3.52 Exercise with Specific Heart Diseases
Exercising at moderate to vigorous intensity, even if you have heart disease, is thought to be quite safe. There is not a large amount of research on this topic, but here is what we know at the present time and the recommendations that you should follow.
For “competitive athletes”, which most of you probably are not, there were some specific guidelines published which you can review here. Here are the recommendations for specific heart conditions.
Coronary artery disease: If you have coronary artery disease (coronary blockage, coronary stent, prior heart attack), it is safe to exercise at moderate to vigorous intensity. Competitive sports at high intensity (i.e. marathon running, triathlons) should be avoided. These events can be done at low to moderate intensity (i.e. walking a marathon or jogging slowly).
Congestive heart failure: If you have congestive heart failure, it is thought to be safe to exercise at moderate to vigorous intensity, but there is less research in patients with congestive heart failure. Competitive sports at high intensity (i.e. marathon running, triathlons) should be avoided. These events can be done at low intensity (i.e. walking a marathon).
Heart rhythm disorders: If you have heart rhythm problems, it is generally safe to exercise at moderate to vigorous intensity, but avoid high intensity. Competitive sports at high intensity (i.e. marathon running, triathlons) could be done depending on which rhythm issue you have. Atrial fibrillation or atrial flutter are not thought to pose a risk of cardiac arrest, however there may be higher risk with ventricular tachycardia. Be sure you know what your heart rhythm problem is and ask your doctor what exercise you can do.
Heart valve disorders: If you have a leaking heart valve, it is safe to exercise at moderate to vigorous intensity, but avoid high intensity. Competitive sports at high intensity (i.e. marathon running, triathlons) should be avoided. These events can be done at low to moderate intensity (i.e. walking a marathon or jogging slowly). If you have a blocked heart valve, such as aortic stenosis, you should be cautious. If the aortic stenosis is severe, avoid vigorous intensity exercises. It is safe to exercise at low to moderate intensity, although there is not a lot of research on this topic.
Aneurysms: If you have an aneurysm, your doctor may want to limit strength training or weightlifting. It really depends on the size and location of your aneurysm, so you will have to see what your healthcare provider’s recommendations are.
Marfan’s Syndrome: If you have Marfan’s syndrome, your exercise limitations are quite dependent on certain factors such as the presence of aneurysm or family history of aortic dissection. You really need to ask your doctor about your own specific situation.
Hypertrophic Obstructive Cardiomyopathy (HOCM): If you have HOCM you should not participate in any competitive sports at all. Low intensity exercise should be OK, but the severity of HOCM is different from person to person, so ask your doctor and be careful.
Remember, specific recommendations from the American Heart Association do recommend 150 minutes per week of “moderate intensity” physical activity or 75 minutes per week at “vigorous intensity”. It is rare for someone with a heart condition to have exercise restrictions, but ask your doctor about your situation. Most restrictions in heart disease patients are actually based on symptoms, For example, if you have heart failure and get short of breath after walking 1 block, you may be limited in what you can do, but that does not mean that you can’t keep walking 1 block and try to work your way slowly and cautiously up to 2 blocks.
Exercise and physical activity saves lives. Hopefully after learning the above you feel more safe exercising and will work your way to your optimal heart health state.