Heart Attack (Myocardial Infarction)

• Exercise training: A customised exercise programme to safely improve cardiovascular fitness.
  
  
• Health education: To provide the patient and family members with information on heart attack, its signs and symptoms and its risk factors.
  
  
• Risk factor and behaviour modification: Practical steps in risk factor and behaviour modification will be taught. People who smoke are strongly encouraged to stop and are given advice on how to do so. Stress management is also important.
  
  
• Dietary modification: The patient will be advised to adopt a healthy diet. For instance, food high in cholesterol and saturated fats such as animal fats, whole milk products, eggs, red meats (beef, lamb), coconut oil and palm oil are to be avoided. Healthy food alternatives will be introduced, e.g. low-fat milk or lean meats. Healthy food preparation alternatives will also be introduced to the patient or family members. For example, the use of canola or olive oil and boiling or steaming food instead of frying.
  

• Reduce the risk of a second heart attack
• Relieve chest pain.
• Control risk factors like diabetes, high blood pressure or high cholesterol.

Work

This depends on the nature of a patient’s work. If the work is not physically demanding, the patient can resume work in a few weeks. For a physically demanding or stressful job, the patient may need up to three months away from work. The patient should consult his/her cardiologist regarding his/her suitability for resuming work.

Driving

The patient should consult with his/her cardiologist regarding his/her suitability for driving, especially if one drives commercial vehicles.

Many patients will be able to drive within three to five weeks after the heart attack if they recover well with no complications. However it is best for someone to accompany the patient initially.

Sports

After a heart attack, patients are advised to have adequate rest. The road to recovery of cardiovascular fitness is gradual. The intensity of exercise should be gradually increased.

The patient may start exercising or walking on flat ground in the third week after the heart attack, and may start climbing or do gentle uphill walking from the fourth week. Normal brisk walking can usually resume in about three months.
If a patient experiences chest pain, discomfort or shortness of breath while walking, they should slow down and stop. Report the symptoms to the doctor. The patient should consult his/her cardiologist regarding the specific time frame for resuming normal sporting activities.