Exercise can help keep you well
In the “old days’’ it was not unusual for people with congenital heart disease to be told they should not exercise because they had a “weak heart”. Some of my older patients had never even owned a pair of sneakers as a result! Thankfully, today with increasing amounts of research showing the benefits of regular exercise, people born with congenital heart disease should be encouraged to participate in a range of sports. In fact, one of my patients is now fulfilling his dreams and training as a Paralympian despite having thought as a child he may never even be able to play sport!
If you’re lucky enough to have grown up leading an active life, you might already be involved in regular exercise and may just like a bit more information about your limits and goals. If you’ve never really had this opportunity, don’t feel like the door on an active life is closed forever.
Although there might be big differences in the level and type of activity we recommend for each person, virtually everyone with congenital heart disease can and should be doing some regular exercise. Here are some of the reasons why…
- Your exercise capacity and strength will improve making you feel fitter.
- People with congenital heart disease are at increased risk of being overweight and that can affect heart function and increase your risk of things like cardiovascular disease as you get older.
- Regular exercise burns calories and reduces the risk of cardiovascular disease, diabetes and cancer.
- Research suggests that people born with congenital heart disease often have a negative body image and reduced self-esteem. This is, in part, related to being unwell as a child and their surgical scars. Exercise has been shown to improve these problems by making you feel better about yourself.
- Even in people with more complicated types of congenital heart disease regular exercise has been shown to improve heart function and reduce symptoms of heart failure.
- Regular exercise reduces levels of stress and anxiety.
- In people with complex types of congenital heart disease, more active people have a lower risk of complications. We don’t understand all the reasons why but it appears that exercise does wonderfully complex things to hormones, blood vessels and muscles (to name just a few) that help protect from some complications of congenital heart disease.
Of course I am not saying that exercise will fix everything but its something you can do to help stay as well as possible.
Before you rush out and join the gym or the local netball team there are some important things to consider. First and foremost you should discuss your exercise program with your cardiologist.
Important questions to ask your specialist are:
- What types of exercise are OK for you?
- What level of exertion is best for you?
Sometimes your cardiologist may arrange an exercise test to help decide your training goals. There are some types of congenital heart disease that we do not place any restrictions on but there are others that are safer doing gentler levels of exercise. If you have complicated problems your doctor might even get you started in a supervised setting with the cardiac rehabilitation physiotherapists to make sure to get things right for you. Some problems that we might be a bit more cautious with include major aortic dilatation and severe levels of heart muscle dysfunction, valve dysfunction or pulmonary hypertension.
Sporting activities are usually described in terms of the amount of cardio or resistance activity involved. For example, going for a run is predominantly high-level “cardio” because you are moving your muscles quickly and ultimately building endurance. In contrast, high-level resistance activities like weight-lifting and rock-climbing focus on increasing muscle bulk and strength. These different types of activities have differing effects on heart rate and blood pressure and the harder you work the greater those changes can be. For those reasons, depending on your diagnosis, you might be advised to avoid specific types of exercise.
Have a think about your routine and game plan. Although traditionally the recommendations for regular exercise are about five times a week for 30 to 60 minutes, even a slow walk for 10 minutes or climbing a few extra stairs can improve your fitness if this is more than you usually do. Choose something you enjoy. This is not supposed to be torture! Start with realistic goals and slowly build on the duration and frequency.
There are some special situations that also deserve mention. If you are on warfarin or that family of blood thinners, contact sports like rugby, skiing and snow-boarding are dangerous because if you get injured you could bleed internally. I once had a patient ask if they could bungee jump on warfarin and unfortunately the answer is no. Pacemakers, defibrillators and some special types of grafts and conduits can be damaged if you take a big hit during a rough game of contact sport such as footy so it is important to check about that too with your specialist.
In the world of congenital heart disease we are gradually gaining more and more information from scientific research to suggest that regular exercise is safe when done properly and has really important beneficial effects on the body and mind. I hope you can embrace regular exercise, whatever your abilities, as an essential part of your life.