Physical training for coronary heart disease. For coronary heart disease Walking for heart disease

For example: even very sick patients awaiting a heart transplant should exercise twice a day. Naturally, such patients are not able to run. The training consists of walking and therapeutic exercises. Some patients are only able to move in bed, transfer to a chair, and move around the room. However, if you don't train, your chances of survival while waiting for a heart transplant are significantly reduced. We can say that the more severe the patient’s condition, the more he needs regular, feasible physical training.

Bed rest is indicated only during acute illnesses, as a rule, no more than 2-3 days. At the slightest improvement in the condition, physical therapy and walking are prescribed. Even with myocardial infarction, physical exercises begin from the second day. The main danger of so-called “planned” hospitalizations for patients is a decrease in physical activity.

The principle of physical training is very simple - daily or 4-5 times a week, approximately continuous movements of such intensity that slight shortness of breath and fatigue are noted. The simplest thing is brisk walking.

According to American recommendations, it is enough to walk 2.5 km daily in 30 minutes. You can walk in the apartment, and even on site. The heart needs a rhythmic, continuous load. Loads associated with static tension, especially straining, should be avoided. If the patient is able to run, you can use light jogging, approximately 2-3 km per minute. You can even run around the apartment, in this case the possibility of overload is practically excluded (as Academician Amosov said: “Turn on the TV and train”). Immediately before walking or running, you need to do a short warm-up in the form of gymnastic exercises - stretch all the muscles and joints. During the training process, alternating walking, running and gymnastic exercises is also useful. You can start with 5 minutes a day. Then gradually, depending on how you feel, increase the load and duration of training per day. You can divide the load, for example 10 minutes 3 times a day. In just 1-2 months you can significantly improve your physical condition, performance and well-being.

In addition to walking or light jogging, you can swim in the pool or train on exercise machines.

During exercise, the heart rate, which is determined by the pulse rate, should be between 100 and 130 per minute. A simpler way to assess the intensity of physical activity is the state of breathing: there should be slight shortness of breath, while the trainee could speak freely (“conversational criterion”). In this case, the intensity of the activity is optimal.

One of the techniques that increases the effectiveness of physical rehabilitation: against the background of physical training by walking or running, in addition to them, perform squats daily (or half squats with your hands resting on your knees - depending on the condition of the joints and fitness) - starting with 5-10 squats per day, each increase the number of squats by one for a week - in a year there will be about 50 squats every day. Agree that this is not so bad.

Some patients, after a year of training, continue to add one squat per week, then by the end of the second year the number of daily squats reaches 100. Particularly severe patients can increase the number of daily squats not every week, but every month. Then by the end of the year there will be about 20 squats a day. Such a program disciplines patients, motivates them to make small but regular efforts, and often within a year there is a noticeable improvement in well-being and increased performance.

In the process of physical training, the entire cardiovascular system as a whole is trained. The myocardium is trained, vascular function improves, muscles extract more oxygen from the blood. In patients with hypertension, blood pressure decreases or normalizes. The content of “bad” cholesterol in the blood decreases and the level of “good” cholesterol increases, and the tendency of the blood to form blood clots decreases. Without the inclusion of physical training, any treatment program for any disease will not be effective enough.

It is advisable to perform gymnastic exercises with movement in all joints during warm-up and at the end of training. We can recommend the following sequence:

♦ movements with the hands (clenching and unclenching the fingers, turning, bending and straightening the hands),

♦ movements in the elbow joints (flexion and extension of the ARM),

♦ raising the shoulders and rotating the shoulders forward and backward,

♦ arm movements (claps hands above the head, rotating arms forward and backward), head movements (bending forward and backward, to the sides, turning the head),

♦ squats (or half squats),

♦ bending the body forward (you can do small half-bends),

♦ bending the body back,

♦ bending the body to the sides,

Part III. Treatment methods for cardiac patients

♦ turns the body left and right,

♦ raising on toes.

The pace and amplitude of movements depend on training. Some patients are able to perform, for example, full squats at a fairly fast pace, others - only slow half-squats, resting their hands on their knees, holding the back of a chair or the edge of a table. Academician Amosov, starting from the age of 35, repeated each of the exercises 100 times daily. Amosov believed that 100 repetitions are enough to prevent joint diseases, and if the joint is already diseased, no less movements are necessary for each diseased joint. It is not necessary to immediately do 100 repetitions continuously, you can do 10 times 10 repetitions or, for example, 25 times 4 repetitions. With the help of such gymnastics, you can provide sufficient training load not only on the joints, but also on the heart, if you move from one exercise to another without breaks for rest (or with breaks in the form of walking).

Additionally, to train the abdominal muscles, you can use the following exercise: from a lying position on your back with slightly bent legs, simultaneously lifting your head, shoulders and legs about an inch from the floor. Experts at the Texas Heart Institute believe that this exercise allows you to “burn” belly fat. You can divide this exercise into two stages: separately raising the legs and separately raising the head and shoulders.

Strict adherence to these rules allows you to achieve exceptional results. Even with severe illness, atherosclerotic lesions decrease and the structure and function of the heart and blood vessels improve. Unfortunately, practice shows that only a very small number of patients are able to follow these recommendations. But there are no other ways to maintain or improve health.

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Is it possible to exercise if you have coronary heart disease?

Insufficient oxygen supply to the heart due to narrowing of the arteries and their clogging with plaque leads to the development of coronary heart disease (CHD).

There can be many reasons: alcohol abuse, poor diet, a sedentary lifestyle that contributes to the development of physical inactivity, constant stress and overwork, smoking or bad heredity.

Sports and coronary heart disease are a good combination, because thoughtful exercises that take into account the recommendations of specialists help patients restore vitality and fight the disease.

• All information on the site is for informational purposes only and is NOT a guide to action!
• Only a DOCTOR can give you an ACCURATE DIAGNOSIS!
• We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
• Health to you and your loved ones!

You should never give up; people, even with the most terrible diagnoses, often live to a ripe old age.

What is the benefit

Exercise is beneficial for the body as a whole. People suffering from a variety of diseases, including coronary heart disease, make a huge mistake by completely giving up exercise.

After all, regular exercise, doing simple exercises, and leading an active lifestyle can improve your health and achieve visible results:

• Lose excess weight by burning fat, which ultimately reduces the likelihood of developing or progressing diabetes;
• be able to stay in good shape and form even in stressful life situations that require maximum endurance and patience;
• normalize the content of triglycerides and cholesterol in the blood, due to which the likelihood of developing atherosclerosis is significantly reduced;
• prevent disorders of bone metabolism, as a result of which older people suffer from frequent fractures due to low bone density and increased fragility;
• reduce the likelihood of vessel damage, which causes the formation of a blood clot and the development of pathological processes;
• improve well-being, lift your mood, normalize sleep;
• reduce the likelihood of cerebral hemorrhage by stabilizing pressure.

Daily physical activity can prevent the development of many diseases. The main condition is not to wait for the first symptoms to appear, but to immediately take care of your health. This is not only about physical activity; in parallel, it is advisable to quit smoking and minimize the consumption of alcoholic beverages.

Each disease requires an individual approach when choosing the type of load and frequency of exercise. Atherosclerotic plaque, the formation of which is the main cause of oxygen starvation, narrows the arteries responsible for cardiac blood supply.

As a result, coronary heart disease develops, in which you can only resort to certain physical activities.

You will find a description of coronary artery disease and angina pectoris 3FC here.

If you are overactive, the heart muscle, suffering from a lack of oxygen, may not be able to withstand the load, which contributes to the development of angina pectoris.

Depending on the severity and progression of the disease, medication or surgery may be required

The worst case scenario is a heart attack, which can sometimes be fatal. Having survived it, some people begin to be afraid to take the extra step so that the heart attack does not happen again, not realizing that they are harming their health even more.

A person suffering from coronary artery disease will benefit from daily 40-minute light workouts. Once every three days you need to take breaks, the approximate total number of classes per week is 5. If you overdo it, strong physical activity can only do harm. The result is an attack of angina or a heart attack.

The benefits of moderate physical activity in the development of coronary artery disease are as follows:

• Strengthening of heart vessels, clogging and narrowing of which resulted from the development of atherosclerosis. The level of good cholesterol in the blood increases, and the development of heart failure subsides.
• People who have had a heart attack are 7 times less likely to have a heart attack again. The mortality rate decreases by 6 times. The data was obtained through research by experienced doctors who compared the performance of people who were active and those who preferred a sedentary lifestyle.

You can also give a lot of arguments showing that sports and coronary heart disease are a sure way, if not of getting rid of the problem, then certainly of stopping the active progression of the disease.

Walking is an integral part of any rehabilitation course. If there is no deterioration in the condition, their duration gradually increases. The same is true with physical activity. The main thing is not to overdo it, so each lesson should be carried out under the supervision of a specialist.

During the rehabilitation procedure, the patient experiences increased heart rate. This is normal if, when performing physical activity, this figure increases by no more than 20%.

Its increase to 30% is allowed only in the case of a positive effect of rehabilitation after increasing loads. Depending on the age of the patient, individual lessons are prescribed.

Before discharge, the doctor may additionally prescribe a course of medication and indicate the frequency of visits to the attending physician. And the main condition that is stipulated is the performance of light daily housework.

You shouldn’t wait for symptoms of serious diseases to appear; you need to regularly take care of your health and lead an active lifestyle, eliminating bad habits as much as possible.

The importance of sports and forms of coronary heart disease

Many cardiologists and professors are conducting their own developments in the field of treatment, prevention and rehabilitation of patients suffering from coronary heart disease.

Russian professor Aronov D.M. developed his own methodology, according to which patients were divided into four classes, influencing the list of physical activities intended for them.

Forms of manifestation of angina depending on the functional class of the disease:

According to the theory of the leading Russian specialist, patients of the first functional class are recommended to exercise daily physical activity, perform housework and garden work.

