Physical exercise should be a regular part of everybody’s daily life and patients with congenital heart disease (CHD) are not an exemption to this fundamental principle. The benefits of exercise for CHD patients within reason outweigh any perceived risks. Physical activity improves health, exercise tolerance and quality of life. Exercise training is, for most patients, a high-benefit/low-risk intervention.
Exercise is not only important for your physical health, it can also have a positive impact on and improve mental well-being, sleep, stress and anxiety. Exercise should be introduced to patients with CHD and their families early in life, so as to become routine.
Patients with CHD have, in the past, been asked to restrict physical activity, often on medical advice as a way to protect themselves. But the sedentary lifestyle associated with self-protection also leads to a decline in physical activity and puts them at risk of early cardiovascular and other diseases. So on balance, daily exercise is a great investment to pursue for life for all.
Most people will want to strive for 30–45 minutes of moderate-intensity aerobic exercise two to three times a week, alongside muscle strengthening exercises at least twice a week. Supplementing these days with activities such as walking or cycling (outdoors or on a stationary bike) is a good thing to do.
However, there are a few exceptions. For example, it is advised that a patient with an enlarged aorta (a major artery in the body) does not engage in strenuous activities, such as those that involve straining or grunting - like heavy weight lifting which can cause extreme elevations in blood pressure, or activities that carry a high risk of bleeding (especially if you are on medication that reduces your blood's clotting ability). Additionally, any contact sports that could cause direct trauma to the chest should be avoided.
Therefore, it is best to discuss with your cardiologist or clinical nurse specialist so the advice is personalised for your specific heart condition and according to any changes in your clinical condition. Your health care professionals may want to carry out some tests such as an exercise test on a treadmill or bike, a Six-minute Walk Test or an echocardiogram beforehand.
There are a number of benefits associated with exercise. It can help you:
- Manage high blood pressure (hypertension)
- Improve unhealthy cholesterol levels
- Achieve and maintain a healthy body weight
- Improve mental and emotional states and quality of life
- Decrease morbidity and mortality associated with cardiovascular disease
- Maintain functional fitness as you get older and improves self-confidence and body image
- Increase the efficiency of your muscles so they require less blood flow from the heart
- Reduce the risks of coronary heart disease
- Strengthen the heart muscle
- Improve skeletal and diaphragmatic muscle strength
- Improve sleep.
The best and safest types of exercise are 'aerobic' activities. These increase the heart rate and make you breathe heavily, such as:
- Brisk walking
- Cross-country skiing,
- Stair climbing.
Other Aerobic activates includes team sports such as:
A good rule of thumb is to increase your activity so you breathe hard and fast but can still carry on a conversation with someone. If you can speak in full sentences but still feel your heart pounding, you're likely to benefit from a safe level of physical activity.
It is important to start slowly and gradually, and increase the duration and intensity of your physical workout. The key is to listen to your body and stop if something does not seem right. The goal of exercise is to make you feel better. Remember to drink plenty of water when exercising to prevent dehydration.
You should be able to feel your stamina and breathing patterns improving after a month or two, alongside a decrease in your resting heart rate, following a routine exercise plan. All in all this will be a good short and long-term investment for you.
Useful resources about exercise:
The Somerville foundation
British Heart foundation