Best Exercises for Heart Disease Patients

Talk to your doctor and get started.

Exercise boosts your heart and lungs, tones your muscles and lifts your mood. The Centers for Disease Control and Prevention recommends that adults with chronic health conditions do at least 150 minutes of moderate exercise every week, or if that's too much, engage in regular physical activity according to their abilities. "As a cardiologist, I want you to exercise," says Dr. Martha Gulati, chief of cardiology at University of Arizona College of Medicine--Phoenix. "Even people with heart conditions -- I want you to exercise once an acute condition has been resolved, like having a heart attack or heart failure." For anyone with an underlying heart condition, she says, the first step is talking with your cardiologist about what you can and cannot do. "We want you to exercise, but we want you to exercise safely." By discussing an individual plan with your doctor and following sensible precautions for certain conditions, you can stay physically active for better heart health.

Cardiac rehab after a heart attack

If you're anxious about working out after a heart attack, cardiac rehabilitation is a reassuring way to get moving. Cardiac rehab is like going to a well-equipped gym that also offers medical monitoring, tailored training and fellow patients recovering from heart conditions. "A lot of people who've had a heart attack or angina haven't been exercising very much because exercise might be provoking symptoms -- so it's just easier to sit down and not bring on those symptoms," Gulati says. Cardiac rehab helps heart patients build up their confidence, endurance and strength. Programs combine exercise with heart-health education and typically involve three weekly visits for a three-month period. "You have a constant team of people working with you to keep you safe, your heart safe and you exercising safely," she says. By the time you leave cardiac rehab, you're ready to move forward.

Dancing with a heart stent

Physical activities that you enjoy are always the most motivating. Undergoing heart surgery needn't keep you from putting a golf ball or stepping onto the dance floor with your doctor's approval once you're fully recovered. Gulati recalls a recent patient who previously suffered from angina and was doing well after a procedure to place a cardiac stent -- a tiny mesh tube used to keep a heart artery open. This patient wasn't sure if going dancing, as she loved to do, really qualified as heart-healthy activity. "Of course dancing counts as exercise," Gulati told her. Ask your doctor about your favorite activities and, if necessary, how they can be personalized for your individual condition.

Precautions for aortic aneurysm

When it comes to exercise, some heart conditions require more caution than others. Having an aortic aneurysm carries activity limitations. The aorta is the large, central artery that carries blood from the heart to your body. Portions of the aortic wall can weaken in people at risk. Aortic aneurysm is a bulge or ballooning in the arterial wall. Aortic dissection, a tear in the wall, is a medical emergency. "For people with aortic aneurysm and aortic dissection, then you should definitely be talking with your physician," Gulati says. "We tell people with those kinds of conditions they can't play any contact sports. We also tell them there are limitations on weight they can lift."

Aerobics for people with heart failure

Congestive heart failure is a common condition in which a patient's weakened heart muscle can't pump properly. For these patients, "any exercise or physical activity is encouraged if tolerated," says cardiologist Dr. Wilson Tang, a heart failure expert at Cleveland Clinic. "There are three basic types of exercises -- flexibility, aerobic and strength training," he says. If you have heart failure, doing aerobic activities such as fast walking, jogging or riding a bike at regular intervals -- at least three times a weeks -- is beneficial. "Start with shorter sessions of 10 to 15 minutes with lower intensity, and gradually build up intensity and frequency," says Tang, who also recommends cardiac rehab as an excellent starting point for learning exercise techniques and tips. "Even light-intensity activity can offset serious health risks of being sedentary, and should be considered as a treatment as important as medications or procedures for heart failure," he says.

Flexibility workouts for heart failure

Stretching, yoga and tai chi build flexibility and core strength for people with heart failure and other types of heart disease (and for anybody else). "Flexibility exercises provide better balance, range of motion and joint movements, and are good for preventing injuries or strain," Tang says. Flexibility workouts like gentle yoga can be adapted to any fitness or activity level. The ancient practice of tai chi is linked to numerous health benefits including fall reduction and improved blood pressure. Ask your doctor about the best stretching exercises to meet your individual health goals.

