The European Society of Cardiology published a dedicated Q&A, pooling together useful recommendations from international authorities and medical societies (available in English)
It is not uncommon for people who have heart disease to get chest pain or discomfort.
If you feel:
You should:
If the pain persists for 5 to 10 minutes call an ambulance. Do not drive to the hospital yourself or let someone drive you. Your local hospital may not be equipped to treat heart attacks 24/7.
If you are prescribed glyceryl trinitrate (GTN) spray, spray once under the tongue.
Wait 5 minutes. If the pain persists, spray a second time.
Wait 5 minutes. If the pain persists, spray a third time.
A maximum of 3 sprays of GTN over 15 minutes may be administered. If the pain does not go away after 15 minutes and three sprays of GTN, call an ambulance.
Do not take GTN spray if you have taken medication used to treat erectile dysfunction within the last 24 hours.
Rest until the ambulance arrives.
If the pain does ease with spray or rest but occurs again or more frequently, inform your GP or cardiologist. Keep a written record of your symptoms and pains.
Yes, it can be, if you are on “blood-thinning” medication (antiplatelets such as ticagrelor, prasugrel or clopidogrel, and oral anticoagulants like warfarin, acenocoumarol or phenprocoumon). Check that your international normalised ratio (INR) isn’t too high.
Monitor the bruising. If it is excessive, painful or if you feel a hard lump under the bruising report it to your doctor or nurse practitioner.
Some do – for example beta blockers. Try taking your medications in the morning instead of the evening. Discuss this with your nurse practitioner or doctor.
After a cardiac event you will usually be on aspirin for life. You may also need to take other medications such as a beta blocker, ACE inhibitor, statin or antihypertensive drug. See your doctor, who will review and monitor your medications and discuss which ones you need to keep taking.
If you remember on the same day, then take your medication later that day. If not, leave it out and take it at the usual time the next day. Never double the dose.
The answer is no. A concern shared by many people is that the stent will move around in the arteries once it has been inserted. Once a stent is opened in an artery, the tissues of the artery wall begin to grow over the stent. The stent becomes a part of the artery wall and cannot move.
You can resume sex as soon as you feel ready. Usually, both men and women resume sex within a few weeks after a heart attack or heart surgery. Many have sex as often as before. However, some are less active. This may be due to anxiety, depression or lack of desire. Communication is key, so talk to your partner. Sometimes partners are more anxious than patients. Medical care, time and counselling can help. When you recover from a heart attack, you may be more aware of your heartbeat, breathing, and muscle tightening or tension. This is a normal reaction, so don’t worry. You can touch, hold and caress each other without the goal of orgasm. You and your partner can be intimate without feeling pressure to perform. You can gradually return to your full sex life in your own time. As you get more confident, you’ll feel more at ease with yourself and your partner. Intercourse takes slightly more energy than other sexual activities. A general rule is that if you can climb two flights of stairs without being breathless, you are ready. Patients who don’t have complications can resume sexual activity within a week to ten days. It usually takes eight weeks after heart surgery. If you are unsure, check with your healthcare provider.
For full details on cholesterol and the difference between LDL and HDL see the Cholesterol page.
Your cardiologist will decide when you can resume driving based on several issues however some guidance is available on the Can I drive after a heart problem? page.
Your cardiologist will decide when you can resume driving based on several issues however some guidance is available on the Can I drive after a heart problem? page.
How long you stay off work should be decided by your cardiologist however some recommendations are available on the When can I return to work after a heart attack? page.
If you feel good, you can leave the house immediately. If you live on a higher floor with no lift then take the stairs slowly at the beginning. You can run errands. Start with easy ones and build up according to how you feel. You can get out of the house to do some shopping. During the first month, limit what you carry to 5 kg. Remember to listen to your body. If your body is telling you it is tired, then you are doing too much. Pace yourself, do a little bit of exercise every day and gradually increase it. Rest is also essential for recovery.
This varies from country to country. The social worker will tell you what you are entitled to before discharge. Your country’s social welfare department or equivalent may have an information website or helpline. There may be a citizens advice bureau nearby that can also advise you.
Some countries have support groups. Ask your social worker.
You should have repeat blood tests four to six weeks after hospitalisation. The cholesterol results will determine if your lipid-lowering therapy needs to be adjusted.
If you have a problem taking the medication recommended by the hospital, contact the hospital, cardiologist or family doctor for advice as soon as possible. Do not suddenly stop taking medication.
You will be treated like a “chronic patient” with regular medical follow-ups. The frequency depends on local practice. Usually between six and eight weeks after discharge, then every six months, and then yearly.
You can help prevent another cardiac event by adopting a healthy lifestyle. Stop smoking, exercise, eat healthy food, and lose excess weight. In addition, take your medication to treat high cholesterol, high blood pressure, and diabetes.
For more information see the Risk factors for a second heart attack page.
You should stop smoking immediately. Smoking is a lethal addictive disorder and many healthcare systems offer help to quit. Smoking cessation programmes provide behavioural support and nicotine replacement therapy.
For more information see the Smoking page.
After your heart attack, cardiac rehabilitation is highly recommended and starts about six weeks after hospitalisation.
Your fitness to fly will should be determined by your doctor, more information is available on the Can I travel after a heart attack? page.