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Heart attack - discharge

A heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies. This article discusses what you need to do to take care of yourself after you leave the hospital.

When You're in the Hospital

You were in the hospital because you had a heart attack. A heart attack occurs when blood flow to a part of your heart is blocked long enough that part of the heart muscle is damaged or dies.

Acute MI

What to Expect at Home

You may feel sad. You may feel anxious and as though you have to be very careful about what you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.

Activity

You should know the signs and symptoms of angina.

  • You may feel pressure, squeezing, burning, or tightness in your chest. You may also notice these symptoms in your arms, shoulders, neck, jaw, throat, or back.
  • Some people also feel discomfort in their back, shoulders, and stomach area.
  • You may have indigestion or feel sick to your stomach.
  • You may feel tired and be short of breath, sweaty, lightheaded, or weak.
  • You may have angina during physical activity, such as climbing stairs or walking uphill, lifting, sexual activity, or when you are out in cold weather. It can also happen when you are resting or it can wake you up when you are sleeping.

Know how to treat your chest pain when it happens. Talk with your health care provider about what to do.

Take it easy for the first 4 to 6 weeks.

  • Avoid heavy lifting. Get some help with household chores if you can.
  • Take 30 to 60 minutes to rest in the afternoon for first 4 to 6 weeks. Try to go to bed early and get plenty of sleep.
  • Before starting to exercise, your provider may have you do an exercise test and recommend an exercise plan. This may happen before you leave the hospital or soon afterward. DO NOT change your exercise plan before talking with your provider.
  • Your provider may refer you to cardiac rehabilitation program. There, you will learn how to slowly increase your exercise and how to take care of your heart disease.

You should be able to talk comfortably when you are doing any activity, such as walking, setting the table, and doing laundry. If you cannot, stop the activity.

Ask your provider about when you can return to work. Expect to be away from work for at least a week.

Talk to your provider before engaging in sexual activity. Ask your provider when it is OK to start again. DO NOT take Viagra, Levitra, Cialis or any herbal remedy for erection problems without checking with your provider first.

How long you will have to wait to return to your normal activities will depend on:

  • Your physical condition before your heart attack
  • The size of your heart attack
  • If you had complications
  • The overall speed of your recovery

Diet and Lifestyle

DO NOT drink any alcohol for at least 2 weeks. Ask your provider when you may start. Limit how much you drink. Women should have only 1 drink a day, and men should have no more than 2 a day. Try to drink alcohol only when you are eating.

If you smoke, stop. Ask your provider for help quitting if you need it. DO NOT let anybody smoke in your home, since second-hand smoke can harm you. Try to stay away from things that are stressful for you. If you are feeling stressed all the time, or if you are feeling very sad, talk with your provider. They can refer you to a counselor.

Learn more about what you should eat to make your heart and blood vessels healthier.

Taking Your Heart Medicines

Have your drug prescriptions filled before you go home. It is very important that you take your drugs the way your provider told you to. DO NOT take any other drugs or herbal supplements without asking your provider first if they are safe for you.

Take your medicines with water. DO NOT take them with grapefruit juice, since it may change how your body absorbs certain medicines. Ask your provider or pharmacist for more information about this.

The medicines below are given to most people after they have had a heart attack. Sometimes there is a reason they may not be safe to take, though. These medicines help prevent another heart attack. Talk with your provider if you are not already on any of these medicines:

DO NOT suddenly stop taking these medicines for your heart. DO NOT stop taking medicines for your diabetes, high blood pressure, or any other medical conditions you may have without talking with your provider first.

If you are taking a blood thinner such as warfarin (Coumadin), you may need to have extra blood tests on a regular basis to make sure your dose is correct.

When to Call the Doctor

Call your provider if you feel:

  • Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw
  • Shortness of breath
  • Gas pains or indigestion
  • Numbness in your arms
  • Sweaty, or if you lose color
  • Lightheaded

Changes in your angina may mean your heart disease is getting worse. Call your provider if your angina:

  • Becomes stronger
  • Happens more often
  • Lasts longer
  • Occurs when you are not active or when you are resting
  • Medicines do not help ease your symptoms as well as they used to

Alternative Names

Myocardial infarction - discharge; MI - discharge; Coronary event - discharge; Infarct - discharge; Acute coronary syndrome - discharge; ACS - discharge

Images

References

Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. PMID: 25260718 www.ncbi.nlm.nih.gov/pubmed/25260718.

Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):e354-e471. PMID: 23166211 www.ncbi.nlm.nih.gov/pubmed/23166211.

Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 53.

Mega JL, Morrow DA. ST-Elevation myocardial infarction. In Bonow RO, Mann DL, Zipes DP, Libby P, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 52.

O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):529-555. PMID: 23247303 www.ncbi.nlm.nih.gov/pubmed/23247303.

Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol. 2011;58(23):2432-2446. PMID: 22055990 www.ncbi.nlm.nih.gov/pubmed/22055990.

Review Date 8/2/2016

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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