Around 300,000 people suffer a heart attack in Germany every year, and only just under two-thirds of them survive the first four weeks afterwards. But even when the acute danger has been averted, the fear of what will happen next remains. This fear is well-founded – about one third of survivors will suffer another heart attack. The fear of physical impairment, the question of how everyday life at work and in the family will change, the fear of suffering another heart attack and succumbing to it the next time – the initial relief at having survived quickly gives way to fear of the future. But much can be influenced by the heart attack patient himself, provided he is willing – with professional help and also support from his family – to adapt his lifestyle to the new situation.
After myocardial infarction: treatment initially as an inpatient
Already in the acute hospital, the first measures for aftercare take effect. First, the life-threatening situation is brought under control and the patient is cared for the first few days in intensive care. In order to prevent complications, the aim is early mobilization. Thus – depending on the severity of the heart attack – the patient is already required to move on the 1st or 2nd day: In the beginning, he will help with personal hygiene and perform light exercises, which are gradually increased. After just one or two weeks, he should again be able to walk short distances or even climb stairs. The extent and speed of mobilization are tailored by the specialists to the individual heart attack patient. The time spent in the hospital is ideally followed by a stay of about three weeks in an inpatient rehabilitation facility (follow-up treatment = AHB). It is best to apply for this while still in hospital. The AHB serves to increase the physical performance, to help in coping with the disease, to inform the affected person about the causes, risk factors and consequences of his disease and to show him ways to positively influence these factors.
Help with the transition
To make the most of this time, it is important to make an accurate diagnosis of the current condition at the beginning and find the optimal medication dosage. Only when the heart patient is stabilized can exercise and relaxation training, nutrition seminars and psychosocial counseling be started. A staff of appropriately trained physicians, nurses, physiotherapists, dieticians, psychologists and social workers is available for this purpose. They ensure that the heart attack patient not only makes the most of the time during rehabilitation, but is also prepared for life afterwards. In this way, sufficient space is also given to the topics of the workplace, retraining, family and the arrangement of cardiac sports or self-help groups. For patients who do not want to spend this time without their family, there are also outpatient rehabilitation services in so-called day clinics.
Heart attack: outpatient aftercare
After the heart attack sufferer is back at home, the work really begins. Only if the measures initiated are continued on a permanent basis can they have their positive effect and reduce the risk of another heart attack. Studies have shown that, unfortunately, practice is often different – after just a few weeks, many patients had fallen back into old behavior patterns. They did not take their medication regularly, smoked again, ate as unhealthily and irregularly as before, had stress at work and spent their evenings in front of the TV instead of going for a walk. No wonder that the scales showed more pounds again, blood pressure shot up once more and cholesterol levels climbed to dangerous heights. And thus not surprising that quite a few sufferers found themselves in the hospital with a second or third heart attack.
Personal responsibility is necessary
To avoid another heart attack, personal responsibility and self-discipline are needed. Cutting back and recognizing limits, reducing stress, dealing with oneself patiently and gently, and consistently changing lifestyle habits are vital requirements for the person affected. Regular check-ups with the family doctor, initially every six months and then annually, should be just as much a matter of course as regular exercise. Particularly suitable are endurance sports such as:
- Fast walking
- Slow walking
- Cycling
- Hiking
- Cross-country skiing
Particularly helpful is an individually tailored and controlled training under medical and physiotherapeutic supervision. For this purpose, “coronary sports groups”, which also allow contact with other sufferers. Self-help groups for sufferers and relatives provide additional support and encouragement, especially through the exchange of experiences.
