The general advice about exercise given above also applies to those with a history of heart problems. The target – as for others – is to accumulate a minimum of 30 minutes activity on most days of the week. There are, however, some additional general points to bear in mind.

Firstly, there is the question of the type of activity to be taken. Activities recommended for the heart are aerobic - i.e. they involve major muscle groups in a rhythmical fashion (e.g. brisk walking, swimming, cycling etc). But isometric exercise is quite different. An example of isometric exercise in everyday life is when you try to raise a jammed window, or lift an extremely heavy suitcase. This type of activity produces a sharp rise in blood pressure and a considerable strain on the heart muscle. If the heart is already damaged from a previous heart attack, or if you have high blood pressure, then activities such as lifting heavy objects, shovelling snow, heavy digging etc can be dangerous. If you have had heart surgery, isometric exercise can be painful and may cause movement in the chest wound. So for all patients with heart problems the advice is the same; if there are heavy weights to be lifted, get someone else to do it!

The second consideration is the intensity of the activity. The general advice is to start slowly with walking programmes and then move on to normal activities. Use the `talk test’ to gauge the intensity of your exercise. If you use a Training Zone Heart Rate, keep to the lower level initially and do not exceed the upper level heart rate. Consider investing in an electronic heart rate monitor.

Here are some general points for all heart patients:

 

• Start gradually and concentrate on aerobic activities such as walking on a treadmill, swimming or using a stationary exercise bicycle
• Do not lift heavy weights (very light weight training may be beneficial later)
• If you feel unwell, or experience chest discomfort, palpitations or dizziness, stop exercising immediately
• If you exercise with a partner, may sure they keep to your pace, not you to theirs
• Tennis and badminton are examples of competitive activities, so the rule is to always play well within your limits, not those of your partner/opponent
• Do not exercise with a fever
• Listen to what your body tells you and learn to distinguish the difference between genuinely not feeling well enough to exercise and being lazy. If you really don’t feel like it – DON’T GO!

A preliminary walking programme

Level 1	For two weeks walk 1 mile in 30 minutes
Level 2	For two weeks walk 1½ miles in 42 minutes
Level 3	For two weeks walk 2 miles in 50 minutes
Level 4	For two weeks walk 2½ miles in 57½ minutes
Note:	Walk on five days per week

When you have completed this preliminary stage, I would suggest you move onto a more vigorous 12-week walking programme, beginning at the lowest level. After this you can then progress to a normal exercise programme, paying attention to type, frequency, duration and intensity. But to begin with, you should again start at the lower end of your Training Zone Heart Rate.