A heart attack or myocardial infarction (MI) is the death of a segment of heart muscle caused by a loss of blood supply. The blood is usually cut off when an artery supplying the heart muscle is suddenly blocked by a blood clot. If some of the heart muscle dies, patients experience severe chest pain and electrical instability of the heart muscle. It is a serious medical emergency that requires immediate treatment, ideally within an hour. If appropriate treatment could be given in time, chances of death significantly reduces with minimized severity. After heart attack, prescribed medications must be taken strictly in order to reduce risk of subsequent heart attack and help damaged heart to function more effectively. More importantly, lifestyle modification remains essential to lower risk of subsequent episode. Lifestyle changes include maintaining a healthy weight with a heart-healthy diet, managing stress and controlling conditions that can lead to heart attack such as high blood pressure, high cholesterol and diabetes as well as having regular exercise. Patients who exercise regularly after having a heart attack, along with taking other strides toward improved heart health, may live longer and enjoy a better quality of life. Nevertheless, strenuous exercise and activities might potentially result in increased chances of heart attack. Therefore, exercise with appropriate activities and duration is highly recommended to safely improve the heart’s health and strength.

Get to know heart attack

A heart attack or otherwise called myocardial infarction occurs when the flow of blood to the heart is blocked. The blockage is often caused by a plaque in the arteries that feed the heart (coronary arteries).The plaque eventually breaks away and forms a blood clot. As a consequence, the interrupted blood flow can damage or destroy part of the heart muscle. This condition could be fatal, but treatment has improved dramatically over the years. Common heart attack signs and symptoms include tightness or severe chest pain, a squeezing sensation in the chest or arms that may radiate to the neck, jaw or back, shortness of breath, sudden dizziness or lightheadedness, nausea and heartburn or abdominal pain. Without immediate treatment, complications during an attack are typically fatal including abnormal heart rhythms (arrhythmias), heart failure and sudden cardiac arrest. Diagnostic tests and procedures typically involve chest X-ray, echocardiogram, coronary catheterization (angiogram), exercise stress test with electrocardiogram (ECG), cardiac CT and MRI. Treatments primarily aim to restore blood flow quickly in order to prevent heart damage. Treatments involve medications, surgical and other procedures which are:
 

• Coronary angioplasty and stenting. Also known as percutaneous coronary intervention (PCI), a long, thin tube (catheter) is inserted through the groin or wrist and passed to reach a blocked artery in the heart. If patients have had a heart attack, this procedure is often done immediately after a cardiac catheterization –a procedure used to find blockages. This catheter has a special balloon at its tip. Once it is placed in position, it is briefly inflated to widen a blocked coronary artery. A metal mesh stent might then be inserted into the artery to keep it open for long term, restoring blood flow to the heart. Depending on the condition, a stent coated with a slow-releasing medication to keep artery opening might be used.
• Coronary artery bypass surgery. In some severe cases, emergency bypass surgery might be performed at the time of a heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked coronary artery, allowing blood flow to the heart to bypass the blocked section.

After treatment, cardiac rehabilitation programs are extremely important. These programs generally focus on medications, lifestyle changes, emotional issues and a gradual return to daily life and normal activities.

Lifestyle modifications after heart attack 

Appropriate exercise greatly helps to strengthen the heart, resulting in lowered chances of subsequent heart attack. However, heart attack often causes some damages to the heart, thus several weeks or months are required for a full recovery. 

• Before starting exercise and cardiac rehabilitation programs, stress test might be primarily needed in order to evaluate physical fitness level and strength in individual patients, allowing cardiac rehabilitation specialists determine the appropriate exercise programs that suit for each patients.
• Starting exercise gradually. Being active every day is key to a healthy heart after heart attack. Aerobic exercise such as walking, jogging, swimming or biking is strongly recommended in order to strengthen the heart and increase flexibility safely. Anaerobic exercise with a higher intensity e.g. weightlifting is NOT recommended since overdosing on high-intensity exercise during anaerobic exercise may actually increase the risk of death from a heart attack. To safely exercise after heart attack, it is recommended to gradually start aerobic exercise. During the first 2-4 weeks, the first step should include a 15 up to 30 minute-flat walk. The duration can be increased to an hour per day.
• Appropriate exercise. Recommendations include: warm up, cool down and stretch, avoid high-intensity activity or heavy lifting, avoid too cold and too hot, while exercise in mild weather or indoors is preferable. After six weeks, with the doctor’s permission, new exercise such as swimming or playing golf can be added.
• Watch for Cardiac Warning Signs. To be safe with exercise after a heart attack, stop physical activity and seek immediate medical assistance if these symptoms exhibits;
• Chest pain, discomfort, tightness or heaviness
• Pain that radiates to the neck, arm or jaw
• Extreme shortness of breath.
• Very fast heartbeat
• Lightheadedness or sudden dizziness

Without any cardiac complications, stay active with regular exercise after heart attack. The American Heart Association (AHA) recommends building up to exercising 30 minutes a day five times a week to keep the  heart in shape, especially for heart attack recovery. Focus on being physically active every day to have a healthy, happy heart.