© 2017 VitalityCardiology

David Freedman Medicine Professional Corporation

6633 Highway #7 East, Markham

Tel: 905.472.7127   email: Ashgrove@cardiomatters.com

398 Steeles Ave West, Thornhill

Tel: 905.881.0334  email: Steeles@cardiomatters.com

EXERCISE

In the beginning, It is always a good idea to spend some time with a personal trainer. A professional who will be knowledgable in the activity which you are looking to do, and can define your areas of strength, as well as your weaknesses which you must be wary of when starting something new. If you are aware that you have an area of weakness or a limitation, then you can design a program which will avoid injuring yourself. Young people tend to recover quickly from an injury, whereas the rest do not.

Exercise is important both for healthy people as well as for people who already have heart disease such as coronary artery disease, congestive heart failure, post-bypass status, post-angioplasty status, etc.

Patients with heart disease can benefit a lot, and should not be afraid to exercise. However, they need to speak with their cardiologist first or enrol in a cardiac rehabilitation program wherein they may receive adequate supervision. It is also important for any patient who is  considered to be at risk for coronary disease to undergo a proper assessment before engaging in an exercise program. Examples of patients at risk include patients with heart disease, diabetes, multiple cardiac risk factors, etc. There are also noncardiac risks which may also be addressed at the time of assessment including but not limited to, underlying lung disease, musculoskeletal imbalances/deficiencies, general physical condition, etc. Patients with some of these problems may need to adopt a gentler type of exercise program wherin they "start low and go slow" relative to the healthier type of patient.

It is important to remember that adequate rest and proper nutrition are also important in order to provide the body with the essential nutrients that it requires as well as the opportunity for the muscle to recover (and to grow).There are three types of exercise, each of which can be used to achieve different goals. It is best to combine the different types of exercise, so that your body can benefit from each of these targets. It also helps you to avoid getting bored. 

Flexibility exercises allow for improved range of motion.

Aerobic exercises improve cardiovascular health and increase the odds of you living longer.

Strength training allows for muscle development and may be achieved with the use of weights, resistance bands or isometric type exercises. These weight bearing exercises also help to promote increased bone density which in turn helps to reduce the risk of bone fractures later in life.

Cardiology guidelines vary from source to source, but generally they often  recommend that cardiac patients exercise a minimum of 30 minutes per day, at least 5 days per week. The exercise program should attempt to include a moderate aerobic workout aiming for a target heart rate of 65-70% of the age-related target heart rate.  Strength training is important as well, and has been shown to add to the benefits of endurance type exercises. In reality, many sports or coordinated activities combine elements of each of these forms of exercise.  

A warm-up phase is important because it helps to gradually prepare the body for the workout. A cool-down phase is very important because it allows for a gradual "return to normal" of ourbreathing, blood pressure, heart rate, etc. This period of "slow exercise" is also thought to assist in the removal of metabolic waste products (ex lactic acid) which would have built up during the workout. It is also thought to be important in helping to avoid dizziness.

  • During exercise, the heart generates a blood flow throughout the body which is affected by  the heart's pumping function (pressure), the fact that the peripheral veins are distended,  and the fact that the moving limbs actively squeeze the blood back towards the heart so that it can be pumped out again in the next cycle. If the patient abruptly stops exercising, the heart would continue to beat fast, but would no longer receive the same volume of blood  returned to it due to blood now pooling in the inactive limbs. As a result, the blood flow pumped out would drop and the blood pressure would drop. So, the absence of a cool-down may make some patients prone to dizziness. By continuing a phase of slowed exercise, you maintain a match between the fast heart beat and the blood volume being recirculated and avoid dizziness. Each patient may require their own tailored cool-down depending on their blood pressure pattern, their level of fitness, and the nature of their exercise.

 

It is extremely important to remember that physical activity is a necessity and not simply something that we can afford to neglect. If we can remember to devote some time to this, then we can benefit on several levels.