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You had a heart attack - now what?

What to expect after a heart attack. 

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Heart disease is the most common cause of death in men and women, but some people still think of cardiac issues – particularly heart attacks – as a male problem. Unfortunately, research suggests that not only are heart attacks a concern for women, but they’re also becoming more common among women at a younger age. One in eight women between the ages of 45 and 64 (relatively young for cardiac patients) lives with cardiovascular disease, and, according to a 2018 study in the journal Circulation, out of 28,000 people hospitalized for attacks, 30 percent were under the age of 54.

If you’re already balancing multiple responsibilities such as working, parenting or caring for family members, experiencing a heart attack, on top of everything else, means trying to figure out how to fit in your own health and well-being. With this in mind, the experts from the Women’s Cardiovascular Health Initiative at Women’s College Hospital offer some key steps so you can prioritize taking care of yourself in order to achieve a full and timely recovery.

1. You’re going through an emotional rollercoaster. Numerous studies have found significantly higher rates of anxiety and depression in people following a heart attack than in the general population. In one study, women in all age groups and patients aged 45-65 had an even greater risk. According to Lina Jobanputra Parmar, social worker with the Women’s Cardiovascular Health Initiative at Women’s College Hospital, in the aftermath of a heart attack, you’re in survival mode trying to get mobilized with the physical aspects of care, so while acute emotions like shock and anger may pop up, stress, anxiety, fear and depression will often show up further down the road, which can be surprising. “These emotions are the ball and chain following behind you – there’s a delayed grief reaction,” says Lina. “It’s common to fear the unknown and worry about this happening again.” 

2. You’ll have to prioritize self-care. “About 60 percent of our patients are caregivers,” says Jennifer Price, advanced practice nurse in cardiology at Women’s College Hospital. “They have multiple roles and responsibilities, and carving out time for themselves can be challenging,” says Price. Learn to set boundaries, say no and ask for help – “it’s an important skill set that’s integral for effectively taking care of yourself,” says Jobanputra. It may help to reschedule your day to build in moments of self-care. “Think, ‘what does my day look like and what can I do to take care of myself?’” says Jobanputra. Setting daily reminders to go for a walk, take a few deep breathes or simply drink water will help you have a healthy mind and body. 

3. You’ll be prescribed blood thinners, which affect your menstrual cycle. Anyone who’s had surgery after a heart attack will be prescribed blood thinners, but not all menstrual women are warned how this medication will affect their periods. “Post-heart attack, most patients will be prescribed blood thinners,” says Price. “This means, if you’re pre-menopausal, you may experience periods that are longer. Some women end up having their period two weeks out of the month.” Blood thinners can increase the flow of blood and the duration of your period. Be prepared for the possibility of extra bleeding and let your doctor know if it seems excessive.

4. Your lifestyle will require a makeover. Your heart attack will lead you to make some healthy lifestyle changes. If you had any modifiable risk factors for heart disease, it’s not too late to act on them. That might mean making changes to what you eat, increasing physical activity, quitting smoking, abstaining or limiting alcohol consumption and prioritizing good quality sleep and stress management.

One of the best things you can do for yourself is to get into a cardiac rehabilitation program, which teaches people with heart disease about lifestyle changes that significantly lower the risk of dying from cardiovascular causes as well as all-cause mortality, improve quality of life and exercise capacity and reduce overall cardiovascular risks. “At the end of rehab, we have a lot of women tell us that they feel better than they have in years,” says Price.

5. You may be hyper-aware of any symptoms. If you’ve had a heart attack, you’re at a higher risk for ongoing heart problems, but that doesn’t mean that every ache or pain is another cardiac event. “Usually your symptoms from heart disease won’t dramatically change,” says Price. “If you had crushing retrosternal – behind the breastbone - pain from walking up the stairs, for example, that’s what your chest pain is going to feel like. It won’t be a little jab that comes and goes.” Education on signs and symptoms, as well as mindfulness meditation and cognitive behavioral therapy (CBT) aimed at shifting your thought process can help mitigate these worries.

THE EXPERTS
Jennifer Price, advanced practice nurse in cardiology, Women’s College Hospital
Lina Jobanputra, social worker with the Women’s Cardiovascular Health Initiative, Women’s College Hospital

This information is provided by Women's College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on January 29, 2020

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