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Coping and support

By Mayo Clinic staff

Having a heart attack is a scary experience. Even if your doctor says you're OK, you may still be afraid. How will this affect your life? Will you be able to get back to work or resume activities you enjoy? Even more frightening — will it happen again?

Fear is just one of the many emotions you and your family must deal with. Other emotions that can be particularly difficult to cope with after a heart attack may include:

  • Anger. You may be angry and wonder: "Why did I have to have a heart attack, and why now?" It's normal to feel some resentment after a heart attack.
  • Guilt. Family members may feel scared at first and then guilty about your heart attack. Some may even feel that they're somehow responsible for doing something that gave you a heart attack.
  • Depression. Depression is common after a heart attack. You may feel that you can no longer do things you used to do — that you're not the same person you were before the heart attack.

These feelings are common, and openly discussing them with your doctor, a family member or a friend may help you better cope. You need to take care of yourself mentally as well as physically after a heart attack. Exercising and participating in cardiac rehabilitation sessions with other people who are recovering from a heart attack may help you work through these feelings.

Cardiac rehabilitation
The goal of emergency treatment of a heart attack is to restore blood flow and save heart tissue. The purpose of subsequent treatment is to promote healing of your heart and prevent another heart attack.

Many hospitals offer cardiac rehabilitation programs that may start while you're in the hospital and, depending on the severity of your attack, continue for weeks to months after you return home. Cardiac rehabilitation programs generally focus on three main areas — medications, lifestyle changes and emotional issues.

Sex after a heart attack
Many people worry that sex after a heart attack will be too strenuous on their hearts. However, most people can safely return to sexual activity after recovering from a heart attack. Each person has a different timeline, depending on his or her level of physical comfort, psychological readiness and previous sexual activity.

The demands sexual intercourse places on your heart approximate those of taking a brisk walk, scrubbing a floor, or climbing one or two flights of stairs. In a way, sexual activity parallels any other physical exertion — your heart rate, breathing rate and blood pressure level increase. Ask your doctor when it's safe to resume sexual activity. With time, you'll likely be able to resume your normal sexual patterns.

Some heart medications, such as beta blockers, may affect sexual function. However, sexual dysfunction following a heart attack is more often due to depression or anxiety than to medications. If you're having problems with sexual dysfunction, talk to your doctor. He or she may be able to help you pinpoint the problem and seek the appropriate treatment.

Ask questions
You and your family may have a lot of questions and concerns following your heart attack. If so, it might be helpful to talk to others who are experiencing some of the same things as you and your family. Many cardiac rehabilitation programs offer counseling services and support groups for heart attack survivors.

Surviving a heart attack doesn't mean that life as you knew it is over. On the contrary, most people can lead full, active lives after a heart attack. But it may mean making some positive changes in your daily habits, being patient as you recover and adopting a can-do attitude.

References
  1. Heart attack. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/HeartAttack/HeartAttack_All.html. Accessed Oct. 1, 2009.
  2. American Heart Association. 2005 Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Circulation. 2005;112:1S.
  3. Ewy GA. Cardiocerebral resuscitation should replace cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Current Opinion in Critical Care. 2006;12:189.
  4. Hefland M, et al. Emerging risk factors for coronary heart disease: A summary of systematic reviews conducted for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2009;151:496.
  5. U.S. Preventive Services Task Force. Using nontraditional risk factors in coronary heart disease risk assessment: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2009;151:474.
  6. Chobanian AV, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New England Journal of Medicine. 2003;289:2560.
  7. Stimulants. National Institute on Drug Abuse. http://teens.drugabuse.gov/facts/facts_stim2.php. Accessed Oct. 1, 2009.
  8. King SB, et al. 2007 update of the ACC/AHA/ SCAI 2005 guideline update for percutaneous coronary intervention. Circulation. 2008;117:261.
  9. Antman EM, et al. Use of nonsteroidal antiinflammatory drugs: An update for clinicians. Circulation. 2007;115:1634.
  10. Shaw LJ, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden. Circulation. 2008;117:1283.
  11. Rind DM, et al. Intensity of lipid lowering therapy in secondary prevention of coronary heart disease. http://www.uptodate.com/home/index.html. Accessed Oct. 1, 2009.
  12. Alcohol, wine and cardiovascular disease. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4422. Accessed Oct. 1, 2009.
  13. Sexual activity and heart disease or stroke. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4714. Accessed Oct. 1, 2009.
  14. Lightwood JM, et al. Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation. 2009;120:1373.

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Nov. 20, 2009

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