At the same time, you should avoid overwork; if you begin to feel weak or your pulse increases sharply, it is better to postpone your planned activities until the next day.

Patients belonging to the second and third functional classes should slightly narrow their type of activity, refusing to do housework in an uncomfortable position, or long walks at a brisk pace. In this case, the intervals between physical activity should be increased and their duration reduced.

Patients belonging to the fourth functional class should completely refuse to perform physical activity. Any heavy lifting or walking can cause another attack of angina.

Only light housework, such as dusting or washing dishes, is permitted. And then there should always be a person nearby who, if necessary, will provide first aid.

Optimal load

Exercises performed by patients who have had a heart attack should be varied to ensure the simultaneous development of the following physical qualities of a person:

Heart-related diseases must be approached with special responsibility. Especially when it comes to rehabilitation after complications: myocardial infarction, progression of unstable angina, etc.

To achieve a positive effect, in parallel with performing physical activity, it is necessary to follow the instructions of the attending physician regarding the use of medications, while being under his supervision.

Experts have listed methods for diagnosing coronary heart disease here.

You can learn about the WHO classification of coronary heart disease from this article.

Sometimes surgery may also be required.

To ensure that exercise brings only pleasure and at the same time is beneficial for health, it is recommended to adhere to the following tips:

• Perform physical exercises that bring positive emotions. To make it more fun, you can involve your friends or relatives in the activities.
• When traveling to a distant store, cinema or other destination, you can get off the minibus one stop earlier and cover the remaining route on foot.
• When living in a multi-storey building, it is better to climb several floors on your own, without using an elevator, increasing the duration of the route every day.
• To add variety to your daily walks, you can take a dog with you, who will guarantee a cheerful mood and draw only positive emotions. A dog in the house is a guarantee that the owner, due to laziness, will not refuse another trip to the fresh air.

Every person should devote maximum time to their health, especially when it comes to heart disease. A reasonable approach to physical activity and moderately active life have never harmed anyone.

Heart and exercise

Let us distinguish three types of physical activity: static, in which there is prolonged tension in individual muscle groups (for example, a forced working position in which you have to spend a certain time), dynamic, when tension and relaxation alternate in muscle groups (for example, walking, running, swimming) and “explosive”, characterized by very strong and short-term muscle tension (for example, lifting weights).

What happens in the body during dynamic load (for example, when walking)? Working muscles require more oxygen, so the heart strengthens its contractions and increases their speed. The hormonal system of the adrenal glands and thyroid gland is activated (in obesity, for example, this system is always suppressed), the combustion of carbohydrates is enhanced, and the absorption of oxygen by muscles increases. Systems that have a hypotensive (BP-lowering) effect are activated. The muscles either compress the vessels, pushing blood out, or release them, allowing the vessels to fill with blood. We get, as it were, a second, “muscular” heart, which helps our heart, relieves it (now it is clear why leisurely walks are recommended even for patients with myocardial infarction and heart failure!). If physical activity increases, the body’s energy needs increase sharply. Oxygen consumption increases (since oxygen is a necessary substrate for energy reproduction). If before this the source of energy was mainly the “burning” of carbohydrates, now fats begin to act as a source of energy. “Burning” of fats begins after about a minute of work. Hence the conclusions: if you need to lose weight, excess calories or excess cholesterol from food, physical activity should be at least 20 minutes. Blood pressure, pulse rate, and the content of adrenaline and other activating hormones in the blood increase. If such a load does not last too long, then the heart and the whole body receive a good training load.

With static loads, there is muscle tension without shortening or lengthening. Those. the muscles are tense, but no external work is observed; they actively consume energy and accumulate the products of this breakdown, primarily lactic acid. Blood vessels are squeezed by tense muscles, the heart has to push blood through vessels that have been compressed for a long time by tense muscles. Not only the inflow, but also the outflow of blood is disrupted - the removal of harmful decay products of energy structures worsens, the fluid stagnates in the tissues and cells, disrupting their natural metabolism. There is a release of hormones and hormone-like substances, which significantly increase blood pressure and increase the load on the heart. Isometric loads and work associated with prolonged static tension are strictly contraindicated for patients with angina pectoris, those who have suffered a myocardial infarction and inflammatory diseases of the myocardium, as well as for persons with signs of heart failure.

Explosive loads are the most unfavorable in their effect on the heart. The demands placed on the heart in this case include the need to ensure significant muscle tension (for example, when lifting a barbell) and combine both the mechanism of static tension, when blood flow in tense muscles is disrupted, and the mechanism of dynamic performance of work (the barbell still needs to be lifted ), when increased muscle contraction causes an avalanche-like energy consumption and a decrease in the content of energy-accumulating substances (for example, ATP). Even despite the short duration of the “explosive” loads, the heart experiences serious overload. Such “explosive” loads are strictly prohibited for people with serious heart and vascular diseases. People who do not have heart problems (and want, say, to train in weightlifting to the limit of their capabilities) are advised to take special care in their approach to the training regimen and structure the training itself. The particular danger for them is precisely repetitive extreme loads of an explosive nature (for a patient with coronary artery disease, the only load may be the last). When developing a schedule and intensity of physical activity, you should consult your doctor.

Heart disease and exercise: The World Health Organization Charter defines health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. Creating a working definition for this concept, in 1957, a working group of the WHO expert committee proposed to mean the concept of “health” as a state or quality of the human body that ensures adequate functioning of the body under given conditions (genetic or environmental). Accordingly, the goal of healing is, as is known, to preserve or restore human health not only in the physical, but also in the mental and social aspects. It is this goal that all types of medical activities to identify, treat and prevent diseases should meet.

Physical rehabilitation of patients occupies an important place in the complex treatment of patients with coronary heart disease (CHD), hypertension (HTN) and chronic heart failure (CHF). This means walking, or swimming, or cycling 5 times a week. upon reaching 75-80% of the maximum heart rate (HR).

This is the main difference from the principles proclaimed 10 years ago (“running from a heart attack”). Moderate (daily) physical training (of course, along with therapy) can reduce the level of neurohormones, increase sensitivity to drug treatment and exercise tolerance, and, consequently, emotional tone and “quality of life.” Before starting self-study, you should definitely consult with your doctor. If you are over 30 years old, then before starting classes you need to have an ECG (electrocardiogram). Your doctor should recommend the most suitable type of physical exercise and help you develop an individual physical training program. For example, people over 40 are recommended to start with measured walking, gradually increasing the pace and distance. For those suffering from obesity, a slower pace and a longer period of training are recommended. I would like to recommend to all readers: “CHARGE WITHOUT GETTING OUT OF BED” - this complex is performed immediately after waking up, in bed, for no more than 5 minutes. The result is a great mood, excellent performance, and most importantly, a healthy mind.

1) rotation of the feet in different planes;

2) clenching and unclenching fingers;

3) alternate and simultaneous raising of hands;

4) stretching while lying on your back and stomach;

5) rotation of the head in different planes;

6) sitting on the bed, tilt the body back and forth, left and right.

To assess fatigue under load (i.e., load criteria - low, medium, high), a simplified but quite effective scheme for determining external signs of fatigue is used. They are summarized in a table, which I bring to your attention.

Sign Degree of fatigue Small Medium Large Skin color Redness Significant redness Purple, bluish lips, pallor Sweating Small Significant, above the waist Significant, below the waist Breathing Rapid rhythmic Very fast, sometimes with the mouth Very fast, irregular, with the mouth Movements Correct Minor disturbances Uncoordinated Sensations Nothing bothers Fatigue, leg pain, shortness of breath, tachycardia Fatigue, headache, nausea, dizziness

It is necessary to remember the old, wise saying (this applies to both the healthy and the sick) - “PHYSICAL EDUCATION HEALS, BUT SPORT CREATES.”

Samoilov I.Zh., cardiologist, NMP MEDINA LLC

Exercise therapy for diseases of the cardiovascular system

Exercise therapy for diseases of the cardiovascular system becomes a preventive measure for heart disease. Since there are many factors in a person’s life that harm the cardiovascular system (smoking, alcohol abuse, exposure to harmful chemicals, stress and a sedentary lifestyle), it is important to know what methods will help prevent the occurrence of serious consequences, which can strengthen cardiovascular system.

What harms the cardiovascular system?

It was noted a long time ago that the first factor that provokes disability and mortality in people in economically developed countries is a weakened cardiovascular system. The incidence of diseases is increasing every year. Even active and cheerful young people began to suffer more often from cardiovascular diseases. As a rule, such diseases arise due to a sedentary lifestyle, external factors, addiction to tobacco and alcohol products, and frequent depression.

The most common diseases are:

1. Angina pectoris.
2. Heart defects.
3. Low blood pressure.
4. Endocarditis.
5. Thrombophlebitis.

Such diseases are followed by various disturbances in the functionality of blood vessels and the heart, and in the future this affects the general condition of the body. There is a possibility that tachycardia, shortness of breath, swelling, and cyanosis will appear. As a rule, pain also appears in the heart, namely in the area of ​​the left shoulder blade and behind the chest.

Due to heart disease, circulatory failure may also occur: the circulatory system is not able to transport blood in the amount needed for the proper functioning of cells and organs. If the patient suffers from chronic deficiency of the 1st degree, then while walking up the stairs and walking quickly, fatigue, shortness of breath, rapid pulse, and a fairly strong decrease in performance may appear. If the patient has a 2nd degree deficiency, then all the signs of the 1st degree intensify, and fluid will accumulate in the pleural and abdominal areas.

Therapeutic exercise for diseases of the cardiovascular system

Everyone knows that blood is transported through the vessels thanks to the heart. However, contraction of the left ventricle alone is not enough for the heart to function normally. Circumstances not related to the heart are of great importance for blood circulation.

