what are the limits of excercise after heart attack?

[hartgeeza]

I am 41yrs old male and had heart attack 100 days ago - there was blockage of LAD and a drug eluting stent put in. My echo 4 weeks after event was very good, heart is beating very strongly and LV function is fine, ejection fraction is high 55 or 56.  I stopped smoking and am nearly at the end of cardiac rehab -  2 sessions left - I feel great.
I would like to cycle properly and regularly but I cannot get a straight answer from anyone - what kind of heart rate can I sustain?
Can I build up to higher levels of exertion and heart rate of 160+ or can I never do that again? Is  140 going to be too much? Should I only ever keep my heart rate as low as 130 for the rest of my life? Can I never try to sprint or jog fast?
Also - if I wanted to cycle 4 to 5 hours without stopping is that going to be ok or should I never try? Currently cycling 1/2 paced for 30 minutes isn't enough for me and I cant lose weight like that. Many Thanks.

[Flycaster305]

No.   It was a few years ago.

[ed34]

So at the time you passed out, was that when your bypass vessels collapsed?

[Flycaster305]

I'm in exactly your situation right now, two of my three vessels have  shut down, but I assure you I couldn't achieve exercise at a high level right now.  At the time I passed out, I had just been prescribed a small beta blocker, and it was determined I just pushed the envelope too far.

[ed34]

To be fair, it all depends on the condition of your heart. If you have recurring blockages and further attacks, then I would agree. What confuses me is what happened to your heart to cause you to pass out with only 150bpm? Did some plaque break loose? It must have been a sudden severe event because if a blockage is forming, you would certainly feel symptoms and be able to stop.
Even when two out of three of my bypass vessels suddenly shut down, I was still wide awake and alert. Do they know what the cause was?

[Flycaster305]

After my second heart attack and blockage/stent in the LAD, I was also confused how high to get my heart rate at age 60.  I was in pretty good shape for an old guy, used to exercising daily, a BMI of about 26.  I was told to use the formula of 220 - my age, and use 80% of that total as a maximum heart rate, about 130.  I would use a Pulsar monitor to keep within that limit, but grew impatient one day, and decided to test the limit.  I remember hitting 150 bpm then the next thing I remember was being in an ambulance, I passed out.  I was told a blockage of the LAD is a serious matter, and pushing the envelope after such an event was dangerous.  After a heart attack, one has heart cells that are stunned surrounding the dead heart muscle, and a gradual increase in exercise/blood flow can revitalize those stunned cells. However, a sudden increase in exercise can be counter-productive.
I'd have patience, and ease back into your regular routine.

[ed34]

Hi
   I found cardiac rehab a bit cautious, but I guess I can understand that. After my first stent, I still had known issues and they complained if my HR exceeded 140 and told me to ease up. After my triple bypass, I had to go through rehab again but then things were very different. My heart rate would accelerate to just over 180 very quickly and I felt fine. Of course, they were running around like headless chickens telling me to sit still for a while and relax. My heart rate was dropping from 186 to 90 in around 1 minute, and then to 68 after another minute or so. I was getting fed up because it seemed I couldn't do anything. Anyway, I had a cardiologist outpatient appointment and I discussed this problem with him. His words were "Your heart is healthy and as far as I'm concerned, because it gets to 180+ quickly with no symptoms and slows down very quickly, I would say these are all excellent signs". I told this to cardiac rehab and they still took no notice. The cardiologist said if I feel no symptoms, then exercise is no issue. The symptoms are the key to if there is an issue to be concerned about, so no symptoms means there is no issue.
My EF has always been 70.

[oldhaus]

I'm 54, had one 90% blockage that I got a stent for, & 2 others @ ~ 50% they're "treating medically" ... I finished the 2nd stage rehab ~6wks ago.  I try to get out & walk, but the HEAT just zaps me.  If I try to do my weekend chores (gardening, construction, what ever) I can do ~ 1 hr & I'm done.  I used to be able to do 10-12 hrs...  I know some of it is the beta blockers ... and the extended release nitro that I'm on... I got my own BP machine, with a USB interface so I can keep a record... I can take it in to my cardiologist or GP when I go to see them.  Me they're worried about low BP so ... I can do a 80/56 & be alert/walking/talking, but that worries them. :)

Talk to your GP... remember Medicine is still "a practice" ..... it's all they can do, statistically guys like you can ... that's all they can say.

It's life... do some Mindfulness Meditation, that will help you understand...

Hang in there.!   JLH