Your cardiac rehabilitation programme will begin when you're in hospital.
You should also have another session within 10 days of leaving hospital.
A member of the cardiac rehabilitation team will visit you in hospital and provide detailed information about:
- your state of health and how the heart attack may have affected it
- the type of treatment you received
- what medicines you'll need when you leave hospital
- what specific risk factors are thought to have contributed to your heart attack
- what lifestyle changes you can make to address those risk factors
They can also answer any questions you have about financial support, welfare rights, housing and social care.
Once you return home, it's usually recommended that you rest and only do light activities, such as walking up and down the stairs a few times a day or taking a short walk.
Gradually increase the amount of activity you do each day over several weeks. How quickly you can do this will depend on the condition of your heart and your general health.
Your care team can provide more detailed advice about a plan to increase your activity levels.
Your rehabilitation programme should contain a range of different exercises, depending on your age and ability.
Most of the exercises will be aerobic. These are designed to strengthen your heart, improve circulation and lower blood pressure.
Examples of aerobic exercises include riding an exercise bike, jogging on a treadmill and swimming.
Returning to work
Most people can return to work after having a heart attack, but how quickly will depend on your health, the state of your heart and the kind of work you do.
If your job involves light duties, such as working in an office, you may be able to return to work in 2 weeks.
However, if your job involves heavy manual tasks or your heart was extensively damaged, it may be several months before you can return to work.
Your care team will provide a more detailed prediction of how long it will be before you can return to work.
According to the British Heart Foundation, you're usually able to start having sex again once you feel well enough, usually about 4 to 6 weeks after having a heart attack.
Having sex will not put you at further risk of having another heart attack.
Following a heart attack, some men have erectile dysfunction, which may make having sex difficult. This is most commonly due to anxiety and the emotional stress associated with having a heart attack.
Less commonly, erectile dysfunction is a side effect of a heart medicine called beta blockers.
If you experience erectile dysfunction, speak to a GP. They may be able to recommend treatment. For example, you may be prescribed medicine such as sildenafil which stimulates the flow of blood to the penis and makes it easier to get an erection.
Find out more about treatments for erectile dysfunction.
If you drive a car or motorcycle and you have a heart attack, you do not have to inform the Driver and Vehicle Licensing Agency (DVLA).
Many people can now return to driving 1 week after a heart attack, as long you do not have any other condition or complication that would disqualify you from driving.
But in more severe cases, you may need to stop driving for 4 weeks.
Your doctor or rehabilitation team should advise how long you must wait before driving after your heart attack.
If you drive a large goods vehicle or passenger-carrying vehicle, you must inform the DVLA if you have a heart attack.
Your licence will be temporarily suspended, for a minimum of 6 weeks, until you have adequately recovered.
Your licence will be reissued if you can pass a basic health and fitness test and do not have any other condition that would disqualify you from driving.
Having a heart attack can be frightening and traumatic, and it's common to have feelings of anxiety afterwards.
For many people, the emotional stresses can cause them to feel depressed and tearful for a few weeks after returning home from hospital.
If feelings of depression persist, speak to a GP, as you may have a more serious form of depression.
It's important to seek advice as serious types of depression often do not get better without treatment.
Your emotional state could also have an adverse effect on your physical recovery.
Reducing your risk
Reducing your risk of having another heart attack involves making lifestyle changes and taking different medicines long term. See preventing heart attacks for more information.
There are currently 4 types of medicines widely used to reduce the risk of a heart attack:
- angiotensin-converting enzyme (ACE) inhibitors
- beta blockers
ACE inhibitors are often used to lower blood pressure, as they block the actions of some of the hormones that help regulate blood pressure.
By stopping these hormones from working, the medicine helps to reduce the amount of water in your blood and also widens your arteries, both of which will reduce your blood pressure.