Often, for any disease, therapeutic exercises are useful along with complex therapy with medications. Such physical education makes it possible to activate the work of extra-cardiac motivators of the circulatory system and promote proper functioning, which has been disrupted. For acute illnesses of the circulatory system or for the purpose of recovery, therapeutic exercises are often prescribed as a method for maintaining the body.

However, such physical education also has its contraindications:

1. Acute stage of rheumatism, myocardium.
2. Imbalance in rhythm and adductor system.
3. Acute cardiac failure.
4. Deficiency of the circulatory system of the 3rd degree.

The systematic nature of physical gymnastics will entirely depend on the characteristics of the disease and the degree of deficiency of general and coronary circulation. Each patient is treated individually, based on the motor mode, physical exercises, volume of load and suitable gymnastics are recommended and assigned.

The influence of physical therapy on diseases of the cardiovascular system

If the patient has myocardium, then physical exercise is performed in the form of massage, normalized walking or walking up the stairs.

If the course of the patient’s heart attack is not characterized by complications, then classes begin approximately on the 2-3rd day: by this period, all aggravated symptoms disappear. At the second stage of the disease, exercise therapy consists of walking in certain norms, therapeutic exercises, simple exercises on exercise machines, and an easy game form of exercise.

Only the speed of the lesson and the number of repetitions increase; exercises using a gymnastic wall and special objects are included.

In case of arterial hypertension, the first goal of physical therapy is to lower blood pressure, prevent crises, and strengthen the patient’s body. During arterial hypertension, activities include normal walking, gymnastics, massage, exercises on a simulator, and swimming.

During heart defects, therapeutic exercises involve a combination of breathing and active exercises. Must undergo a course of exercise therapy for two weeks. Physical education itself is carried out at a slow rhythm, without increasing loads. Then, for the next 2-3 weeks, patients are prescribed physical exercises.

It is important to remember that the effectiveness of classes will depend entirely on the normalized load, on the correct selection of all kinds of therapeutic gymnastics and on the correct sequence of performing the load. All exercises are divided according to anatomical characteristics: for example, exercises for the back, head, legs, torso, according to the degree of tension of muscle groups, and according to the nature of the tasks performed.

What rules should you follow?

When performing gymnastic movements for cardiovascular disorders, it is important for patients to adhere to the following recommendations:

1. Even if you feel good, physical activity should not increase sharply and intensely. Graduality is important.
2. Eating before exercise should be completed one and a half to two hours before exercise.
3. If during exercise therapy you experience discomfort in the heart area, shortness of breath, or headache, then it is best to stop the exercise. If the unpleasant sensation does not go away, then you can drink nitroglycerin or validol. After this, seek help from a doctor.
4. The state of the pulse during physical therapy should be monitored. If at the end of the lesson the pulse has increased per beat and does not remain above 120 beats per minute, and a few minutes after rest it returns to normal, then this is a positive result of such physical activity.

Exercises for Cardiovascular Diseases

The set of exercises is as follows:

1. Sitting on a chair, you need to put your hands on your knees. Then raise and spread your arms to the sides. Breathe. After this, lower your hands and exhale. Do it 4 times.
2. Take the same starting position as in the previous exercise. Extend your arms to the sides and turn your palms up. Then turn the body, look at the palms, inhale and return the body and arms to the starting position. Exhale. Repeat 4 times.
3. Take the starting position. Sitting on a chair with your hands on your knees. Imitate fast walking with high knees. Perform the exercise for up to 3 minutes.
4. Do an exercise similar to cycling. Breathe as comfortably as possible. Move for half a minute.
5. Keep your legs together and lower your arms. Using your hands, take a sitting position, and then sit without using your hands. Repeat up to 6 times.
6. Place your feet together and lower your arms. Raise your hands one by one. It is important to follow the breathing technique: inhale when the hand is up, exhale when the hand is down. Repeat for each hand 5 times.

This program is a simple complex of strengthening physical therapy that helps the heart work in the correct mode and not be overloaded. However, if at any time the patient feels that he is not feeling well or that his heart disease is worsening, then it will be better if he waits until the condition improves and he can begin physical activity again.

The main thing in this set of exercises is the regularity of their implementation, since with constant training, correct breathing is developed, the diaphragm increases, which, in turn, leads to active transportation of blood to the lungs. It is also important to observe the breathing technique during the exercises: when inhaling, you need to make sure that it is deep, and you need to exhale long and calmly. It is worth remembering that you cannot force the load. At the end of the exercises, fatigue should not be intrusive; it tends to be light and pleasant.

• Arrhythmia
• Heart diseases
• Bradycardia
• Hypertension
• Hypertonic disease
• Pressure and pulse
• Diagnostics
• Other
• Heart attack
• Ischemic disease
• ethnoscience
• Heart disease
• Prevention
• Heart failure
• Angina pectoris
• Tachycardia

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People receive such abundant and sometimes contradictory information that the question involuntarily arises: what should one believe and what should one do?

Maybe, first of all, stock up on medicine? But which ones? Should I go to the doctor or start the now very fashionable “heart attack run”?

Not only physical education

External manifestations of detraining, a sedentary lifestyle, and addiction to high-calorie foods are noticeable to everyone. A person becomes flabby and puts on weight. But what is even more significant is what happens inside the body. Fat in combination with proteins (lipoproteins) primarily penetrates the wall of blood vessels, and in particular the vessels of the heart. They become less elastic, their lumen gradually narrows more and more. Myocardial contractility decreases. Heart reserves are noticeably reduced.

And with increased physical activity, when the needs of the heart muscle for nutrients and oxygen sharply increase, such vessels are unable to pass the required amount of blood. Cardiac ischemia develops - a relative insufficiency of its blood supply, and from it only a step to myocardial infarction!

Experience shows that people over 40 years of age often develop arterial hypertension and atherosclerosis. In such patients, angina pectoris often develops. Often the first attacks occur after heavy physical exertion.

You need to start with morning exercises, gradually increasing the load

practice shows that the effectiveness of physical exercises performed regularly in the morning is very high. Industrial gymnastics is also useful.

Consult your doctor first; such a consultation will save you from many troubles.

During mass preventive examinations of people of mature age, it usually turns out that half of those who suffer from angina pectoris do not suspect it and consider themselves healthy. Approximately one third of those suffering from arterial hypertension remain in the same ignorance. Both have an increased risk of developing myocardial infarction.

The heart of people 40-50 years old is also threatened by many other risk factors - neuropsychic stress, smoking, overeating. They should be excluded if possible. It is in vain to hope that by continuing to smoke and being addicted to fatty foods, physical exercise alone can compensate for the harm they cause.

What can we say about running? Does it have advantages over other types of training? Running for 15-20 minutes gives the same workout as walking for an hour or two. Time benefit is an important factor for a busy person. But running must begin when you have completed general strengthening exercises and have been walking.

Cardiologists, generally, for patients with angina pectoris, advise not running, but walking - the most physiological type of training for the body.

A few words about how to understand the requirement: classes must be regular and systematic. This does not mean that you should not take your well-being into account. If you are not feeling well, you can and should take a break for a day, two, or a week. And then resume training again.

With angina, as is known, pain occurs due to a short-term disruption of the blood supply to the heart muscle. This is a consequence of spasm (compression) of the coronary vessels of the heart. The patient’s task is to eliminate this spasm and quickly take a vasodilator medication. The sooner he does this, the faster the attack will pass! The patient should always have validol and nitroglycerin with him.

In cases where an angina attack occurs during physical exertion, it is enough to stop, sit or lie down, and the pain will go away without taking medication.

But if the pain does not go away after a few minutes at rest, you should immediately take validol. And if validol does not work, you should take nitroglycerin.

Some people cannot tolerate nitroglycerin at all: it sharply lowers their blood pressure, their pulse becomes weak, their skin turns pale, and becomes covered in cold, sticky sweat. Nitroglycerin is strictly contraindicated for such patients!

Cardiologists often have to listen to complaints that nitroglycerin helps in some cases, but not in others. As a rule, this depends on whether the drug is fresh and whether the terms and rules for its storage are observed. We do not recommend using nitroglycerin for more than two months after the vial of medicine was first opened.

If the pain is not associated with physical stress, do not expect the attack to go away on its own. For those who overcome the unpleasant sensations and are delayed in taking medications, the attack can become prolonged.

Patients with “experience” usually know well what reasons can provoke an angina attack in them. For some, it’s climbing stairs, going outside in damp, windy, cold weather; for others, it’s straining in the toilet. Knowing this, when going outside, for example, you should take validol or nitroglycerin prophylactically.

For those who have attacks every day and frequently, doctors may prescribe extended-release nitroglycerin tablets. They are not placed under the tongue, like regular validol and nitroglycerin, but are taken orally. When? The attending physician will tell you about this. If the attack has already begun, it is not advisable to take extended-release nitroglycerin.

A person suffering from angina pectoris should know: if the nature of his attacks has changed - they have become more frequent, pain occurs not only during physical exertion (angina pectoris), but also at rest (angina pectoris at rest) and it has become more intense, it is necessary, without delay, to consult a cardiologist or a therapist.

In some patients, attacks occur under the influence of nervous overload and anxiety. Such patients are strongly recommended to consult a neurologist, who, by prescribing sedatives, will often help them more than a cardiologist.

V. I. METELICA, Doctor of Medical Sciences

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Modern medical research has shown that the development of coronary heart disease (CHD+ and angina pectoris) can be facilitated by various factors. As a rule, it is impossible to get rid of the body’s hereditary predisposition to the disease. But it is entirely within your power to avoid another etiology. First of all, this is alcohol abuse, psychotropic and narcotic drugs; smoking; stress; disruption of normal metabolism, which caused an improper diet; chronic fatigue, physical inactivity.

Terms: Physical inactivity is a weakened state of muscles caused by a sedentary lifestyle.

