Can people with heart issues, or those who have suffered from heart diseases lead an active life? There is plenty of confusion, hearsay and unverified bad advice that does the rounds around this issue. Just to be clear, cardiologists say that exercise and physical activity are an essential part of rehab for all survivors of cardiac attacks and those recuperating from heart-related issues. A study presented at the European Society of Cardiology congress in 2018, based on evidence from 22,000 patients, found that being physically active after a heart attack reduces the risk of death.
It may also be possible to perform in top-level athletics and sports for survivors of cardiac arrest. Danish footballer Christian Eriksen, 29, shockingly suffered a cardiac arrest during a Euro 2020 game in June. Although he’s still being rehabilitated, Eriksen returned to his club Inter Milan in early August. While he’s still not being allowed to train, the club are conducting a battery of tests to understand the reason for his cardiac arrest. Eriksen is optimistic though, promising his teammates that he’ll be back playing in five months. It may not be as far-fetched as it sounds. Dutch cyclist Shanne Braspennincx had suffered a heart attack in 2015 at the age of 24. Six years on, she stormed to a gold medal in track cycling at the Tokyo Olympics.
Dr Vishal Rastogi, additional director of cardiac sciences and interventional cardiology at Fortis Escorts Heart Institute in New Delhi says that it is imperative even for regular people, who suffered a cardiac arrest, to exercise and become physically active, says. “They need to start slow and then build it up. The amount and manner in which they are able to [work out] depends entirely on the damage to the heart. They should begin with very basic slow workouts a week after the heart attack but before doing so they should consult their treating doctor,” advises Rastogi.
Dr G Ramesh, consultant interventional cardiologist at Yashoda Hospitals, Hyderabad, explains further. “It is possible to return to an active lifestyle after a heart attack if the patient's left ventricle function is normal or near normal and if the patient does not have any further significant blocks in the angiogram,” he says. The message clearly is this: monitor your heart, consult your doctor and take baby steps towards getting back to an active life.
One of the first things survivors of cardiac diseases have to deal with is a loss of confidence. “Psychologically, a person may feel as though their life has come to a complete standstill and that they might not be able to achieve all the things they set out to,” says Dr Rastogi. That’s exactly what happened to Vipin Thapar, a retired commodore of the Indian Navy.
The 56-year-old Delhi resident suffered a cardiac attack in October 2019 while he was training for a half marathon. “I have been active all my life because of my naval background but after the heart issue, I suffered from a loss of confidence. I took two to three opinions from different doctors before returning to training and my first task was to overcome my loss of confidence,” recalls Thapar, who trained with Delhi-based coach Gagan Arora. “As per the rule book I wasn’t allowed to do a lot of things… doctors choose to err on the side of caution… but I consulted more doctors and then slowly got back to exercise and training.” Exercises can help people regain not only their fitness levels but also their confidence, says Arora.
It’s best to start slowly and only after consulting a doctor, say Rastogi and Ramesh, and you should map out your workout plan in consultation with your doctor and trainer. “A pool of activities which can be performed [by patients] with a health coach, under the guidance of a medical professional especially when they want to do more than just walking and yoga,” says Arora, the founder of Delhi’s Kosmic Fitness. “We start with basic heart rate-based training for aerobic workouts along with flexibility and breathing exercises. Once we see positive outcomes consistently for about 8-16 weeks, we can introduce light strength building exercises twice a week for 20-30 minutes along with small bouts of aerobic interval training that can improve their heart condition and overall fitness.”
Thapar had to adapt his pre-cardiac arrest regimen and readjust his goals. He used to be able to run a half marathon in 2 hours 10 minutes, but he had to cut down on his speed. He was also asked to rigorously monitor his heart rate during training. “I was training for the Tata Mumbai Marathon 2020 in January when I suffered the heart problem. I did end up running the race but much slower and finished in 2 hours 30 minutes. The fact that I was able to finish a half marathon without any trouble gave me a huge confidence boost,” he says. These days, Thapar does a couple of sessions of strength training, stretching and plays basketball every week to this day.
However, even if you’re back to exercising regularly, continue to communicate with your doctor, take your medicines regularly and flag anything that feels amiss, cautions Dr Rastogi. All workout regimens and exercise heart rate zones must be calculated and applied with approval of their doctors, adds Arora. “One should not get excited with initial improvements and ramp up exercise intensity on their own,” he warns. “Avoid any aerobic activity during which you can’t speak properly or start chopping words while doing the activity.”
Start slow and don't go overboard, but do begin to feel your way back to fitness. There is life after a cardiac arrest, one that can be lived to the full.
Shrenik Avlani is a writer and editor and co-author of The Shivfit Way, a book on functional fitness.