Strength training for weakened hearts

Lifting weights and using resistance tubes or bands can help you get stronger to cope with heart failure and other conditions. "Strength training may provide stronger or more toned muscles, and improve muscle mass and weight control," Tang says. However, lighter weights are recommended. "Patients with heart failure are often advised to proceed as tolerated and in moderation -- lifting weights not more than 10 pounds -- and avoid holding (their) breath, as this may cause changes in blood pressure," he says.

Pool exercises for patients with joint problems

People with heart failure may also deal with multiple health issues such as arthritis or obesity. But don't let joint problems or an unsteady gait prevent you from working out. Water aerobics is a good option for adapted exercise programs for patients with heart conditions and other medical complications, Tang says. You can do water exercises regardless of your swimming ability. Just walking on the floor in the shallow end of the pool provides a gentle, low-impact workout. If you prefer to work out on gym equipment, recumbent bicycles can also enable joint-sparing exercise, Tang notes.

Recreation for kids born with heart defects

Kids should be active -- including kids who were born with heart disease. "We encourage all of our patients with congenital heart disease, both before and after surgery, to exercise at the top of their capacity," says Dr. Nicolas Madsen, a pediatric cardiologist at Cincinnati Children's Hospital Medical Center. Kids treated for heart conditions such as ventricular septal defect or Tetralogy of Fallot deserve active childhoods like any other. As always, heart patients (or parents) should consult with their cardiologist for individual activity advice, Madsen notes. "My recommendations are intended to speak in general terms about the entire population of individuals with congenital heart disease," he emphasizes.

Bike-riding and running for kids with heart conditions

Preschool kids with congenital heart conditions should still be climbing trees and playing with their family in the pool, Madsen says. Conditions that leave kids with only a single functioning lower heart chamber, or ventricle, may require extra caution. "As children age into their school years, some limitations develop around strenuous activity," he says. "So things like running competitively or heavy weightlifting are restricted. We encourage activities that are a little less severe. However, he adds, "When we talk about exercise restrictions, we're often talking about organized sports with a coach, and a whistle and somebody telling you to keep running even though you're tired. (With) leisure activities -- where you're in control of your own performance and you can rest whenever you think you need a rest instead of a coach telling you to rest -- the restrictions are less stringent and should be less stringent." With recreational bike-riding, running or gymnastics, kids tend to naturally pace themselves.

Sports for kids after heart surgery

Activity restrictions after pediatric heart surgery vary depending on the heart condition and also somewhat by individual hospital, says Madsen, who serves on the medical advisory board of the Pediatric Congenital Heart Association. Typically, he says, recommendations call for four to six weeks of activity restriction. Kids can still go for a walk but they can't lift anything over 10 pounds, for instance, because of their incision. Once they've completely healed, however, it's a different ballgame. Team sports like soccer may not necessarily be out of the question. Doctors have historically been leery of contact sports after heart surgery, Madsen says, "but the truth is the sternum -- that bone in the middle of your chest -- heals just like the bones in your arm," he adds. "If they've had one heart surgery and no complications relative to their sternum, they're fine participating in contact sports." However, he notes, kids taking blood-thinner medications should not play contact sports.

Community workouts for an extra boost

If you could use extra motivation to exercise with a heart condition, look around your community. Silver Sneakers, a free health and fitness program for older adults who qualify, may have participating gyms or community centers in your area. In a different approach, some doctors not only advise their heart patients to be active -- they actually walk with them. Walk With a Doc is a nonprofit program in which a doctor briefly discusses a health topic before leading a group of participants on an outdoor walk at their own pace. In yet another option, people who've completed their three-month cardiac rehab period but really enjoy the camaraderie, safety and support may be able to continue. Extended programs known as Phase 3 cardiac rehab are sometimes available, Gulati says. "It's finding that community -- finding that exercise you'll stick with," she says.

Heart Disease and Safe Exercise

People should ask their doctors about specific exercises and heart conditions:

-- Cardiac rehab after a heart attack or angina.

-- Golf, gardening or dancing following heart surgery.

-- Strict activity precautions with aortic aneurysms.

-- Aerobics, flexibility and strength training for heart failure.

-- Water aerobics for heart patients with joint issues.

-- Outdoor play and recreational sports for kids with congenital heart defects.

-- Community-based workouts for adult heart patients.