Heart Attack

What is a heart attack?

Heart attack, or myocardial infarction, is defined as death of a portion of the myocardium, or heart1. This occurs because of a lack of oxygen supply to the heart. Just like you have arteries that carry oxygen-rich blood to your entire body, the heart itself has arteries that supply it with oxygen. There are two major arteries of the heart: the left coronary artery, and the right coronary artery. If one or a portion of these arteries becomes blocked due to plaque build-up, you could experience a heart attack.

Heart disease (which heart attack falls under) has the following risk factors2:

Risk Factors you can change:

  • High cholesterol (Total, LDL, Triglycerides)
  • High blood pressure
  • Smoking
  • Physical inactivity
  • Diabetes
  • Obesity
  • Stress

Risk factors you cannot change:

  • Family history
  • Gender
  • Older age

 

What are the symptoms?

Learn to recognize the warning signs of a heart attack (similar to angina):

• Pressure, tightness, or pain in the chest and upper back;
• Pain in shoulders (left more than right), left arm, jaw;
• Shortness of breath and/or fatigue; and
• Dizziness

People who think they are experiencing these symptoms should seek medical attention immediately. For early symptoms, see your family doctor as soon as possible, who may refer you to a heart specialist for further evaluation.

 

How physio can help

Cardiac Rehabilitation, or “Cardiac Rehab”, is a comprehensive, multidisciplinary approach to the prevention, stabilization and possible reversal of cardiovascular disease. It is not only for people who are at high risk, or have had, a heart attack; patients who have undergone valve replacement, stent insertion, or bypass surgery also qualify. Members of the care team typically include physiotherapists, kinesiologists, social workers, nutritionists, nurses, physicians, and psychiatrists.

The many benefits of Cardiac Rehab include4:

  • Improved exercise tolerance and strength;
  • Reduced blood fat levels;
  • Improved psychological well-being;
  • Improved quality of life;
  • Faster ability to return to work;
  • Reduced stress;
  • Increased awareness of cardiac risk factors; and
  • Decreases cardiovascular morbidity and mortality

In collaboration with kinesiologists, physiotherapists at Cardiac Rehab programs focus on:

  • Aerobic exercise: ellipticals, bikes, ergometers, and rowing machines to name a few while monitoring your heart rate and blood pressure;
  • Mobility and strengthening exercises;
  • Trunk stability and strengthening;
  • Improving exercise tolerance and endurance; and
  • Flexibility exercises

In Canada, only 15% or less of patients with heart attack participate in Cardiac Rehab! You will likely need a physician’s referral. Your physiotherapist will help you to choose exercises that YOU enjoy. You can also see “Heart Wise” exercise facilities, which can be used to maintain exercise levels after Cardiac Rehab.

Please also see the Canadian Physiotherapy Association’s Value of Physiotherapy fact sheet on Cardiovascular Rehabilitation.

 

Preventing a heart attack

Physiotherapists recommend these tips for reducing heart attack risk:

• Be physically active – Regular physical activity helps to reduce the risk of heart attack;

• Maintain a healthy weight –Being overweight increases your risk of high blood pressure, high cholesterol and diabetes. However, in the absence of losing weight, physical activity ALONE can still greatly improve your health;

• Be smoke-free –Talk to your doctor about the many helpful smoking cessation programs available;

• Control your blood pressure – Eat a healthy diet. Have your blood pressure checked regularly. If you are prescribed blood pressure-lowering medications, take them as prescribed; and

• Reduce stress –Individuals with high or prolonged stress may have higher blood cholesterol levels and experience increases in their blood pressure. Connect with family and friends for support, and talk to your doctor if your stress is too high; they may refer you to a mental health care professional.

If you have a pre-existing medical condition or have not been physically active, consult your physician before beginning any exercise program or a diet.

 

author

By Kerry Kittson, PT

 

REFERENCES

1) Frownfelter D & Dean E: Cardiovascular and pulmonary physical therapy evidence and practice. 4th ed. St. Louis, MO: Mosby Elsevier; 2006.
2) Risk Factors. Cardiac Health Foundation of Canada. Accessed July 22, 2015.
3) Cardiac Rehabilitation – an untapped resource. Cardiac Health Foundation of Canada. Accessed July 22, 2015.
4) Benefits of Cardiac Rehabilitation. Cardiac Health Foundation of Canada. Accessed July 22, 2015.
5) Myth Busters. Canadian Women’s Heart Health Centre. Accessed July 22, 2015.

 

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