Leaving hospital after your heart attack can be an anxious time.
Ask your doctor any questions you have before you leave hospital. You could ask them when they think you can go back to work, for example.
Recovery from a heart attack
Recovering from a heart attack can take several months. It's very important not to rush your rehabilitation.
During your recovery, you'll get support from a range of healthcare professionals.
These may include:
- nurses
- physiotherapists
- dietitians
- pharmacists
- exercise specialists
Your healthcare professionals will support your physical and mental recovery.
Your recovery usually takes place in stages.
It starts in hospital where your:
- condition can be monitored
- individual needs for the future can be assessed
After you are discharged, you can continue your recovery at home.
The 2 most important aims of the recovery process are:
- to restore your physical fitness (known as cardiac rehabilitation)
- to reduce your risk of another heart attack
At home it is important for you to have a calm, stress-free environment but not to be over-protected.
You may feel anxious or even depressed after your heart attack. This is normal. But if these feelings do not go away after a few weeks or get worse, talk to your GP.
Cardiac rehabilitation
Your cardiac rehabilitation programme will begin when you're in hospital. You should have another session within 10 days of leaving hospital.
A member of the cardiac rehabilitation team will visit you in hospital.
They'll give you information about:
- your state of health and how the heart attack may have affected it
- the type of treatment you received
- what medications you'll need when you leave hospital
- what risk factors are thought to have contributed to your heart attack
- what lifestyle changes you can make to address those risk factors
They can also answer any questions you have.
Exercise
Your doctor will decide how much activity is safe for you in the early recovery period. They will decide this based on your level of activity in hospital and your exercise test.
You may feel very tired when you leave hospital. You will have to gradually increase your daily activity to get back to normal.
If you do too much, you may find you get:
- short of breath
- chest pain
- light-headed
It’s important to mention this to your doctor. It’s better to start with a little exercise and increase your activity in a controlled way.
Your rehabilitation programme should contain different exercises. They will depend on your age and ability.
Most of the exercises will be aerobic. Aerobic exercises strengthen your heart, improve circulation and lower blood pressure.
Examples of aerobic exercises include:
- riding an exercise bike
- jogging on a treadmill
- swimming
Getting back to work
Some people get back to work in 6 weeks or less. Others need longer to recover.
You must tell your employers about the heart attack if you:
- are a bus driver
- have a licence to drive a heavy goods vehicle
In certain cases you may not be able to return to your previous job. If your job is very demanding, it is important not to overdo it for the first few weeks.
If your job is very stressful, you might need to change how you work or the type of work you do.
Driving
You must stop driving for at least 1 to 4 weeks if you have had an angioplasty. Some people recommend that you should not drive for 6 weeks after your heart attack.
But talk to your GP. They can tell you when you can drive again.
If you drive a car or motorcycle
You have a heart attack, you do not have to inform the NDLS.
If you drive a truck or a bus
You must tell the NDLS if you have a heart attack and you have a group 2 licence. You must stop driving for at least 4 weeks.
Travelling
It’s recommended that you do not go on long journeys or trips abroad for 6 to 8 weeks. When you do travel, you should go with someone else. Make sure you also have enough medicine for the journey and for your holiday.
Avoid very cold and very hot climates. Make sure you drink enough fluids in hot weather. It is always safest to discuss your trip with your doctor before making plans.
Sex
You can have sex again 2 to 4 weeks after your heart attack. Some people might take longer until they feel up to having sex again.
Usually, if you are able to walk up 2 flights of stairs, you should be physically able to have sex.
Men often have impotence or difficulties maintaining an erection after a heart attack. This may be due to emotional upset rather than a medical problem. If you’re depressed or anxious, this can cause the problem.
Some medicines that are used after a heart attack, such as beta blockers, can cause impotence.
If this is a problem, talk to your GP.
Depression
Having a heart attack can be frightening and traumatic. It's common to have feelings of anxiety afterwards.
The emotional stresses can leave you depressed and tearful. You might feel like this for the first few weeks after you leave hospital.
If feelings of depression do not go away, talk to your GP. You may have a more serious form of depression.
It's important to get help. Serious types of depression often do not get better without treatment.
Your emotional state could also effect on your physical recovery.
Medicines
There are currently 4 types of medicine used to reduce the risks of a heart attack:
- angiotensin-converting enzyme (ACE) inhibitors
- anti-platelets
- beta-blockers
- statins
ACE inhibitors
ACE inhibitors are often used to lower blood pressure.