It is necessary to carry out a competent correction of the lifestyle, to revise the canons of life for the better, which will allow us to avoid the above factors. First of all, and this applies to any person, even those who do not have complaints, it is worth following a daily routine, eating right, leading an active and healthy lifestyle, not smoking, not taking drugs and not drinking alcohol.

What are the benefits of physical activity (exercise) for angina and coronary heart disease?

• Regular repetition of physical exercises will constantly keep your muscles toned;
• physical activity leads to an increase in “useful” lipids in the blood and prevents the occurrence of atherosclerosis;
• the likelihood of blood clots decreases;
• overall well-being and positive attitude improves;
• body weight is reduced and diabetes is prevented and much more.

Angina and sports

Many people wonder: is it possible to play sports, run, go to workouts and do physical exercises with angina pectoris? Here the answer is clear - you can. But there is one condition. Exercise therapy for angina pectoris is selected for the patient by a doctor. This is because during physical education the myocardium will require even more oxygen than before.

And acute oxygen deficiency will lead to pain and discomfort. If exercises for angina are prescribed by your doctor, the situation will look different. This does not mean that the set of exercises will provide only joy, there will be difficulties. But moderate physical activity will be beneficial, and not vice versa.

Breathing exercises for angina pectoris

It is useful to engage in physical therapy, but it is also worth remembering about proper breathing, during which the myocardium is fully saturated with oxygen. You can do breathing exercises following the example of yogis:

• Sit on a chair; keep your back straight; think about something good and positive until you relax. Then take a deep breath in through your nose for 1-2-3, hold your breath for 1-2 and exhale through your mouth for 1-2-3. At the moment of exhalation, it is recommended to bend your elbows and hit your chest with your “wings” like a bird. It’s worth repeating this breathing set of exercises once. Three times a day.
• For people suffering from angina pectoris, doctors recommend walking every day in the fresh air, mentally imagining the oxygen saturation of the myocardium.

Therapeutic exercises for angina and heart failure

Preventive treatment and further restoration of the body after treatment requires a set of special therapeutic exercises. For coronary heart disease, the following exercises are recommended:

• Sit on a chair and lower your hands to the floor. Inhaling air, raise your arms at an angle of 180 degrees, and exhaling, return them to the starting point. It is recommended to repeat such manipulations during ischemia five times.
• Sitting on a chair, fix your hands on your belt. Then, alternately extend one arm after the other and return them to the starting point, repeating the exercise five times.
• For ischemia, place your feet shoulder-width apart. Bend your elbows and raise them to chest level. As you inhale, spread your arms and turn your body to the side. When the patient returns to the starting position, you can exhale. Repeat the exercise four to six times.
• If you have problems with running, then they recommend a moderate walking rhythm for half a minute, and then a fast pace for a minute. During this time, the body will not have time to become very depleted before acute pain appears.

Physical activity for coronary heart disease

According to modern medical data, a large number of factors can contribute to the development of IHD (coronary heart disease). Among the most common and “aggressive” ones are poor heredity, alcohol abuse, smoking, chronic stress, metabolic disorders due to poor nutrition, chronic fatigue, and physical inactivity. Of course, it is almost impossible to get rid of a hereditary predisposition to IHD, and you cannot completely protect yourself from stress. But you can adjust your lifestyle so as to avoid the other factors mentioned above. First of all, you should quit smoking, optimize your diet and ensure proper physical activity on the body.

The benefits of physical activity:

• Regular physical activity allows you to stay toned and in good shape.
• With regular physical activity, the amount of “useful” lipids in the blood increases, which helps reduce the risk of developing atherosclerosis.
• The likelihood of blood clots is reduced.
• Blood pressure is normalized, which helps reduce the risk of cerebral hemorrhage (stroke).
• Exercise promotes weight loss and prevents the development of diabetes.
• Regular exercise helps improve mood, normalize sleep, and make it easier to cope with stressful situations.
• Regular physical activity reduces the risk of developing osteoporosis, the most common cause of bone fractures in old age.

Regular physical activity is beneficial for everyone, as it allows you to protect yourself from the development of many unpleasant diseases. But, unfortunately, it is only the illness itself that often pushes us to change our lifestyle and regular exercise.

Only certain types of physical activity are suitable for patients with coronary heart disease.

IHD develops as a result of acid starvation, which leads to the formation of atherosclerotic plaque. The plaque causes the artery that supplies the heart to narrow, causing less oxygen-rich blood to reach the heart muscle. In this case, the intense work of the heart becomes difficult and, under heavy loads, angina pectoris develops - a painful attack of the heart muscle.

Naturally, angina attacks require limited physical activity. Often, in order to get rid of angina, it is necessary to resort to medication, or even surgical treatment. In the case of a severe heart attack - a heart attack, patients even begin to be afraid of physical activity and, in an effort to “protect” the heart, often limit movement to the point of giving up walking.

For patients with angina and those who have had a heart attack, physical activity can have twofold meaning:

• On the one hand, excessive physical activity and intense physical activity can provoke angina attacks and lead to a second heart attack - such excessive activity should be avoided.
• On the other hand, moderate physical activity and periodic exercise (no more than 40 minutes 5 times a week) are very beneficial.

Moderate physical activity helps increase the level of good cholesterol, which prevents the further development of atherosclerosis, reduces the rate of development of heart failure, strengthening the cardiovascular system. Regular aerobic exercise helps normalize the functioning of collateral blood flow - an interarterial connection that serves to redistribute blood flow, which helps to increase the amount of oxygen-rich blood reaching the heart muscle.

As medical studies show, physical activity in patients who have had a heart attack helps reduce the risk of a second heart attack by 7 times, and reduce mortality by 6 times, compared with patients who prefer to reduce physical activity as much as possible.

Therefore, for patients who have had a heart attack, performing normal household activities (light daily housework) is mandatory. After an inpatient course of treatment, it is preferable for such patients to undergo a course of physical rehabilitation under the supervision of specialists in a cardiological sanatorium. If rehabilitation in a sanatorium is impossible for one reason or another, it is necessary to undergo a course of physical rehabilitation on an outpatient basis under the supervision of a cardiologist.

The easiest option for physical activity in this case is daily walking. At the same time, you should not overload yourself: the walk should take place at a slow or moderate pace (depending on how you feel), for half an hour - an hour, but not less than 5 days a week. If during a walk you feel weak or tired, you need to take a break - sit down on a bench or return home at a slow pace. Don't be upset - during the rehabilitation process you will be able to go through more and more. However, an increase in physical activity, just like the beginning of physical exercise, after hospitalization must be agreed upon with a physical therapy specialist or the treating cardiologist.

Physical activity should never lead to another attack of angina. During exercise, severe shortness of breath or rapid heartbeat is unacceptable. During physical activity, you need to monitor your pulse - its frequency should increase in accordance with the increase in load. In this case, the optimal increase in heart rate should be determined by the attending physician on an individual basis, according to the severity of coronary artery disease and associated pathologies.

In the first stages of physical rehabilitation, heart rate can increase by no more than 20 - 30%, approximately 15 - 20 beats per minute. If the loads are tolerated without complications, an increase in heart rate can be allowed by more than 30%, however, no more than the value calculated using the following formula: 200 - the patient’s age. For example, for a patient with coronary artery disease aged 60 years, the maximum permissible heart rate should not exceed 140 beats per minute.

Leading Russian specialist in the field of rehabilitation of patients with heart diseases, Professor D.M. Aronov, developed recommendations for physical activity, depending on the functional class (severity of manifestation) of the disease. According to the tables below, developed by Professor D.M. Aronov, it is possible to determine the permissible load in each specific case.

Remember that, depending on the severity of the manifestation, angina is divided into four functional classes, where I is mild angina, in which attacks occur only during very intense physical activity, and IV is the most severe angina, in which an attack occurs at the slightest physical activity and even at rest. Prohibited loads are marked with a “-” sign, while permitted loads are marked with a “+„ sign. The number of “+” signs indicates the permissible intensity and volume of loads.

Daily physical activity

Fast (130 steps/min)

Medium (100/120 steps/min)

Slow (<=шагов/мин)

Types of household work

Work on a personal plot

large watering can (10 kg)

small watering can (3 kg)

Note: it is necessary to avoid working in the open sun, heat, or in an upside down position. The load should be performed in several approaches, with short breaks. If you experience pain in the chest area, feelings of weakness or fatigue, you should stop working and rest.

What physical activity is optimal for patients who have had a heart attack?

The priority is the types of loads aimed at developing endurance. However, it is best to combine these exercises with loads aimed at developing flexibility and strength.

Activities aimed at developing endurance include: walking and cycling, swimming, dancing, tennis and housework.

Strength activities include: walking up an inclined plane, including climbing stairs; lifting and carrying weights such as shopping; digging up plots of land, some types of housework.

The following types of work are aimed at developing flexibility: dancing, swimming, gymnastics, working on a personal plot or in the garden.

Do not forget that the loads should be gradual, especially at the beginning of physical rehabilitation. Expanding your physical activity without prior consultation with a cardiologist, especially after coronary complications such as myocardial infarction, unstable angina, progressive heart or coronary failure, can only worsen your condition and provoke complications.

For complete rehabilitation after suffering coronary complications, it must be comprehensive and include drug therapy, an individual physical rehabilitation program, and, if necessary, surgical correction. All restorative procedures must be carried out under the supervision of the attending physician.

• Give preference to those exercises and loads that bring you pleasure. Do the exercises in the company of family or friends. Positive emotions are the key to a speedy recovery.
• Try to walk at least one floor a day. Gradually, without sudden jerks, increase the number of floors that you overcome without the help of an elevator.
• In order to gradually increase physical activity, you can go to the stop earlier and cover the remaining distance on foot.
• If walking alone makes you sad, get a small dog as a travel companion. Firstly, you will have more fun together, secondly, a pet is always a positive emotion, and thirdly, a dog in the house is a guarantee that you will go for a walk regularly.

