Rehabilitation after a heart attack

After a heart attack most people are first looked after on a coronary care unit, where heart rhythm and blood pressure are watched closely, before moving to a cardiac ward. The British Heart Foundation says the stay is usually about 2 to 5 days overall. It describes about 2 to 3 days after angioplasty or stenting and at least a week after bypass surgery.

Rehabilitation begins here rather than after discharge. Ward nurses and physiotherapists encourage short, supervised walks, and a cardiac rehabilitation nurse often visits to explain what comes next. Leaving bed early, within what your team allows, is part of the treatment because it limits muscle loss and builds confidence.

Medicines are a core part of secondary prevention, meaning steps that lower the chance of a second heart attack. The BHF lists antiplatelets, commonly prescribed for a year; ACE inhibitors or angiotensin receptor blockers, which help the heart and blood pressure; beta blockers to slow the heart rate; statins to lower cholesterol; and a GTN spray for chest pain.

Rehabilitation sessions are a useful place to ask why each tablet matters and what side effects to report. Stopping a medicine because you feel well is a common mistake, so bring questions to the team before changing anything.

The BHF suggests treating small tasks as achievements early on: washing and dressing, making a hot drink, walking round the house, or marching on the spot for a minute. Activity is then built up gradually rather than all at once.

The NHS notes that most people can return to normal activities once they have recovered, but need rest at first, including time off work. How long that takes depends on how much heart muscle was affected, the treatment given and the demands of your job, so there is no single date to aim for.

• Spread activity through the day instead of doing one long effort.

• Stop and rest if chest pain, unusual breathlessness or dizziness appears, and follow the instructions your team gave you for chest pain.

• Keep a simple note of what you managed each day to show the rehabilitation team.

The BHF describes cardiac rehabilitation as a programme of exercise and education to help you recover and live as fully as you can. Sessions include talks and information from experts, supervised exercise, regular assessments and the chance to meet people going through something similar.

Delivery varies by area. The NHS says attendance may be in person or remotely from home using video calls or apps, and the BHF publishes guided home exercise videos and an email support programme for people who cannot attend. Ask your cardiac nurse which option is available locally and whether a hybrid is possible.

Driving rules depend on treatment. The BHF says that after a successful angioplasty with no further procedure planned the gap is 1 week, while after a heart attack with no angioplasty or an unsuccessful one it is 4 weeks. It states that the DVLA does not need to be told for these situations, although other rules apply to heavy vehicle licences and your insurer may have its own terms.

Returning to work is discussed individually. Desk-based roles are generally easier to restart than heavy manual ones, and a phased return can help. Your cardiac team or GP can provide a fit note.

A heart attack can be frightening, and the BHF notes that recovery may involve fear, frustration and isolation. It describes anxiety and depression after a heart event as normal reactions rather than weakness.

The NHS advises talking to your GP if you feel anxious or have low mood after a heart attack, because treatment and support exist. Rehabilitation sessions, the BHF Heart Helpline and peer groups, either local or online, are further routes to support.

Chest pain that is not relieved by your usual GTN routine, or pain with sweating, breathlessness or collapse, needs a 999 call rather than waiting for a routine review. If you have a GTN spray, follow the written instructions you were given, and do not drive yourself to hospital.