STEP BY STEP GUIDE OF

- - ....

WH A T SHOULD YOU EXPECT

A FTER A A DI GNOSIS OF

HEA A RT DISE SE

JC Alencastro  

Athletic Trainer Physiotherapist

Heart Disease in any form
is Frustrating...
 If you are reading this guide then
you've probably already done a
lengthy search on Google or WebMD.
A new diagnosis of heart disease can
be overwhelming, and each day and
activity is a learning curve. 

I know it's difficult accepting you've had a significant

health scare, but please fight the tendency to play things
down. 
In my practice I work with clients, who wake up in the
middle of the night and start to think...."what if it happens
again?"
They frantically search for answers on the internet and
think about the latest statistics they read, every time they
grab an aspirin before heading out the house.
"What can I expect?", they mostly ask. "How will the rest
of my life play out?"
The truth is I don't know.
And neither does your doctor...or Google...because there
is no crystal ball that guarantees what's in store for your
future whether you have heart disease or not.

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This shouldn't be surprising. I'm sure you've already
compared yourself to others you know with or without a
similar diagnosis and found that...
You have a different family medical history.
You have a different presentation.
You have a different support system.
To be honest you have so many things as an individual
going on that it's impossible to predict what you'll
experience.
So what we are going to focus on are the things we do
know through proven research, that improve your
symptoms, help prevent heart attacks or surgeries, and
maintain your independence. 
You have the power to choose your path through
educating and empowering yourself. 

Most people tend to want to change their lifestyle, when

the disease is too advanced....But I'll tell you this: the
people who are invested in their own health as you are
(because you're reading this) are the ones who have the
best outcomes. 

Here we go...

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Lifestyle Modification is Key
"All of these changes we have to make in our lives
are not easy, but I know now that all of the
changes I have made are worthwhile."
-Heart Attack Survivor-

#1. Stop Smoking- Now! 

By now you're probably already aware that smoking is one of the main risk
factors for heart disease. But you already have it, so "what's the point of
quitting now ?" You probably feel skeptical about how much it would actually
help you if you stopped smoking at this point. 

WHY EXACTLY IS IT BAD...?

smoking increases the blood's tendancy
to form clots by turning on the clotting
cells (this is the cause of a stroke or
heart attack).
the chemicals in tobacco increase your
bad cholesterol (LDL) and bring down
the good cholesterol (HDL) in your blood
(this plaque is what narrows your
arteries and makes it harder for blood
to flow through to your heart).

This Will Cause You A High Blood Pressure

The blood flow in your arteries is comparable to driving a car on the highway,
it will run into traffic. This via the blood clots or the narrowing due to plaque
buildup from the bad cholesterol. It makes your heart have to work harder and
increases the pressure to try and get the blood through the "traffic jam". And if
the blood carrying oxygen can't get by, then the heart cells die and a heart
attack happens.

What life changing decisions have you already had to make

because you didn't quit smoking and prevent your heart
disease? That annual physical you failed that made you
retire early from your job? That very expensive bypass
surgery or stent placement you had to have?

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 YOU'VE TALKED ABOUT WANTING
TO QUIT. "ONE OF THESE DAYS", YOU
SAY, "I'M GOING TO DO IT. I JUST
NEED TO FIGURE IT OUT."
 " After not Now of course this is great to prevent your first heart
attack, but even more important for you if you've already
smoking for one had one or been diagnosed with heart disease.
year, you actually   
reduce the risk to    1. First, you should agree on a quit date with your doctor
and write down your reasons for quitting ( 'Is This Worth
your heart by Another Heart Attack', 'I Want To See My Grand kids
more than 50%". Graduate'...) 
  
  2. Ask your doctor for quit aids you can use. You have
options like Nicotine replacement therapy (patches, gum,
nasal spray, inhalers) and Bupropion SR (an anti-
depressant) can be used to help you quit smoking in the
case of any withdrawal symptoms. 

  3. Make friends and family aware so that they could help

you cope with challenges to sticking with your goal. It also
helps them know not to smoke around you so that you
don't get tempted into buying cigarettes or wanting to
smoke.

  4. Throw away all the cigarettes, lighters, matches, and

ashtrays in your home, car, and place of work.

  5. Sign-Up for SmokeFreeTxT, text-alerts have been a

validated strategy to help you quit smoking. You'll receive
encouragement, advice, and tips that will help you quit for
good. Constantly being reminded about quitting will help
you stay on track.

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 #2. Start Exercising Now! 

Exercise Is Medicine
    As you enter this new phase in your life, living with heart disease, you will notice
that one of the most powerful things you could do is Exercise.

                     This Is A Part Of Your Life Now, And Should Be Looked At As A

                                  Vital Dose Of Medication That You Shouldn't Skip. 
  
   Of course I'll admit, there will be times when your body protests severely, but you
have to push yourself through it. We all have a "What if...?" regret in our lives, don't be
the person who has them again and again. Trust me....You'll feel better afterward. The
rewards will continue to benefit you if you keep at it. 

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    Even if you don't know how to structure an exercise plan, just get moving more.
Walking is a great way to increase your physical activity, and the best thing about
it....is it's FREE.
    The secret is to gradually increase your activity so that you don't overdo things.
This will help you stay motivated and not feel discouraged.
    You can easily start right at home by doing more of your daily activities (like
personal hygiene and dressing) by yourself without any help.
    Of course there are recommendations out there, for example up to 150 minutes (2.5
hours) of moderate intensity physical activity is recommended by the guidelines. This
can be done in 5-10 minute bouts throughout the day or how ever you'd like as long as
you reach 150 minutes by end of the week. 
    These are just guidelines however, I don't want you to get boggled down on having
to hit that target as the end all. 
     These days step-counters are a popular little wonderful gadget that keeps track of
how many steps you take throughout the day (10K/daily recommended steps). Did you
know taking a few hours in the morning to do some house tasks can equate to
about 4K-6000 steps. So it just goes to show you that physical activity and/or
exercise doesn't have to be complicated at all, as long as your heart is working harder
than it would be when you're either standing still or lying in bed. 