ACE inhibitors have been known to reduce the supply of blood to the kidneys, which can reduce their efficiency. This means blood and urine tests may be done before you start taking ACE inhibitors to make sure there are no pre-existing problems with your kidneys.
Annual blood and urine tests may be required if you continue to take ACE inhibitors.
The side effects of ACE inhibitors can include:
- tiredness or weakness
- a persistent, dry cough
Most of these should pass within a few days, although some people continue to have a dry cough.
If ACE inhibitors are taken with other types of medicines, including over-the-counter medicines, they can cause unpredictable side effects.
Check with a GP or pharmacist before taking any other medicines if you are taking an ACE inhibitor.
It's usually recommended that you begin taking ACE inhibitors immediately after having a heart attack and, in most cases, continue taking them indefinitely.
Some people cannot take ACE inhibitors. If this is the case, a related medicine called an angiotensin receptor blocker (ARB) may be prescribed as an alternative.
Antiplatelets are medicines that help prevent blood clots. They work by reducing the "stickiness" of platelets, which are tiny particles in the blood that help it to clot.
It's usually recommended that you take low-dose aspirin, which has blood-thinning properties.
These can also be used if you're allergic to aspirin.
Side effects of antiplateletes can include:
As with ACE inhibitors, treatment with antiplatelets usually begins immediately after a heart attack.
How long you will take an antiplatelet can be between 4 weeks and 12 months and depends on the type of heart attack you have had and the other treatment you have received.
It's usually recommended that you take low-dose aspirin indefinitely.
If you experience troublesome side effects from aspirin, you should contact a GP for advice.
Do not suddenly stop taking aspirin, as this could increase your risk of another heart attack.
You may occasionally also be prescribed another blood-thinning medicine called warfarin.
This usually only happens if you have remained in an irregular heart rhythm (atrial fibrillation) or sustained severe damage to your heart.
Excessive bleeding is the most serious side effect of warfarin.
Seek immediate medical attention and have an urgent blood test if you experience any of the following side effects:
- passing blood in your pee or poo
- passing black poo
- severe bruising
- nosebleeds that last longer than 10 minutes
- blood in your vomit
- coughing up blood
- unusual headaches
- heavy or increased bleeding during your period or any other bleeding from the vagina
You must also seek immediate medical attention if you:
- are involved in major trauma (an accident)
- experience a significant blow to the head
- are unable to stop any bleeding
Beta blockers are a type of medicine used to protect the heart from further damage after a heart attack.
They help to relax the heart's muscles so the heart beats slower and blood pressure drops, both of which will reduce the strain on your heart.
It's usually recommended that you begin treatment with beta blockers as soon as your condition stabilises, and continue taking them indefinitely.
Common side effects of beta blockers include:
- cold hands and feet
- a slow heartbeat
- feeling sick
Less common side effects include:
- difficulty sleeping or nightmares
- inability to obtain or maintain an erection (erectile dysfunction, or impotence)
Beta blockers can also interact with other medicines, causing possible adverse side effects.
Check with a GP or pharmacist before taking any other medicines, including over-the-counter medicine, in combination with beta blockers.
Statins are a type of medicine used to reduce blood cholesterol.
This helps to prevent further damage to your coronary arteries and should reduce the risk of another heart attack.
Statins block the effects of an enzyme in your liver called HMG-CoA reductase, which is used to make cholesterol.
Statins sometimes have mild side effects, including:
- abdominal pain
Occasionally, statins can cause muscle pain, weakness and tenderness.
Contact a GP if you experience these symptoms, as your dosage may need to be adjusted.
It's usually recommended that you take statins indefinitely.
Everyone who experiences a heart attack will face different problems and challenges, and any guidance or advice you receive will be tailored to your needs.
There are many local and national cardiac support groups where you can meet people who have been through a similar experience.
The British Heart Foundation's heart helpline offers confidential information about your recovery and advice about how to keep your heart healthy.
Call the helpline on 0300 330 3311 from 9am to 5pm, Monday to Friday.