Can You Bounce Back from a Heart Attack?

Podcast Transcript

Announcer:

Welcome to Love Your Heart, brought to you by Cleveland Clinic's Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute. These podcasts will help you learn more about your heart, thoracic and vascular systems, ways to stay healthy, and information about diseases and treatment options. Enjoy.

Luke Laffin, MD:

My name's Luke Laffin, and I'm a preventive cardiologist at the Cleveland Clinic. And it's great to speak with you today, a little bit about bouncing back from that heart attack that you may have had.

Luke Laffin, MD:

No one ever likes to have that crushing sensation of chest pain, get rushed to the heart catheterization lab, and get a stent. But it's important to understand that with the newer technologies that we have now, patients are in and out of the hospital quickly, and they're on their way to a full recovery. When we think about bouncing back from a heart attack, post-discharge, there are a few things to really keep in mind moving forward.

Luke Laffin, MD:

I think number one is to take your prescriptions as they're written. Oftentimes, people that have had a heart attack may not have been on any medicines before, or not taking them regularly, or on significantly lower doses. The best example I see of this, oftentimes, is cholesterol-lowering medicines, where someone may have been on 10 milligrams of atorvastatin, which is otherwise known as Lipitor, and now post-heart attack, they're up on 80. There's good data to support that that's actually going to reduce your risk of a future heart attack. So look at those patient instructions carefully. Before you're even out of the hospital, ask your healthcare provider, which medicines are changing, and if I should anticipate any side effects associated with them. Because it's really important to take your medicines once you've had that heart attack, particularly in the early time after a heart attack, but oftentimes, long term as well.

Luke Laffin, MD:

The second thing that we think about post-MI, i.e myocardial infarction the more technical term for heart attack, is enrolling in cardiac rehabilitation. There's really great evidence that shows that patients that participate in cardiac rehabilitation do better, not only over the short term but over the next five to 10 years.

Luke Laffin, MD:

And cardiac rehabilitation, oftentimes you'll get some information about it before you leave the hospital, but what it is, is it's a supervised exercise and educational program that takes place over 36 sessions. It's covered by all insurance companies. And what it is, is it's typically about 45 minutes to an hour, three times a week in a monitored setting. We monitor your heart rate, we monitor your blood pressure and we promote healthy lifestyle activities and really get you back on your feet and oftentimes in a better physical activity or better physical shape than you were before you even had any type of heart attack. It's highly recommended for anyone that's had a stent, heart attack, et cetera.

Luke Laffin, MD:

Another thing that you can do, and oftentimes a heart attack is a galvanizing factor, is really to keep track of your weight. Weight management and obesity within the United States is just growing at such a tremendous rate. And we know that those extra pounds contribute to risk of hypertension, diabetes, high cholesterol, which ultimately increase one's risk for strokes and heart attacks. So really starting to think about what the right dietary patterns for you, what will be helpful for losing weight, but also how it's going to be helpful for losing weight in a sustainable manner. It's no good to lose the weight over two month period and put it on six months later. We have to start thinking long-term in the post-heart attack period. And so talk to your doctor about different resources, dieticians, et cetera.

Luke Laffin, MD:

It probably goes without saying, but it needs to be said, that you also have to stop smoking if you're smoking. And if someone's smoking around you, second-hand smoke is no good either. So really making that effort, trying to find those certain therapies to try and get you off of cigarettes or cigars, whatever you are smoking is going to be really helpful. Maybe it's a patch, maybe it's gum, there are other medications that your doctor can prescribe, so important to do that as well.

Luke Laffin, MD:

Now, other factors associated with bouncing back after a heart attack include really being aware or attuned to one's mental health. We know that there can be a significant change in one's mood following a heart attack. You may have thought you were young, healthy, vibrant, active, and then bam, this stops you in your tracks. And people can be depressed. We know that people that have depression post-heart attack tend to do worse long-term. So really being aware of those signs and symptoms that may be associated with depression, okay, depressed mood, lack of sleep, inattention, just feeling overall fatigued or not yourself. It may not be the medications, it may just be more of a depression. So talking to your doctor, should you seek some further guidance? Should you start medications? These are all things that should be addressed in that period as well.

Luke Laffin, MD:

Another factor is you really want to surround yourself with support as much as possible. So talk to your family members, talk to your friends, you'll be surprised the number of them that may have already had some type of cardiovascular event, be it a valve problem, a rhythm problem, or oftentimes a heart attack, that would be very common in the United States. That's also why things like cardiac rehabilitation can be so successful. Cardiac rehabilitation is not a solo effort, it takes place in a group setting. So you get to know people that are honestly in similar situations oftentimes to yourself, okay. They live in the same geographical area oftentimes it's very similar demographics and they've all gone through, maybe it's someone's second heart attack or their second heart surgery, and so they know a little bit more about what to expect and how to bounce back ultimately. So really surrounding yourself with those supports is important.

Luke Laffin, MD:

And then finally, I think it can't be stressed enough, to really start looking ahead and don't look back. It doesn't do you any good to say, "Oh my gosh, why didn't I start that cholesterol-lowering medicine sooner?" Or, "Why didn't I start controlling my blood pressure sooner?" Or, "Why didn't I take the diagnosis of diabetes seriously?"

Luke Laffin, MD:

We can all do that and it's natural to do that, but really self-defeating more than anything else. We want to look forward, look forward to the next five years, 10 years, et cetera. As I mentioned, right at the beginning or right off the top of this discussion, mortality rates for MIs are increasingly going down or continuing to go down because of the newer technologies that we have. So we have to look forward and say, "It's not about these next six months or a year. It's about the next 10 years, 20 years." And we have patients that have had heart attacks 20 years ago and then do wonderfully for 20, 30, 40 years into the future.

Luke Laffin, MD:

So those are some of my thoughts about the best way to bounce back from a heart attack. And it was great speaking with you today.

Announcer:

Thank you for listening. We hope you enjoyed the podcast. We welcome your comments and feedback. Please contact us at heart@ccf.org. Like what you heard, subscribe wherever you get your podcasts or listen at clevelandclinic.org/loveyourheart podcast.