© "Profimedica", 2016. Multidisciplinary clinic

St. Petersburg, Bogatyrsky pr., 64, bldg. 1 (Primorsky district),

metro Staraya Derevnya, Pionerskaya, Komendantsky Prospekt.

The materials published on this page are for informational purposes only and do not constitute a public offer. Site visitors should not use them as medical advice. The diagnosis and choice of treatment method is made by your attending physician!

How to exercise for people with cardiovascular disease

Zozhnik considers why “core” people need to engage in physical activity and how exactly. However, remember: if you suffer from high blood pressure or cardiovascular disease, consult your doctor and get any necessary tests before starting any type of exercise - especially one that you have not done before.

Exercise for heart health

Approximately 1 in 5 cases of coronary heart disease (CHD) in developed countries is associated with low physical activity (inactivity). Regular moderate-intensity physical activity reduces your risk of coronary heart disease and may reduce your chance of dying from heart disease.

Scientists from the National Heart Foundation of Australia say:

“Lack of physical activity is associated with a poorer survival prognosis in people who have had a myocardial infarction compared to patients who are physically active.”

People with cardiovascular disease can gain the following benefits from regular exercise:

Improvement of physiological functions

Physical rehabilitation consistently improves objective measures of functional ability (work capacity) in patients with heart disease. Endurance training improves mobility among stroke survivors and increases the walking distance of people with peripheral vascular disease and those with claudication.

Regular exercise reduces recurrent symptoms of angina, reduces shortness of breath associated with heart failure and stroke, and reduces the severity of claudication when walking in patients with peripheral vascular disease.

Improved coronary risk profile

Regular moderate-intensity physical activity reduces high blood pressure and triglyceride concentrations and increases high-density lipoprotein (heart-protective cholesterol) in people with coronary artery disease. In addition, regular exercise reduces insulin resistance and increases glucose sensitivity in individuals predisposed to developing diabetes.

People who move regularly reduce their chances of dying after a heart attack by up to 25% compared to patients who led a sedentary lifestyle before the heart attack.

Resistance training increases physical strength and self-confidence in people with cardiovascular disease, and improves the ability to perform physical activities of daily living.

It is important to note that the effect of regular physical activity on cardiovascular health and a person’s ability to work is a very short-term phenomenon. As soon as a person stops exercising, his functional abilities rapidly decline. In addition, the combination of regular exercise and accompanying medication can further improve heart health.

Physical rehabilitation is associated with small but consistent changes in quality of life scores among myocardial infarction survivors and people with heart failure and peripheral vascular disease.

People with heart disease who exercise regularly often report increased self-confidence; they experience a sense of well-being and a decrease in depression and anxiety. Importantly, these people have a reduced sense of social isolation.

How exactly does exercise help people with heart disease?

The American College of Sports Medicine (ACSM) states that regular aerobic exercise reduces heart rate and blood pressure both at rest and during exercise. Subsequently, the load on the heart decreases, and the unpleasant symptoms of angina pectoris may appear more mildly.

Regular exercise strengthens muscles, enhances transport and delivery of oxygen to tissues, resulting in the patient feeling more energetic and less tired. This is an important point for people with heart disease, whose aerobic performance is inferior to their healthy peers. It is noted that the most significant improvements are observed in individuals with the weakest physical fitness.

Contraindications for core athletes to training

The ACSM Guidelines for Pre-Exercise Assessment and Training Program Design outline contraindications to exercise for individuals with cardiovascular disease.

Contraindications to training for those suffering from cardiovascular diseases:

o Unstable angina,

o Uncontrolled hypertension with systolic pressure >180 mm Hg. Art. and/or diastolic >110 mm Hg. at rest,

o Orthostatic drop in pressure (>20 mm Hg systolic and/or >10 mm Hg diastolic) with symptoms (dizziness, nausea, weakness, blurred vision, loss of consciousness)

o Severe aortic stenosis,

o Uncontrolled atrial or ventricular arrhythmia,

o Sinus tachycardia (pulse > 120 beats/min.),

o Uncontrolled heart failure,

o Third degree atrioventricular block in patients without a pacemaker,

o Active pericarditis and myocarditis,

o Recent embolism,

o Acute thrombophlebitis,

o Exacerbated chronic disease or high fever,

o Uncontrolled diabetes mellitus,

o Thyroiditis, hypo- and hyperkalemia, hypovolemia,

o Severe orthopedic diseases that interfere with physical activity.

If you have one of the above contraindications, you need to hold off on training.

How and how much to exercise for people with heart disease

If a person with heart disease has no contraindications to exercise, he can gradually increase his physical activity under the supervision of a doctor. It is the physician who must approve the type, frequency, duration, and intensity level of exercise that will be appropriate to physical abilities and not harmful to individuals with cardiovascular disease.

According to ACSM scientists, walking, elliptical exercise, exercise cycling, and stair climbing are the best forms of aerobic exercise for people with heart disease.

Significant improvements are observed when people with heart disease exercise aerobically 3 times a week for at least 12 weeks. Moreover, if people train more than 3 times a week, the improvements become even more noticeable.

The duration of aerobic training for people without contraindications should be 30 minutes. Moreover, a person has 2 options to choose from: either do one half-hour workout at a time, or break these 30 minutes into 3 workouts of 10 minutes each.

Based on the data obtained from the pre-training test (which should be performed by a physician or qualified professional), the ACSM recommends training at an intensity of 40-80%, which is calculated based on cardiac reserve (HRR).

Cardiac reserve is the difference between your maximum heart rate and your resting heart rate.

1. Determine your maximum heart rate by subtracting your age from 220.
2. Determine your heart rate for 1 minute at rest.
3. Calculate the difference between your maximum heart rate and your resting heart rate.
4. Calculate the required intensity using Karvonen's method:

For example, let's calculate the intensity at 50% for a person aged 60 years and heart rate 65 beats/min. at rest.

Target heart rate zone = % intensity. x heart reserve + resting heart rate

Maximum heart rate: 220 – 60 years = 160 beats/min.

Cardiac reserve: 160 – 65 (resting heart rate) = 95 beats/min.

Final calculation: 65 (rest) + 50% intensity. x 95 beats/min. = 112 beats/min.

112 beats/min. – approximate heart rate at which you need to train.

How to choose intensity without doing calculations

Scientists from the British Heart Foundation believe that training should take place at a level of intensity at which the heart rate noticeably accelerates and it becomes harder for a person to breathe. In this case, the person must be able to carry on a conversation. If he cannot talk during aerobic training, then its intensity is too high.

Some “core athletes” are not able to adhere to the above recommendations regarding the duration and intensity of training. However, at the initial stages, at least some activity is welcome. Start with short 5-10 minute walks at a slow pace, as this is much better than nothing at all.

Core training with weights

Resistance training can effectively and safely increase muscle strength and endurance in patients with clinically stable coronary artery disease. Upper body strength training leads to improved cardiovascular function by lowering blood pressure and heart rate. Consequently, such training helps reduce the load on the heart during work and everyday activity.

In addition, as noted by specialists from the Department of Cardiac Rehabilitation and Cardiovascular Research, strength training is especially important for the most fragile patients who, due to weakness in the legs, have difficulty in aerobic training.

Training equipment used:

During strength training, you can use rubber expanders, exercise machines, and even free weights - barbells and dumbbells.

o Raise and lower weights with complete control,

o Avoid holding your breath,

o Avoid strong tension and straining,

o Do not squeeze the barbell (dumbbell) or the handle of the machine too tightly, as this may cause an excessive pressure surge.

The intensity should be selected in such a way that a person can perform repetitions without significant straining - at a level of approximately 30-40% of the 1-time maximum for the muscles of the upper body and approximately 50-60% of the maximum for the muscles of the lower body (your maximum in the case of " "it is contraindicated for heart patients" to identify it! It can be calculated on the "strength calculator" here, but doing exercises to failure for heart patients is in any case contraindicated). Increase the working weight by no more than 1-2 kg for the upper body and 1-4.5 kg for the lower body, but only when you are able to complete all 15 repetitions without significant straining.

At the initial stages, exercises for the main muscle groups (arms, shoulders, chest, back, buttocks, abdominal muscles and legs) need to be performed only 1 approach. In total, it is recommended to perform from 8 to 10 exercises for the above-mentioned muscles per workout.

o Strength training should begin only after a person has completed a thorough aerobic warm-up. (In general, we also recommend reading: “Why you need to do a warm-up and cool-down”).

o Train large muscle groups before small ones.

o Include multi-joint exercises in your workout that involve more than 1 muscle group.

o After training, a person should feel moderate, but not severe, fatigue.

It is important to note that since most of the benefits of physical activity are largely due to aerobic training, weight training should complement, not replace, aerobic exercise.

The American Heart Association states that exercise should be supplemented with daily activity - walking during breaks at work, using the stairs instead of the elevator, doing housework or gardening. It is noted that with 5-6 hours of total physical activity per week (including activities of daily living), patients can reap the maximum health benefits.

The best activity to start training is walking

For people with heart disease, walking has several advantages over other types of physical activity in the initial stages of training. This type of training can significantly improve the fitness and health indicators discussed at the beginning of the article.

In addition, walking is a fairly light-intensity form of aerobic exercise, which, as a rule, is tolerated without problems by patients with heart disease. In addition, walking does not require the purchase of a gym membership or training equipment - just one pair of sports shoes is enough.

Risks and Cautions

According to scientists from the National Heart Foundation of Australia, the benefits observed from physical activity significantly outweigh the risks associated with it. Experts from the ACSM report that the development of cardiovascular complications during training is observed once every training hour. At the same time, their colleagues from Australia note that the death of patients with heart disease during training occurs only once during training hours. It is worth noting that the risks in the absence of training for heart patients are higher.

