How do you exercise if you have heart problems?

cardiologist, specialist in echocardiography and functional diagnostics at EMC

Is it possible to do sports with a weak heart?

Exercise is gaining popularity, and many people go to the gym without consulting a doctor. This is one of the most serious mistakes: even if you have no injuries or obvious illnesses, there may be problems in which you should not force the exercise. However, there is also the opposite situation: a person knows about the presence of certain health problems and avoids any loads. We tell you whether you can exercise people who have problems with the cardiovascular system.

Before you start exercising, you should come to see your cardiologist, or better to a sports cardiologist and conduct a number of tests. These will show what is going on with your heart and blood vessels at the moment. Mandatory minimum – cardiogram and ultrasound of the heart (echocardiography). It is not recommended to start sports without them. If a person has an arrhythmia, it is likely that he or she will also need ECG monitoring – daily or for a longer period of time. With this information, the doctor can accurately predict the necessary physical activity, its volume and parameters.

It is also good to visit an orthopedist or rehabilitation specialist. The doctor will help to select insoles for those who have flat feet or problems with pronation, that is, the way the foot is set. This is to reduce joint stress and improve the quality of walking. A few months after starting training, the visit to the doctor can be repeated. He will see how the patient has coped with the recommended walking distance and possibly increase the load.

What kind of training should be emphasized in this case?

It is best to start with regular walking. Scandinavian has proven itself very well – it is considered an excellent load. If a person walked, for example, three thousand steps a day, it can be recommended to increase the load and do 6-7 thousand a day. If he walked eight thousand steps, you should switch to 12-15 thousand daily.

When the patient is ready to switch from walking to running, we recommend jogging at a slow pace. Even if you want to and can run faster, you should not increase the speed at first. This is necessary so that the cardiovascular system adapts to the running loads, you feel your heart rate and do not get running injuries, which will put off the possibility of doing sports for a long time.

Running can be replaced with interval training such as tennis, squash, badminton or table tennis. The key is to make a physical effort every day. Cardiosport and cardio exercises not only make a person feel better, but also help to reduce the number of medications, and sometimes even abandon them altogether. And above all, this applies to arterial hypertension.

As an example, I would like to cite the story of one of my patients: he came to me about 10 years ago at the age of 45. Then he was examined in the cardiology department of a large federal center, where he was diagnosed with arterial hypertension and recommended four drugs to reduce blood pressure. He left the center saying, “That’s it, I’m running.” And indeed he put on sneakers and ran. Running daily and gradually increasing the load, he ran first 5 km, then 10 km, then began to run half-marathons, and then a marathon. Actively engaged in sports, he not only normalized blood pressure, but also gradually abandoned any drug therapy.

Such a test makes it possible to individually select the load and make running safe.

Be attentive to your blood pressure and heart rate. If after 2-4 months of training your blood pressure has decreased excessively, this is a reason to reconsider the amount of therapy. If the pulse has decreased excessively and became 47-48 (less than 50) beats per minute or, on the contrary, you more often began to see non-rhythmic pulse, rhythm disturbance, you should definitely consult a cardiologist. The doctor will look at the medications you are taking and give recommendations on the intensity and type of loads you are practicing.

What is categorically forbidden to do?

And people with cardiovascular problems, and in general, all novice athletes should not force the load. If a person has previously sat in the office and moved little, from the car to home or from the car to work, then going out for a running workout for him will be a huge risk. He is unlikely to be able to run for long because he will quickly develop a running injury such as plantar fasciitis (inflammation of the ligaments) or inflammation of the Achilles tendon (located near the heel).