Exercise

Regular exercise is a great way to keep our hearts and bodies healthy and strong. Most of our patients know this, but still want more info on what exercise is right for them. We’re here to help with some exercise tips for people with CHD.

Why should I exercise?

Exercise helps keep your mind and body healthy. Regular exercise can make it easier for you to do the things you want to do now (like hanging out with friends) and also in the future (like going to college or getting a job).

Do I need to limit my exercise?

For most people with CHD, exercise is safe and we encourage our patients to go for it. Some people with CHD have even been in the Olympics.

Some people, however, may find that they can’t do as much exercise as their friends. Others may have been told to limit their exercise, or change the type of exercises they do. Examples of patients who have limits on their exercise include those with:

• High pressure in the lungs (pulmonary hypertension)
• Weak pumping chambers (heart failure)
• Unusual heart rate or rhythms (palpitations)
• Large aortas (like some patients with Marfan Syndrome or Bicuspid Aortic Valve)

You should ask your doctor before starting any new exercise. The first step is to think about what kind of physical activity you want to do. Your doctor might suggest a structured exercise program called Cardiac Rehabilitation. This means that you would be monitored by health professionals when you start or increase your exercise.

But I get tired easily! Why?

There are 4 main reasons why a person with CHD might not be able to exercise like their friends.

• Heart: The pumping chambers of the heart might not be able to work harder with exercise.
• Lungs: Lung problems can make it harder to take in oxygen when exercising
• Restrictions: Some patients have been told not to exercise by their parents or teachers over the years. Therefore, they might have become de-conditioned, which means that their muscles do not work the same as those of someone who wasn’t restricted from exercise. The good news is that this can often be changed!
• Medications: Some patients take medications that can make it difficult to exercise.

If my doctor says I can exercise, how should I start?

• Find something you like to do and can do (like walking, biking)
• Pick an exercise that you can control the speed or pace
• Try to find an exercise buddy
• Start slowly and build up gradually
• Warm up first (go slow for the first few minutes)
• Take care to cool down – don’t stop suddenly
• Make exercise part of your regular routine (try walking to school or to your favorite place, instead of taking the bus)
• Avoid exercising outdoors in hot and humid weather
• Don’t exercise right after eating (wait 30-60 minutes)
• Drink water before and after exercising (unless you have been told to limit your fluids)

If my doctor says I can exercise, how often should I exercise?

It’s good to do some exercise most days of the week. However, this may be too much for you at first. Instead, start at 2 days per week for the first few weeks. Then increase to 3 days per week for a few weeks. Keep going like this until you’re exercising as many days as you can without feeling too tired at the end of the week.

Some people may never exercise every day – that’s OK! The goal is to do as much exercise as you can comfortably do. Any amount of exercise is better than none!

If my doctor says I can exercise, how hard should I work out?

Some people with CHD have no limits. Others need to limit their exercise. Either way, it’s best to discuss it with your cardiologist.

The most common advice we give our patients is that exercise should be moderate: not too easy and not too hard.

You’re an expert in how your body feels. Only you know whether you’re feeling good or bad. That applies to exercise too. Listen to what your body tells you and stop or slow down if you:

• Feel very short of breath
• Are unable to speak more than a few words at a time
• Have palpitations
• Have chest pain
• Feel dizzy

If you’ve been told to limit your exercise but don’t know when you’ve reached your limit, use the ‘talk test’. The goal is to be able to have a conversation when you exercise. If you cannot speak comfortably, you’re doing too much!

If my doctor says I can exercise, how long should my exercise last?

Getting up to 30 to 60 minutes of daily exercise is a good goal.

Like anyone starting a new exercise program, you should build it up slowly. For example, you might go for a 10 minute bike ride one day and go for a little longer ride the next time. If 30 minutes of continuous exercise is too hard, you can break it up into shorter sessions (like three 10-minute walks).

If my doctor says I can exercise, what types of exercise should I choose?

You’re in charge of your life. So pick an activity that is right for you. If you want to be able to walk to school without getting too tired, you should do more walking. It’s best not to focus on keeping up with your friends. The goal is to find an activity that you enjoy and want to get better at.

The best types of exercise for your heart and overall health are those that involve most of your body. Some examples are:

• Walking or hiking
• Riding a bike
• Swimming
• Dancing
• Aerobics
• Jogging

If you want to play a sport or do something not on this list (like lifting weights, martial arts or contact sports) ask your doctor first.

What about competitive sports?

Some people with CHD should not take part in sports where people compete against each other. This is because they might feel pushed to perform and not be able to stop when they feel they need to. If you really want to play a team sport, discuss it with your doctor first. If team sports are OK, let your team mates know that you may need to take some time out if you feel tired or short of breath.

What about contact sports?

Some people with CHD should avoid contact sports (like football, hockey, and many martial arts).

We’re not trying to be mean when we tell you to avoid contact sports. We have a good reason. If you were to get hit, this could change the pressure in the chest which can affect the normal flow of blood and pressure within the heart. It can also cause problems with the rhythm of your heart (arrhythmias). This may also be an issue if you are on blood thinners. People with pacemakers or implantable cardioverter defibrillators (ICDs) are also advised to avoid getting hit in the chest.

But I get scared when I exercise!

This is very common for some people with CHD. You might not know how you should feel when you exercise, especially when you haven’t done it before. It can take a while to get used to the changes that happen during exercise, like a faster heart rate and getting a little out of breath. That’s one reason why it’s good to build up slowly. You can build your confidence along with your fitness. You can ask your doctor about taking part in a structured exercise program called Cardiac Rehabilitation. You will have an exercise program designed especially for you!

Who else should I tell about my exercise?

If you join a gym or exercise with other people, it’s a good idea to let them know about your heart condition and what to do in the case of an emergency. You can also tell them what to do and who to call if you feel unwell or pass out.

Another option is to wear a Medic-Alert bracelet. American adults can obtain their Medic-Alert bracelet here, and Canadian adults can obtain theirs here.

Want more information?

Check out these articles:

• Canadian Adult Congenital Heart Network – Exercise & CHD
• Canadian Heart & Stroke Foundation – Physical Activity Guidelines
• American Heart Association – Physical Activity Guidelines