In general, experts agree that the risk of relapse and complications increases during physical activity in people who previously led a sedentary lifestyle and exceed the recommended intensity during training. In order to reduce the risks, the patient should start with the lowest intensity training and increase it very gradually.

Thus, as ACSM scientists note, physical activity for the purpose of rehabilitation is safe for patients with stable heart disease. Serious complications are very rare; Moreover, patients who exercise regularly have a reduced risk of heart disease complications during exercise.

In what cases should training be stopped immediately?

The ACSM position notes that no matter what type of exercise a person with heart disease does, they should be aware of 4 key warning signs that indicate a possible deterioration in their health:

1. The appearance of constant or recurrent angina pain (pain or pressure in the chest, pain in the jaw or neck, discomfort in the lower arms, pain in the shoulders and back).
2. Unusual difficulty breathing, shortness of breath,
3. Dizziness,
4. Heart rhythm disturbance.

Australian experts also include nausea, uncharacteristic sweating, fatigue too quickly, leg pain and physical weakness as symptoms that may be a reason to stop training.

If at least one of the above symptoms appears, you must stop training (gradually reducing its intensity) and consult a doctor.

How people with heart disease should not exercise

Extremely strenuous exercise, or activity that alternates between intense periods and sudden stops, puts quite a lot of stress on the heart, especially in people who lead a sedentary lifestyle. For example, shoveling heavy, wet snow causes a significant increase in heart rate and blood pressure. For this reason, heart attacks often occur in middle-aged and elderly people who are clearing snow-covered roads.

British scientists recommend that people with heart disease avoid strenuous daily activities such as carrying very heavy objects or heavy gardening work, such as digging soil. It is also not recommended to participate in high-intensity competitive activities - you should not play basketball, football, volleyball, squash, and so on.

In general, people with heart disease or high blood pressure should avoid strenuous physical activity that makes breathing difficult or difficult, or straining too much.

Core athletes should also avoid static exercises that require exerting force against a fixed object or holding the body in a tense position (for example, pushing a wall or plank exercise). Additionally, individuals with high blood pressure are advised to avoid excessive amounts of strength work, which involves lifting weights overhead with the arms.

Important!

If you are taking medications to lower your blood pressure, you should avoid sudden changes in body position - for example, getting up quickly from a chair, jumping from a lying position to a standing position, as this may cause dizziness. You should also extend your cool-down time, as medication may lower your blood pressure too much if you end your workout suddenly.

Also, when your doctor prescribes you a new drug, be sure to ask whether it will affect the physical activity you are doing. This is especially true for beta blockers, which lower your heart rate.

Training tip for people with cardiovascular disease:

o Do not start exercising until you have received approval from your doctor.

o Increase the level of physical activity smoothly - gradually increase both the duration and intensity of training.

o Each of your workouts should consist of three blocks: a thorough warm-up, the main part and a cool-down.

o Do not exercise immediately after eating, wait at least an hour and a half.

o Make sure you drink enough fluids before, during and after your workout.

o Your training uniform should be comfortable and your shoes should fit perfectly.

o Do not train in extreme cold, heat or high altitude conditions. If you train in cold and windy conditions, dress warmly, including a scarf and hat.

o Do not exercise if you have a viral infection or high body temperature.

o Stop training if dangerous symptoms appear and report them to your doctor.

o Do not take a hot shower in the first 15 minutes after finishing a workout - this can cause an increase in heart rate and arrhythmia.

Conclusions:

As you can see, heart disease should not become a reason for refusing physical activity. Moreover, if people with cardiovascular disease want to improve their health, they simply need to move. However, it is critical not to overdo it. Don’t chase records, because all this is not worth your health and life. Have fun training, strengthen your heart and live long.

o Exercise for Persons with Cardiovascular Disease, ACSM Current Comment.

o ACSM’s Guidelines for Exercise Testing and Prescription, 9th ed., Exercise Prescription for Patients with CVD.

o ACSM's Resources for the Personal Trainer, Chapt. 15, Cardiorespiratory Training Programs.

o Physical activity and your heart, The British Heart Foundation (BHF).

o Physical activity in patients with cardiovascular disease: management algorithm and information for general practice, The National Heart Foundation of Australia.

o Being active when you have heart disease, U.S. National Library of Medicine.

o T. Briffa, A. Maiorana, Physical activity for people with cardiovascular disease: recommendations of the National Heart Foundation of Australia, Med J Aust 2006; 184 (2): 71-75.

o Heart Failure – Exercise, Cleveland Clinic.

o Paul D. Thompson, Contemporary Reviews in Cardiovascular Medicine: Exercise Prescription and Prescription for Patients With Coronary Artery Disease, Circulation, 2005; 112.

o Recommendations for Prescribing Exercise to Patients with Heart Disease, The Central Health Education Unit, Hong Kong.

o Orthostatic Hypotension, MD.

o Orthostatic Hypotension, Cleveland Clinic.

Myocardial infarction is one of the forms of coronary heart disease. This is a terrible disease that poses a threat not only to the health, but also to the life of the patient.

The outcome of the disease (both favorable - recovery, and unfavorable - death of the patient) largely depends on the coordinated actions of medical personnel.

A doctor who was able to diagnose a disease in time and prescribe the correct treatment and a nurse who properly organized nursing care can save a person’s life!

The actions of a nurse during a myocardial infarction are regulated by emergency care protocols and patient care algorithms.

The nursing process during myocardial infarction includes the basic requirements for the actions of a nursing professional.

Emergency first aid in acute cases

Acute myocardial infarction is a critical condition that requires precise and effective actions from nursing staff.

A nurse, providing pre-medical care to a patient with a heart attack, must be guided by the algorithm of care - perform independent nursing interventions and prepare everything necessary to carry out the doctor’s instructions (drugs, instruments).

Algorithm for providing nursing first aid to a patient with acute myocardial infarction:

1. Lay the patient down, remove tight clothing, provide fresh air.
2. Eliminate irritating physical and psycho-emotional factors, a warm bath on the left hand, mustard plasters on the heart area.
3. Nitrates - nitroglycerin (tablets or aerosol), acetylsalicylic acid - 0.25 g, chew.
4. Monitor hemodynamic parameters - blood pressure, heart rate, respiratory rate.
5. Carry out oxygen therapy.
6. If possible, register an ECG.

The nurse's role is to maintain vital signs (blood pressure, heart rate, respiratory rate) until the ambulance arrives.

Fundamentals of nursing patient rehabilitation

The nursing process for myocardial infarction involves caring for the patient in a hospital setting (during a stay in the intensive care unit or in the infarction department) and nursing care at home during post-infarction rehabilitation.

Phase of nursing care for a patient in a hospital

Care begins with hemodynamic and electrical stabilization of the cardiovascular system in the intensive care unit and continues until the patient is discharged from the infarction department.

• In the first 1-2 days of the disease, bed rest should be observed.
• It is necessary to systematically prevent bedsores, especially if strict bed rest is maintained for a long time.

The nurse monitors the patient’s diet: it should be fractional, easily digestible, low-calorie, and fluid intake is limited. In the acute period (the first days of illness), especially with pain in the heart, the patient’s food is limited to several small portions of fruit juice.

Over the next few days, grated cheese, steamed cutlets, fruit and vegetable purees are added. The calorie content of food increases only after the patient's condition improves.

The patient should defecate and urinate while lying down. The patient should have bowel movements at least once every 2 days. For this purpose, it is possible to prescribe laxatives, cleansing and laxative enemas; the nurse must strictly follow the doctor’s prescriptions and report to him about the patient’s bowel problems.

A nurse talks about the benefits of eating prunes, dried apricots, and honey to facilitate physiological functions.

In case of urinary retention, bladder catheterization may be prescribed. The nurse providing care must remember to strictly adhere to the rules of asepsis and antisepsis when performing this manipulation.

Washing and eating in the first few days of the disease are carried out strictly while lying down, with the head end of the bed raised.

The nurse should perform passive movements of all the patient’s limbs (5 times for each limb 2 times a day), active movements of the feet and hands (5 times every hour), lowering the legs over the edge of the bed, sitting for 15 minutes 2 times a day.

The role of these exercises is to prevent congestion in the bloodstream and strengthen the cardiovascular system.

• From 3-5 days the patient is allowed to sit in a chair for 15-60 minutes 3 times a day, partially wash himself (first with the help of medical staff), and comb his hair. From the 6th day, sit in a chair without restrictions, wash and comb your hair at the sink, standing.
• Twice a day the patient performs additional exercises for the limbs, walks around the ward without restrictions, walks in the corridor for 7-10 minutes 3 times a day under the supervision of a nurse.
• In the future, the patient is allowed to walk along the corridor for 15-20 minutes 3 times a day, go down 10 steps, and later down and up 15 steps with self-monitoring of the pulse before and after exercise. The nurse monitors all changes in the patient's condition and immediately reports them to the doctor.
• The nurse's responsibilities include regularly monitoring the patient's hemodynamic parameters and entering them into the appropriate medical documentation.

Phase of nursing care for a patient after inpatient treatment (at home)

The nursing process for myocardial infarction involves the participation of the nurse in caring for the patient from the moment of discharge from the department until complete physical and psychological rehabilitation.

This time is allocated for sanatorium-resort and outpatient treatment. The goal of this phase is to return the patient to a full life and professional activity as quickly as possible. The role of the nurse in this phase is extremely important:

• A conversation should be held with the patient about the categorical exclusion of alcohol and the ban on smoking. You can give an example of a patient who successfully rehabilitated after this disease, does not smoke or drink alcohol.

  And another patient whose treatment effectiveness was significantly reduced due to his smoking and non-compliance with recommendations. Information about the role of a correct lifestyle in post-infarction rehabilitation will also be useful.

