How to Prevent a Future Heart Attack If You've Had One

Will I need to start treatment to prevent another heart attack or complications?

If you've had a heart attack, your cardiologist's primary goal is to prevent another heart attack or complication. To start, they'll tell you to follow a heart-healthy diet and commit to at least 150 minutes of moderate-intensity exercise per week. They will also prescribe you medications for both the short-term and long-term.

Short-term and long-term medications can prevent future heart attacks and facilitate recovery. Your cardiologist will work with you on making the needed lifestyle modifications and determining the best combination of medications for you.

How long will it take to make a full recovery after a heart attack?

Recovering from a heart attack is a different journey for everyone. How long it will take depends on several factors, such as the size and severity of your injury, your overall health, and if you have any complications.

I typically recommend one to two weeks of recovery time before getting back to everyday activities. Generally speaking, you can return to driving after about one week. You should wait 10 to 14 days before going back to work.

Fully recovering from a heart attack may take several weeks. It's a gradual process. As your body adjusts to your new medications and lifestyle, your heart will heal.

Is it safe to exercise on my own?

After a heart attack, you should discuss with your cardiologist when it's safe to exercise again. In most cases, you'll have to undergo an exercise stress test or risk assessment as part of your recovery. These will give your cardiologist a better idea if you're ready to return to regular exercise.

I recommend minimizing strenuous exercise, including sexual intercourse, for about two weeks after a heart attack. Eventually, you should start incorporating exercise into your weekly routine. Aerobic exercise has the most cardiovascular benefits.

When you're ready to work out on your own, start slow and build up. You can start by walking a few minutes every day at a comfortable pace. Do this for one to two weeks. Then, gradually increase your speed as you're able.

What is a 'heart-healthy' diet?

A heart-healthy diet emphasizes fresh fruits, vegetables, whole grains, poultry, fish, low-fat dairy products, legumes, nontropical vegetable oil, and nuts. Foods to avoid include sweets, red meat, fried food, and sugar-sweetened beverages. Drink plenty of water and try to limit yourself to one glass of red wine per day, if you chose to drink at all. Talk to your doctor to see if it's safe for you to drink alcohol in moderation.

Is it OK to drink alcohol?

The answer to this question depends on your specific circumstances. Some medications may negatively interact with alcohol and cause you more harm. If you have suffered complications from a heart attack — such as heart failure or heart arrhythmia­ — it may not be wise to consume alcohol while you're healing.

Light to moderate alcohol consumption is one drink per day for women and two drinks per day for men. However, this amount can vary with each type of alcohol. You should consult with your cardiologist before consuming alcohol after you've had a heart attack to determine when or if it's safe for you to drink.

The American Heart Associate (AHA) does not recommend starting to consume alcohol if you don't already consume alcohol.

What are my chances of having another heart attack or stroke?

Having a heart attack or stroke puts you at an increased risk of having another one in the future. This is because, at this point, atherosclerosis has affected the blood vessels (arteries) that provide oxygen and nutrients to your entire body, including your heart and brain.

You can work with your cardiologist to make the right lifestyle modifications and find the right combination of medications. This can substantially reduce your chances of experiencing another cardiovascular event, including a heart attack or stroke.

How long will I need to take medication?

After a heart attack, you'll likely need to stay on treatment for the long haul to avoid further complications like another heart attack or stroke. This means sticking to a heart-healthy diet, exercising regularly, continuing to take your prescribed medication, and going to the doctor for any testing as needed.

You may be able to decrease the dosage of your medication as you heal, or discontinue it altogether. Of course, this will depend on your specific case, and you'll need to wait on the green light from your doctor.

Will it ever be safe to 'treat' myself with high-fat foods?

I don't endorse eating any high-fat foods. Fatty foods include trans-fat, saturated fat, and cholesterol. These are the main culprits in the development of obstructive plaques of a disease process called atherosclerosis. These plaques can grow large enough to limit blood flow to the heart muscle or break open and form a clot that abruptly stops blood flow. This can cause the heart attack or stroke we're trying to prevent.

---

Dr. Harb Harb is a non-invasive cardiologist working within the Northwell Health System in New York, specifically at the North Shore University Hospital, affiliated with Hofstra University. He completed medical school at the University of Iowa Carver College of Medicine in Iowa City, Iowa, internal medicine at the Cleveland Clinic in Cleveland, Ohio, and cardiovascular medicine at Henry Ford Health System in Detroit, Michigan. Dr. Harb moved to New York City, choosing a career path in academic medicine as an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. There, he teaches and works with cardiovascular and medical trainees as well as medical students. He is a Fellow of the American College of Cardiology (FACC) and American board-certified in general cardiology, echocardiography, and stress-testing, and nuclear cardiology. He is a registered physician in vascular interpretation (RPVI). Lastly, he obtained graduate education in public health and business administration to contribute to national healthcare reform research and implementation.