Making a plan with your doctor

Getting regular exercise is an important part of your treatment plan for coronary artery disease. If you aren't already active, your doctor may want you to try an exercise program. Here's how you get started.

• Get any tests you need.

  Have a thorough physical exam before you start any exercise program. Your doctor may do an electrocardiogram (EKG) to measure the electrical signals that control the rhythm of your heartbeat. And you may get an exercise stress test to assess what level of activity your heart can handle.

• With your doctor, create a plan for your exercise program.
  • Your doctor will let you know what types of exercise are safe for you. An exercise program usually consists of stretching, activities that increase your heart rate (aerobic exercise), and resistance training (lifting light weights).
  • Some organizations have programs for people with heart disease. For example, many cities have senior centres that offer low-cost exercise programs.
  • When you see your doctor to create your plan, bring a list of any questions or concerns you have.
• Learn how to find the right intensity of exercise.

  Ask your doctor what level of intensity is safe for you. You can learn how to find your target heart rate and how to track it. If you've had cardiac rehab, you may know about rate of perceived exertion. Or you can try this easy way to check whether you are exercising enough, but not too much. You note how hard you are breathing.

  • If you can't talk and exercise at the same time, you are exercising too hard.
  • If you can talk while you exercise, you are doing fine.
  • If you can sing while you exercise, you may not be exercising hard enough.
• Start out slowly.

  Try parking farther away from the store, or walk the mall before you shop. Over time, you will be able to do more and more.

• Keep a record of your daily exercise.

  It's okay to skip a day now and then or to cut back on your exercise if you are too tired or aren't feeling well.

Exercising safely

Regular exercise can have lots of benefits when you have coronary artery disease. And it's very important to exercise safely. Always talk to your doctor about what level of exercise is safe for you.

When you exercise, keep the following in mind.

• Pace yourself.

  Exercise at different intensities. Rotate light workouts, such as short walks, with more strenuous exercises, such as low-impact aerobics or swimming.

• Avoid outdoor extremes.

  Don't exercise outdoors in extreme temperatures, high humidity, or poor air quality. When the weather is bad, exercise indoors at a gym or walk at a mall.

• Don't hold your breath.

  Avoid exercises that require or encourage you to hold your breath. These include push-ups, sit-ups, and isometric exercises. Also avoid heavy lifting.

• Be aware of your symptoms.

  Stop exercising and rest if you have palpitations and angina symptoms. Also stop if you find it hard to breathe or you get dizzy or light-headed. Call your doctor if these symptoms don't go away.

• Be careful if your medicines change.

  Ask your doctor about continuing your exercise program if your medicines change. New medicines can affect how you feel when you exercise.

• Measure your heart rate.

  Keep your heart rate where your doctor wants it to be. Take your pulse often, or wear a heart rate monitor. Watch your pulse when you walk up hills or stairs.

• Adjust your exercise program if needed.

  Make sure you adjust your exercise program if it is interrupted for more than just a couple of days. Bit by bit, increase to your regular activity level.

Stretching

It's best to warm your muscles a bit before you stretch them. Walk or do some other light aerobic activity for a few minutes, and then start stretching.

Do all stretches gradually. Don't push or bounce the stretch. You should feel a stretch, not pain.

Breathe normally as you stretch. Don't hold your breath. If you like to time your breathing with your exercise, you can breathe out as you stretch, breathe normally in and out 2 or 3 times as you hold the stretch, and then relax. This will mean each stretch takes 15 to 30 seconds.

Doing resistance exercises

Resistance training is often done with weights. Before you start, talk with your doctor about what level of exercise is safe for you.

Start with a weight that you can easily carry through the required range of motion. You should only increase the resistance when you can comfortably do the exercises and weights that you've been using for a few weeks. If you have angina, heart failure, or other heart conditions, you may increase the number of times (repetitions) you do each exercise, but keep the resistance the same.

Your movement should be slow and controlled at all times. If you feel that you can't control the resistance, decrease the resistance or lower the weight. Don't strain. Stop exercising if you feel symptoms such as dizziness, unusual shortness of breath, or any form of pain.

Repetitions and sets

Repetitions are the number of times you perform each exercise. For example, if you lift a dumbbell up and down once, that's 1 repetition (or rep). If you lift it 5 times, that's 5 reps. Sets are the number of times you do a certain number of repetitions. For example, if you lift the dumbbell 15 times, take a rest, and then lift it another 15 times, you have done two sets of 15 reps each.

Making exercise part of your daily routine

Getting exercise might be easier if you can find ways to fit it into your daily routine. Here are some tips.

• Get up 15 minutes early, and stretch.
• Find ways to walk.
  • Walk or jog in place.
  • Take a walk at lunchtime or after dinner.
  • Use the stairs instead of the elevator.
  • Walk to a co-worker's office instead of calling or emailing.
  • Get off the bus one or two stops early, and walk the rest of the way.
  • When you go shopping, park farther away from the store.
  • Take a brisk walk around the mall before you start to shop.
  • Walk the dog.
• Do active chores.
  • Wash your car by hand instead of driving through the car wash.
  • Wash the windows.
  • Work in your garden or yard.
  • Use a push mower instead of a riding mower.
• Lift light arm weights.

  For example, do it while you talk on the phone.

• Find active things you enjoy.

  For example:

  • Ride a bike.
  • Work out to an online exercise video, or use a fitness app.
  • Go dancing.
• Try to be active as a family.

  For example, play tag or catch, and take active holidays.