Coronary angioplasty is often the starting point for making lifestyle changes to improve your heart health. It’s no secret that exercise plays an essential role both for heart health and overall health, but it’s important to do the right type and level of exercise after coronary angioplasty. In an acute situation, a patient will usually see a Physiotherapist in the hospital the day after their angioplasty operation.

Cardiac rehabilitation, also called cardiac rehab, is a customized outpatient program of exercise and education. The program is designed to improve health and recover from a heart attack, other forms of heart disease or surgery to treat heart disease. Cardiac rehabilitation often involves exercise training, emotional support and education about lifestyle changes to reduce your heart disease risk, such as eating a heart-healthy diet, maintaining a healthy weight and quitting smoking.

Why it's done ?

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Cardiac rehabilitation is an option for people with many forms of heart disease. In particular, you might benefit from cardiac rehabilitation if your medical history includes: Heart attack, Coronary artery disease, Heart failure, Peripheral artery disease, Chest pain (angina), Cardiomyopathy, Certain congenital heart diseases, Coronary artery bypass surgery, Angioplasty and stents, Heart or lung transplant, Heart valve repair or replacement, Pulmonary hypertension.

This list of advice which can best be labeled as a ‘rule of five’ or a ‘hand rule’ following the stenting procedure is essential for ideal long term outcomes.

Rule No. 1: Take Your Medicines Regularly

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It is quite common for patients to be irregular or non-compliant with medications – particularly as the time from the procedure elapses. There is an erroneous belief that once the procedure has been accomplished successfully, medication can be discontinued. Contrary to this belief, medications (at least blood thinners and cholesterol -reducing statins) are mandatory following stent implantation – since they prevent an important life-threatening complication I.e stent thrombosis.

Rule No. 2: Do not Ignore or Hide Symptoms

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If a post-angioplasty patient develops any unusual discomfort in the form of chest pain , dyspepsia or breathing difficulty, it is always advisable to get an ECG and consult a cardiologist . No symptom – even if it occurs at an awkward time or location – should be ignored – as any complication in this group of patients can be life-threatening.

Rule No. 3: Moderation in Diet

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There is a general belief that some types of diet need to be discontinued following angioplasty. In a social context, it is extremely difficult for an individual to suddenly stop a dietary pattern that he has been brought up with. It is much more rational to advise moderation in the existing diet – I.e tries and reduces the overall dietary intake by about 20-30 percent with a replacement of undesirable food items with more desirable ones. It should be remembered that the stricter a dietary advice, the less likely that a patient will follow it!

Rule No. 4: Moderate exercise after stenting procedure

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No patient needs bed rest following stent implantation. It is advisable for patients to commence moderate exercise and cardiac rehabilitation such as walking on the plain ground soon after angioplasty and gradually increase the intensity of exercise. One can expect to reach the pre-disease exercise status within one month of a stenting procedure. Heavy exercise such as lifting weights or walking up steep slopes should be avoided for about 4-6 weeks.

Rule No. 5: Go for regular follow-ups

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Follow-ups following angioplasty/stenting are aimed at optimization of treatment, screening for adverse effects or complications as well as control of risk factors. The frequency of follow up might vary depending on the clinical situation and the risk profile of a patient. They are generally once a month – and these must be adhered to as advised by the treating cardiologist.

The Benefits of Exercise After Coronary Angioplasty

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If one can don't exercise and eat a healthy diet after coronary angioplasty, can put your heart health at risk. Exercise can help you achieve and maintain a healthy weight, but the benefits don't stop there. It helps the entire cardiovascular system, not just the area treated with the procedure.these are: It improves circulation in the vessels that underwent the procedure, It increases nitric oxide absorption, which aids in widening blood vessels and increasing blood flow & It mobilizes cells in the body that help repair damage caused by previously hardened arteries.

How to Start Exercising After Coronary Angioplasty

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Be sure to discuss exercise with your cardiac physiotherapist before resuming or initiating an exercise plan after coronary angioplasty, your cardiologist and physiotherapist will let you know how soon and at what level you can begin or return to exercise after coronary angioplasty. Depending on your particular circumstances prior to the procedure, you doctor may say you can start a walking program right away — or prefer that you engage in a cardiac rehabilitation program.

Finding Exercises That Work for You

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There are many good exercise options to consider when you're ready to start being active as part of your cardiac rehab after coronary angioplasty. “Walking, running, weight lifting, and any activity that raises heart rate and increases cardiovascular fitness can be safe after recovery from coronary angioplasty.

Cardiac Rehabilitation

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Exercises Consist of 3 Parts :

1. Warm-up or stretching exercises
2. Cardio exercises
3. Strengthening exercises
4. Cool-down exercises

Before starting blood pressure and heart rate are checked, warm-up is done for 15 minutes, then start the main exercise end with the cooldown exercise for 10 minutes and again check the blood pressure and heart rate. Wear soft-soled shoes, tracksuits and keep a bottle of water by the side.

1: Warm-up

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Always warm-up for 15 minutes with light exercise e.g. walking, marching on the spot, or low-level cycling, followed by stretching of the muscles, that reduces the risk of injuries.

2: Cardiovascular Exercises

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After a warm-up and stretching exercises, cardio exercises are started. These exercises strengthen the heart muscles and help them to pump harder and faster.

These aerobic exercises include:

• Stationery biking
• Elliptical machine exercising
• Jumping rope
• Walking
• Jogging
• Running
• Swimming
• Dancing
• Playing sports

3: Cooldown

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• Cooldown exercises are done for 10 minutes to bring the body back to its resting state, this reduces the risk of dizziness or fainting that can occur due to a sudden drop in blood pressure as a result of suddenly stopping exercise. Stretching during the cool down also helps to reduce muscle soreness that may be caused by the activity. The cool-down exercise should be performed at a slower speed.