• The patient should be given recommendations on a healthy diet and a correct daily routine in order to prevent recurrent heart attacks.
• The patient should participate in group exercise classes or exercise at home. The nurse teaches the patient the elements of therapeutic exercises, self-massage and health path (metered walking). You can recommend yoga and breathing exercises. The role of such exercises is very great - they significantly reduce the risk of recurrent heart attacks.

The patient is explained the need to timely undergo the necessary examinations and follow-up.

This phase is aimed at maintaining the patient's physical and mental well-being, and the duration of this period is not limited.

Actual and potential problems

Regardless of where exactly nursing care is provided, nursing staff need to solve the patient’s actual and potential problems on a daily basis:

The nurse takes an active part in the medical and social rehabilitation of patients with myocardial infarction.

Her role is not only to carry out the doctor’s prescriptions, but also to maintain the patient’s faith in recovery, recommendations regarding daily routine and nutritional therapy, and consultation on all issues of interest.

Correct actions and professionalism of the nurse will preserve and improve the patient’s quality of life, contribute to his speedy recovery and return to a full life.

• Do you often experience discomfort in the heart area (pain, tingling, squeezing)?
• You may suddenly feel weak and tired...
• I constantly feel high blood pressure...
• There is nothing to say about shortness of breath after the slightest physical exertion...
• And you have been taking a bunch of medications for a long time, going on a diet and watching your weight...

Causes, signs and treatment of angina pectoris 3 FC

Cardiovascular diseases are one of the most significant factors influencing mortality rates. Death is caused mainly by coronary heart disease (CHD). Its common form is angina pectoris, which, in turn, also has 4 degrees of severity.

• The essence and typology of forms of the disease
• How the disease develops
• Diagnosis of the disease
• First aid for a seizure
• Treatment of the disease

The essence and typology of forms of the disease

The heart, the main muscle of the body, receives nutrition through the supply of oxygen and nutrients through the arteries. The daily requirement may increase if a person performs a certain physical activity. Accordingly, blood flow to the main organ increases.

The coronary and coronary arteries, which “serve” the heart, come from the aorta. If they are not normal, blood flow is disrupted. This means that a certain part of the heart muscle will not receive enough oxygen and the necessary substances for normal functioning.

This failure is called ischemia. If this condition lasts more than 30 minutes, cardiomyocytes in the heart begin to die, which leads to myocardial infarction. The pathology can become more active when the permissible level of physical activity is exceeded and is accompanied by pain.

There are 4 functional classes of the disease (FC). The main criterion for differentiation is the severity of the form and the permissibility of physical activity:

1. FC 1 is a relatively mild degree of the disease, in which moderate exercise is allowed. An attack is possible only in case of extreme physical stress.
2. FC 2 involves restrictions on physical activity. This class includes patients whose angina attack begins after walking 500 m or when climbing stairs to the second floor. In addition, patients are not recommended to walk in cold and windy weather, to be active immediately after waking up from sleep, or to experience emotional stress. All this can also provoke a deterioration in well-being.
3. FC 3 significantly limits a person’s physical activity. An attack can be triggered by walking at an average speed for 100-500 m and climbing a flight of stairs.
4. FC 4 is the most severe form. This is a disability in which seizures can occur even when at rest.

It is also worth noting that patients with FC 3 disease can usually control their abilities well. They are also able to sense upcoming attacks. This helps to neutralize them in advance and reduce the intensity to nothing.

How the disease develops

Damage to blood vessels can be caused by diabetes mellitus, cholesterol deposits and other reasons, due to which so-called plaques form on the walls of the arteries. They narrow the passage in the blood vessels, preventing normal blood circulation.

An attack of IHD angina pectoris with FC 3 or 4 is most often accompanied by severe pain. But sometimes it can be limited only to severe shortness of breath, cough and weakness. The main distinguishing feature of the disease: when a crisis occurs, you can always clearly determine the beginning and end.

The pain may spread to an area on the left side of the torso, behind the breastbone. Sometimes it involves the left arm, jaw or shoulder blade. The patient experiences sensations of pressure and compression in the heart area. With FC 3 or 4, pain may also be accompanied by the symptoms already listed above - shortness of breath, cough, etc.

During an attack, a person usually feels a characteristic pressing pain. It cannot be confused with anything and cannot be overcome if the appropriate drugs are not at hand. Fortunately, the attacks are usually short and often end unexpectedly, at the very peak of frustration. The disease is dangerous, first of all, due to the increased chances of getting a myocardial infarction.

Usually an attack with FC 3 or 4 lasts about 3-5 minutes, but in some patients it can be significantly delayed. In particularly advanced cases or after severe overload, the patient’s pain intensity can be wave-like, ranging from severe to excessive. In this case, you must immediately call an ambulance, since conventional neutralizers are not able to stop the crisis.

It is also worth noting that, depending on the predictability and nature of the attacks, angina in FC 3 or 4 can be stable or unstable:

1. A stable form suggests that the patient can predict the onset of a crisis. He knows for sure that if he does not exceed a certain standard of physical activity, he will be able to avoid pain. In this case, the disease is easy to control. The main thing is to define in advance the limits of what is permitted and calculate your capabilities.
2. In the case of an unstable form, attacks can begin without cause or prerequisites. The insidiousness of the disease is also that conventional medications may not help.

The forms of the disease largely determine the course of diagnosis and treatment that will be prescribed to the patient.

Diagnosis of the disease

Due to the specific clinical picture, diagnosing coronary artery disease angina is not particularly difficult for specialists. A cardiologist can determine the disease based on patient complaints alone. The diagnosis is even more likely if one of the patient’s relatives suffers from similar attacks in forms FC 3 or 4.

To confirm the disease, a series of instrumental examinations is used.

These include:

• electrocardiogram;
• Holter ECG monitoring;
• stress tests;
• Ultrasound of the heart;
• blood chemistry;
• myocardial scintigraphy;
• coronary angiography.

The most common and accessible diagnostic method is an electrocardiogram. To obtain more accurate data, it is recommended to do it directly during an attack.

Holter monitoring involves a series of ECGs, the results of which are recorded throughout the day using a special device. The patient goes about his business as usual. He independently records the monitoring data in a diary.

Ultrasound of the heart can detect disturbances in the functioning of the valve apparatus and myocardial contractions, which usually accompany ischemia of the heart muscle.

A biochemical blood test is used to diagnose the condition of blood vessels. In particular, they are tested for cholesterol and the degree of atherosclerotic lesions, which makes it possible to determine the degree of blood flow intensity.

First aid for a seizure

Angina pectoris is a chronic disease. Therefore, a complete cure is not always possible and only through surgical intervention.

But first of all, the patient and his immediate environment need to learn how to provide first aid during attacks.

Nitroglycerin and drugs based on it are the main means for stopping a crisis. At the first symptoms, the patient needs to put one tablet under the tongue and dissolve it. If the attack is severe, you can give it twice. It is better if the oral cavity is sufficiently moist. The maximum dose, 5 tablets, is taken in extremely severe cases when medical help is not expected.

You can also use a spray instead of tablets. The results of the action of nitroglycerin can be seen within a couple of minutes.

Sometimes they try to stop the attack with validol. This is a grave mistake, since this medicine not only does not help, but can cause serious harm to health.

But those around you can use simple ways to ease the crisis. To do this, it is necessary to stabilize the patient’s condition as much as possible, both physically and morally:

• the person must be allowed to stand for a while and catch his breath if the attack was provoked by intense physical activity;
• if the cause is stress, the patient needs to be reassured;
• it is important to provide the person with a sitting or semi-sitting position, as well as an influx of fresh oxygen;
• the body should be freed from any oppressive objects, including belts, collars, and excess outerwear;
• You can place heating pads with warm water on your feet.

Treatment of the disease

Aspirin should be used for therapeutic purposes. The drug reduces blood viscosity and facilitates its fluidity inside the vessels. For the same purpose, it is recommended to take:

• beta blockers;
• calcium antagonists;
• mixed action antiadrenergic drugs;
• vasodilators.

The course of therapy usually includes sedatives. It is important to understand that treatment must be supervised by a cardiologist. If you have this diagnosis, you should also acquire several useful habits:

1. Always carry a pack of nitroglycerin or spray with you. You can also stock up on medication at work and at home.
2. Before possible physical or emotional overload, you need to put a tablet under your tongue in advance.
3. Observe nutritional culture and maintain a routine. The condition of the blood vessels directly depends on this. The more cholesterol is deposited on their walls, the worse the blood flow and nutrition of the heart muscle, and the longer and more intense the attacks will be.
4. Monitor your condition and regularly attend general examinations. This is a must to keep attacks to a minimum. Suffering from obesity, advanced diabetes or other cardiovascular diseases, it is very difficult to get rid of the disease.
5. Move as much as possible. With angina pectoris FC 3, sports and intense walking are prohibited. However, it is acceptable to move slowly, shop on your own, or take a walk. You must first discuss your physical activity norm with a specialist.

You must stop smoking and overeating fatty foods. If all preventive and therapeutic measures do not help achieve complete recovery, the patient may be recommended invasive intervention. This could be bypass surgery or coronary artery grafting. Such radical treatment is applicable if angina attacks in forms FC 3 or 4 pose a real threat to the patient’s life.

You should not start a disease that can provoke the parallel development of cardiovascular disorders: tachycardia, severe forms of arrhythmia, heart attack. As a rule, complications progress and lead to disability.

It is prescribed to people for the purpose of normalizing the functioning of the cardiovascular system and breathing, in order to fully provide the body with oxygen after suffering a pathology. If you strictly adhere to your doctor's recommendations, then physical exercise for coronary heart disease can bring benefits, even more than pills. Let's figure it out.

