• Bouncing Back After a Heart Attack: It’s Not Always Easy

    senior couple You have had a heart attack and the worst is over. If you are like most people, you will be able to return to work and the activities you enjoy within just a few months. If your heart muscle is very weak, however, your activities may be more limited. In either case, easing back into life after a heart attack is not always so easy. What can you expect and how can you cope with the challenges?

    Phase One: Coping With the Initial Shock

    Having a heart attack is, for many people, a traumatic experience. The first few days are often marked by shock and feelings of being overwhelmed. You might experience elevated levels of stress, anxiety, and depression after being hospitalized for a heart attack. During your hospital stay you are subjected to an onslaught of tests, drugs, and information. You may need to rest and let your heart heal, but your environment may be anything but restful! Your family may be scrambling around, hovering over your bed, and perhaps demanding information from your doctor. You may feel as though your family and your doctor are throwing too much at you and that things are happening way too fast. Keep in mind that the shock of your situation is perfectly normal, and that soon you will be going home. Try to get some rest.

    Phase Two: Going Home From the Hospital

    The next phase of adjustment takes place when you leave the hospital. While many people are eager to return to the comforts of home, they (and their families) may also be frightened of leaving the physical safety of the hospital coronary unit. During this time, it is not uncommon to feel lost and worried about the absence of a doctor or nurse. Your family may also share these feelings, and may be excessively watchful.
    Under your doctor’s advice, you will gradually become more active. Depending on your condition, you may initially need some degree of assistance with daily tasks such as maintaining the house, shopping, cooking, bathing, and remembering to take your medicines. As a result, family roles may change as well. Your spouse or children may make adjustments in their lives so that they can help take care of you. While these gestures are intended to help, you may find that they sometimes stir up uncomfortable feelings.
    After a heart attack, it is normal for people to experience negative feelings such as:
      Fear of:
      • Dying
      • Having chest pains or another heart attack
      • Not being able to have sex
      • Not being able to work
      • That this happened to you
      • At the responses of family and friends
      • From feelings of helplessness and hopelessness
      • Because you may not be the same again
      • Because others might think you are weak
      • That this is an inconvenience for your family
      • That you will not be able to fulfill certain responsibilities
    It is healthy to talk about these feelings with your family, a compassionate friend, or a therapist. In time, these feelings should go away.
    Your family and friends may feel:
    • Frightened that you have had a heart attack
    • Angry that it came at an inconvenient time
    • Guilty because they think that somehow they “caused” your heart attack
    Talking openly about bad feelings can help you and your family to cope more effectively with the situation.

    Phase Three: Rehabilitation

    Rehabilitation is the longest and often the most difficult phase of the recovery process. It requires not only that your body heal itself, but also that you take an active role in helping it to get stronger.

    Lifestyle Changes

    During this time you will probably continue to increase your activity level, make some changes in your diet, reduce your level of stress, and give up any habits that could negatively affect your health, such as smoking and drinking too much alcohol. You will almost certainly have new medications to take, perhaps along with some mild to moderate side effects. These medications will greatly reduce your risk of another heart attack, but they must be taken as directed. Some people find themselves highly motivated to make and sustain needed changes. Others begin the changes but gradually fall back into old habits, becoming complacent once they feel better. You are more apt to make and sustain lifestyle changes with proper information, resources, and support.

    Social Support

    The support of family, friends, a therapist, or support group may not only reduce some of your fears, stress, and feelings of isolation. It may also increase your chance of survival after a heart attack. For instance, a study published in 2004 found that limited social support was associated with increased death after a heart attack. Researchers looked at five studies which followed 3,433 patients for six months to nine years. Four of the five studies found a significant association between death and social support.

    Psychological Intervention

    Perhaps along with social support, you may need additional help as you recover. Some people experience anxiety, depression, or other psychological distress after they have a heart attack. As shown in the study above, in addition to social isolation, the American Psychological Association found that a person’s level of depression and hostility can predict death from heart disease as well as the recurrence of cardiac problems. These conditions may also lower a person’s motivation to follow medical recommendations. Addressing these psychological conditions via therapy may help ease the distress after a heart attack. Talk with your doctor if you are interested in learning more about mental health therapy.

    Making Choices

    By making the right choices during the recovery process, you have a good chance of returning to a full, active life. Here are some tips that can help:
    • Get as much information as you can from your doctor. Prepare for appointments and do not be afraid to ask questions.
    • Follow your doctor’s recommendations. Talk about any difficulties you have in making lifestyle changes, so that the two of you can develop a plan that works best for you.
    • Learn as much as you can about your heart and how you can make it stronger with lifestyle choices such as diet and exercise.
    • Seek help for depression or other emotional difficulties.

    Resuming Your Normal Activities

    Your doctor will provide you with guidance about resuming your normal activities after your recovery. Most people are able to go back to work within 1-3 months. Depending on the condition of your heart and the strenuousness of your work, you may have to make some changes in how you do your job.
    Most people are able to have sex again in 3-4 weeks after a heart attack. As with other activities, you may need to start slowly and work up to your normal patterns. If you or your partner have any concerns, talk to your doctor.
    Recovering from a heart attack can be difficult. But the aftermath of a heart attack can present an opportunity to re-examine one’s life and clarify important values. For many people, the experience is a springboard to a healthier and more fulfilling lifestyle.


    American Heart Association http://www.americanheart.org

    National, Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov


    Canadian Cardiovascular Society http://www.ccs.ca/home/index%5Fe.aspx

    Heart and Stroke Foundation of Canada http://www.heartandstroke.com/


    Carson-Dewitt R. Heart attack. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=1034. Updated September 2009. Accessed November 23, 2009.

    Cossette S, Frasure-Smith N, Lespérance F. Clinical implications of a reduction in psychological distress on cardiac prognosis in patients participating in a psychosocial intervention program. Psychosomatic Medicine. 2001; 63:257-266.

    Depression and heart disease. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/publicat/depheart.cfm. Accessed on February 28, 2003.

    Heart attack: getting back into your life after a heart attack.American Academy of Family Physicians, American Family Physician website. Available at: http://familydoctor.org/handouts/002.html. Accessed on February 28, 2003.

    How will I recover from my heart attack? American Heart Association website. Available at: http://www.americanheart.org. Accessed on February 28, 2003.

    Psychology helps after a heart attack. American Psychological Association website. Available at: http://www.apahelpcenter.org/articles/article.php?id=14. Accessed November 23, 2009.

    ST-elevation myocardial infarction (STEMI) EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 8, 2009. Accessed November 23, 2009.

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