Well What If I Had A

Surgery Or Heart Attack
     Don't you worry, it is absolutely okay to increase your physical activity.You will
probably already be doing so every time you move around while lying in bed,
performing your personal hygiene, wash, dress, get in and out of a chair. This is why,
without a doubt I advise you to start early-on doing many of these things on your own.
As you'll be not only exercising your heart but also working all the muscles in your
body. 
     Now for those of you wanting a complete cardiac rehab program that includes
strength training, they usually start during the following:
Coronary Artery Bypass Graft (CABG)- 6-8 weeks to allow your sternum bone to heal
after the surgery.
Myocardial Infarction or Unstable Angina- 4 weeks after deemed medically stable.
Percutaneous Coronary Intervention/Stent/Angioplasty- immediately after.
The Number #1 type of activity you can do regardless of what I stated above......
                                                             WALKING

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 #3. Know Your
Numbers
200mmHG
It's very easy to over complicate things regarding your
blood pressure. I frequently get asked "If exercise is
150mmHG
supposed to help lower my blood pressure, why is it
so high when I try and do a bit more physical activity?" or
100mmHG
"Will my high blood pressure cause a stroke or heart
attack?"
50mmHG
First, lets get down to some basics, so that we are all on
the same page.
0mmHG
The graph on the left shows you what the normal
progression of your systolic BP (top number), should look
BP
ic
ol
st

like when you're increasing your physical activity. 

Sy

What does this all mean you're probably asking

yourself. Well the truth is this is all just a guide or
Normal cheat sheet for you. Because, for your target blood
pressure your doctor might be happy with
Resting Systolic BP: 85 to < 130 mm HG
 a top number of 150 over a bottom number of 90
Resting Diastolic
A normal restingBP: 60 to
blood 90 mm (BP) 
pressure HG
mm HG. As you can see to the left, that number is
85 to <130mm HG/ 60 to <90 mm HG above the "normal". It's okay...And it's also ok for
Your bodies response to
your BP to rise when you're physically active like
Activity Systolic BP: Progessive     with
the chart above shows, as long as it follows a
intensity of activity.
gradual progression. Your BP will also be increase
Activity diastolic BP: +/- 10 mm HG
if you gain a large amount of weight, drink
excessive alcohol or eat a high salt diet (which we
will discuss later).

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Heading into the next day after surviving a
heart attack is nerve wrecking. Now
imagine you are 2 years after and still
having anxiety when your heart is
bouncing around 140 BPM.

No matter what you fear you

have to accept that you
Normal
simply have to live with this
Adults / Seniors: 60-100 Bpm
and recognize it is NOT the "Resting"
worst thing that can happen
Abnormal
to you. Knowing what your
heart rate (HR) numbers SVT/ Tachycardias: > 100 Bpm
should be is the first step to Bradycardia: < 60 Bpm

control and having peace of

mind.

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www.physicallyempowered.com
 Cholesterol
Monitor Your Lipid Panel
Especially If You Are On
Medication
It's good to keep an eye (really two eyes) on your cholesterol. It's especially important if you've
Normal
been prescribed meds for it like atorvastatin. You want to make sure that the drugs are still
doing what they are meant to do for your cholesterol levels (lower it), and also you want to see
if the lifestyle modifications you've made are having a positive affect on your total cholesterol.
If you are lowering your cholesterol levels enough withAbnormal
lifestyle changes, then there could be a
chance your doctor may take you off the medications. 
So how do I understand my blood work?, you ask. 
Well below I have provided you with what "normal" levels should look like. You can then
compare this to the lipid profile your doctor prints out.

Type Normal
If your numbers
are above these
Total Cholesterol < 200 mg/dL
normal values, you
are at higher risk
HDL (Good) 40-60 mg/dL
of further damage
< 100 mg/dL  to your heart.
LDL (Bad)

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4. You Have To Eat Differently

Healthy eating is an important factor in helping to reduce your risk. You should
ask your doctor for an individual consultation to discuss your diet. Healthy eating
advice should be tailored to your needs but can also be extended to the whole
family. 

Cholesterol
1. High Sodium or salty foods lead to high blood
pressure. This happens because sodium makes your
body retain water increasing the pressure within
your blood vessels. 
-If you have a hard time eliminating salt from your
diet then aim to eat 3-6g of salt per day. One gram
of sodium is about 1/2 tsp of salt.
-Studies have shown that if you reduce 1700 mg of
sodium from your diet it can lower your systolic BP
by 4-5 mmHG.
Normal
2. Eating a Mediterranean style diet has been
validated as one of the best ways to eat for heart
health and to prevent a heart attack. 
Abnormal
What Should You Eat

Fruits- At least 5 portions/day

Vegetables- At least 5 portions/day
Bread- (wholegrains)
Nuts & Legumes- 4-5 portions/week
Fish (herring, sardines, mackerel, salmon, trout,
tuna)
Olive Oil (used mostly to cook everything)

This diet includes less red meat (2-3 portion/week)

and relies mostly on fish.

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 Make The First Move
If you are educating and empowering yourself tomorrow can be a better
day then today is. 
Use this guide and consistently apply it everyday. 
You'll realize that you will improve your independence and life in the
long term.
Take these small steps and gain momentum.
If you found this helpful and want to learn more about how to
continuously improve your heart health...………

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Normal
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