They effect some of the hormones that help control your blood pressure. They stop these hormones from working. This helps to reduce the amount of water in your blood. It also widens your arteries. These two things will reduce your blood pressure.
ACE inhibitors can reduce the supply of blood to the kidneys. This can make them less effective. So you might need to have blood and urine tests before you start taking ACE inhibitors. This is to make sure there are no pre-existing problems with your kidneys.
You may need to have blood and urine tests once a year if you continue to use ACE inhibitors.
The side effects of ACE inhibitors can include:
- dizziness
- tiredness or weakness
- headaches
- a persistent, dry cough
Most of these should pass within a few days. But some people will still have a dry cough.
ACE inhibitors can have unpredictable effects if you take them with other medication. This includes over-the-counter medicines.
Important
Check with your GP or pharmacist before taking anything with ACE inhibitors.
You're usually advised to take ACE inhibitors immediately after having a heart attack. In most cases, you will need to continue take them.
If you cannot take ACE inhibitors, your doctor might prescribed another medication. This is an angiotensin receptor blocker (ARB).
Anti-platelets
Anti-platelets are a type of medication that can help prevent blood clots. They work by reducing the 'stickiness' of platelets. These are tiny particles in the blood that help it to clot.
It's usually recommended that you take low-dose aspirin. This has blood-thinning properties, as well as being a painkiller.
You may get extra anti-platelet medication if you've had stent treatment.
This medication includes:
- clopidogrel
- prasugrel
- ticagrelor
If you're allergic to aspirin, you can make these medicines instead.
Side effects can include:
- diarrhoea
- bruising or bleeding
- shortness of breath
- abdominal pain
- indigestion
- heartburn
Treatment with anti-platelets usually begins straight after a heart attack. You might have to take them for 12 months. But some people only need them for 4 weeks. It depends on the type of heart attack you have had. It also depends on the other treatment you have had.
It's usually recommended that you take aspirin until you're told not to. If you get bad side effects after taking aspirin, talk to your GP. Do not stop taking the aspirin. This could increase your risk of another heart attack.
You may also need to take other blood thinning medication (anticoagulants). For example, warfarin, apixaban, dabigatran, edoxaban, rivaroxaban.
You'll usually only need to take it if you have:
- an irregular heart rhythm (atrial fibrillation)
- sustained severe damage to your heart
Side effects of blood-thinning medication
Excessive bleeding is the most serious side effect of blood thinners. But get immediate medical attention and have an urgent blood test if you:
- have blood in your pee or poo
- have black poo
- have severe bruising
- have nosebleeds that last longer than 10 minutes
- see blood in your vomit
- cough up blood
- get unusual headaches
- have heavy or increased bleeding during your period or any other bleeding from the vagina
Emergency action required: Call 112 or 999 straight away if you:
- are involved in an accident
- experience a significant blow to the head
- are unable to stop any bleeding
Beta-blockers
Beta-blockers help protect the heart from further damage after a heart attack. They help to relax the heart's muscles. The heart beats slower and the blood pressure drops. This reduces the strain on your heart.
You'll usually begin treatment with beta-blockers as soon as your condition stabilises. You may need to continue taking them for good.
Side effects of beta-blockers
Common side effects of beta-blockers include:
- tiredness
- cold hands and feet
- slow heartbeat
- diarrhoea
- feeling sick
Less common side effects include:
- sleep disturbances
- nightmares
- erectile dysfunction or 'impotence'
Beta-blockers can also interact with other medicines, causing possible adverse side effects.
Check with your GP or pharmacist before taking other medicines. This includes over-the-counter medication, in combination with beta-blockers.
Statins
Statins are a type of medication. They're used to lower your blood cholesterol level. This helps prevent further damage to your coronary arteries. This should reduce the risk of another heart attack.
Statins block the effects of an enzyme in your liver. This enzyme is HMG-CoA reductase. This is the enzyme that makes cholesterol.
Statins sometimes have mild side effects, including:
- constipation
- diarrhoea
- headaches
- abdominal pain
Sometimes, statins can cause muscle pain, weakness and tenderness. Contact your GP if you experience these symptoms, Your GP may need to change your dosage.
It's usually recommended that you take statins for good.
Content supplied by the NHS and adapted for Ireland by the HSE
