your diet and take medications for a long time. You may have to be cautious about exercise, as well. Talk to an HCP about what level of physical activity would work for you; many people can start walking right away.

Depending on the nature of your job, you may be back to work in as little as two weeks, and you may be driving within a few days’ time. Talk to an HCP about when it’s okay to resume your sex life.