Features of exercise therapy for ischemia

Gymnastics for coronary heart disease faces 8 main tasks:

1. Put the central and autonomic nervous system in order.
2. Eliminate muscle imbalances.
3. Stimulate metabolism by increasing redox reactions and energy expenditure.
4. Normalize carbohydrate and fat metabolism.
5. Improve the general condition of the cardiovascular system through:

• normalization of coronary and peripheral blood flow;
• increasing the contractile function of the myocardium;
• creating the necessary tone in the vessels;
• activation of the blood anticoagulant system.

Increase the efficiency of external respiration due to:

• increased mobility of the diaphragm, sternum, vertebral joints, muscle strength of the respiratory system;
• increasing the surface of the lungs;
• creating a network of complete ventilation-perfusion relationships.

Bring the activity of the gastrointestinal tract back to normal, preventing splanchnoptosis and the occurrence of cardiac hernias, as motility and secretions begin to work better.

Increase the vital functions of the body and its tolerance to physical activity.

Gymnastics for coronary heart disease is selected taking into account the current functionality of the patient’s cardiovascular system and his ability to engage in physical exercise. To do this, load tests are carried out using a bicycle ergometer and/or treadmill. In this case, heart rate at the threshold load will be the basis for calculating heart rate readings during gymnastic exercises. The training pulse can be:

• maximum - 50-80% of the threshold value;
• minimum - 80-85%.

The peculiarity of assessing the patient’s condition is to undergo special tests, of which there are quite a few. So, K. Cooper tested patients by the maximum distance they could cover in 12 minutes. Then their health is assessed from excellent to very poor.

Indications and contraindications

Exercises for cardiac ischemia are prescribed to patients divided into groups:

• co ;
• after and/or with acquired ;
• with a left ventricular aneurysm, which resulted in myocardial infarction.

Training is selected taking into account the degree of pathology:

• at initial insufficiency of the coronary system there are no symptoms;
• in a typical case, the clinical picture does not appear until the patient begins to increase physical activity or suffers emotional stress;
• with pronounced clinical manifestations of the pathology are present even at rest.

Do not forget about the contraindications of exercise therapy for ischemic heart disease:

• frequent angina pectoris;
• there are acute disorders in the coronary circulation;
• failure from the first stage and above;
• persistent rhythm disturbance;
• cardiac aneurysm.

In this case, exercise therapy can be prescribed in the intervals between attacks of angina:

• mild attack - you can start on the second day after it;
• severe case - day 8;
• elderly people after a moderate attack - on the 4th day.

A characteristic feature of modern society is physical inactivity - a disruption in the functioning of the body due to a lack of physical activity. The development of the transport network, automation of production and the increase in the number of “knowledge” workers have led to the fact that people began to lead a sedentary lifestyle. Unfortunately, this factor has a negative impact on the health of the human cardiovascular system. Diseases such as angina pectoris, stroke, and heart attack have become increasingly common. Therapeutic exercise for coronary artery disease is an important component of the rehabilitation of patients who have suffered heart disease.

The benefits of physical activity for cardiac ischemia

For physical rehabilitation, doctors prescribe light exercises at the very beginning of the post-infarction period. The purpose of such exercises is to restore breathing and bring the patient out of a serious condition.

It must be remembered that therapeutic exercises for ischemic heart disease are prescribed strictly by a specialist. Excessive physical activity and too intense exercise can negatively affect your health and lead to a relapse of the attack.

Regular physical activity is beneficial for everyone. For healthy people, it helps prevent the onset of diseases, and for those who have already suffered heart disease, physical education reduces the recovery period and prevents the development of relapse.

Physical activity for coronary artery disease helps:

• keep muscles toned;
• reduce the level of atherogenic lipids in the blood (cholesterol, low-density lipoprotein, etc.), thereby reducing the risk of atherosclerosis;
• normalize blood pressure;
• prevent the formation of blood clots;
• improve quality of life, improve mood;
• normalize sleep;
• prevent obesity and reduce the risk of diabetes.

According to medical research, people who engage in physical therapy after a heart attack are 7 times less likely to suffer a recurrence of such a heart attack and reduce the likelihood of death by 6 times. Exercise therapy for coronary heart disease can improve the general health of the patient. Regular exercise improves blood flow, minimizes the effects of heart failure, and strengthens the cardiovascular system.

Features of physical education for ischemic heart disease

Not all types of physical activity are suitable for patients suffering from coronary heart disease. The type of load and its intensity are determined by the attending physician based on the specific clinical picture.

For patients who have suffered heart disease, the nature of exercise therapy can be of decisive importance:

1. With moderate activity, recovery speeds up, strength and endurance of the body increase.
2. With excessive exercise, angina pectoris may occur, which often leads to a repeat attack.

The priority areas of physical education are exercises aimed at developing endurance. These include quiet walks, cycling, housework, and dancing. Loads should gradually increase. In this case, the heart rate should increase by no more than 15-20 beats per minute.

Indications and contraindications

Coronary heart disease is a pathological condition that is characterized by disruptions in the blood supply to the myocardium due to damage to the coronary vessels. The reason for this situation is the lack of oxygen entering the heart with blood. Indications for performing therapeutic exercises are acute forms of coronary artery disease (with a history of myocardial infarction) and chronic forms (with periodic attacks of angina pectoris).

Contraindications for exercise therapy for ischemic heart disease:

• frequent attacks of angina pectoris;
• acute disturbances in coronary circulation;
• advanced stages of heart failure;
• persistent arrhythmia;
• cardiac aneurysm.

For patients suffering from angina, doctors recommend that they carry out therapeutic exercises in between attacks. So, with a mild attack, simple exercises can be done already on the second day, with an average one - on the fourth day, with a severe one - on the eighth day.

Rules for performing physical exercises for ischemic heart disease

Physical education for patients with coronary heart disease is carried out only after the condition has been stabilized.

Initially, it is advisable to do breathing exercises and exercises aimed at the activity of individual muscle groups. Then, in a clinical setting, a submaximal test is performed to determine the permissible intensity and volume of loads as part of post-infarction rehabilitation.

The test ends when the heart rate increases to 120 beats per minute or when clear signs of intolerance appear. The heart rate recorded at the end of testing becomes the threshold value and subsequent physical activity should not exceed 75% of the experimentally established value.

At first, the optimal loads will be: therapeutic exercises, walking, exercise bike, swimming, jogging.

Prohibited loads are marked with a “—” sign, and permitted loads with a “+„ sign. The number of “+” signs indicates the permissible intensity and volume of loads.

Daily physical activity

Types of household work

Type of activity	Function class
	I	II	III	IV
Sawing	+	-	-	-
Working with a hand drill: comfortable position awkward position	++ ++	+ -	- -	- -
Working with a vacuum cleaner	++	+	-	-
Washing vertical surfaces (windows, walls, cars): comfortable position awkward position	++ +	+ -	- -	- -
Wiping dust	+++	+++	++	+
Washing dishes	+++	+++	++	+
Wash: comfortable position awkward position	++ +	+ -	- -	- -
Sewing, embroidery	+++	++	+	-

Work on a personal plot

Type of activity	Function class
	I	II	III	IV
Excavation work (loosening the soil, digging the ground, digging holes)	++	+	-	-
Carrying loads manually (water, sand, cement, bricks, fertilizers, etc., in kg)	up to 15	until 8-10	until 3	-
Transportation of goods by wheelbarrow (kg)	until 20-25	up to 15	until 6-7	-
Watering: hose large watering can (10 kg) small watering can (3 kg)	+++ +++ +++	++ ++ ++	+ - +	- - -
Landing: trees seedling	++ +++	+ ++	- +	- -
Harvesting: from the trees from the bushes	+++ +++	++ +++	+ +	- -

A set of exercises for coronary heart disease

Exercises for the treatment of coronary artery disease include a combination of breathing exercises and physical activity. Physical education can be carried out in a clinic or at home based on the recommendations of the attending physician. During classes, you need to monitor your breathing - it should be calm and even.

Here are some examples of exercises that speed up rehabilitation after heart disease:

1. The patient lies down on a hard horizontal surface with his arms and legs spread wide. Then he slowly bends and straightens his fingers. The exercise is repeated 5-6 times.
2. In a supine position, the patient does breathing exercises - alternating deep, slow breaths with exhalations. The number of repetitions is 3-4 times.
3. Lying on his back and stretching his legs, the patient alternately pulls the sock towards himself and away from himself. The exercise is repeated 5-6 times.
4. Sitting on a chair, the patient lowers his arms along the body. Then, inhaling deeply, he raises his hands up, exhaling - down. Number of repetitions 5 times.
5. In a sitting position, the patient fixes his hands on his belt. Then he straightens his arms one by one and returns them to their starting position. The number of repetitions is 5-6 times.
6. The patient takes a “standing” position and makes 3 slow rotations of the head in one direction and 3 in the other.
7. In a standing position, the shoulders are alternately raised and lowered. The number of repetitions is 5-6 times.
8. The patient puts his hands on his belt and makes 3 circular rotations of the body in one direction, 3 in the other.
9. The patient stands next to the chair, leaning his arms on its back. Then he slowly sits down on a chair while inhaling and rises to his original position when exhaling. Number of repetitions - 4-5 times.

What physical activity is optimal for patients who have had a heart attack?

In the post-infarction state, they will help achieve better recovery of endurance load, in combination with exercises for flexibility and strength. For example, it is better to alternate walking and cycling with walking up an inclined surface, while developing strength and endurance. Housework or gardening can be alternated with dancing or swimming.

It should be remembered that any loads are introduced gradually. An increase in physical activity must be agreed upon with a specialist. Otherwise, such physical exercise can only worsen your health and provoke a repeat attack.

Post-infarction rehabilitation should be comprehensive. This means that increasing activity alone is not enough. To fully restore the body, additional drug therapy and adjustments to the patient’s diet and lifestyle are carried out. In difficult cases, rehabilitation may include surgical correction.