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Question: My angiogram test showed blockages in three arteries, but they cannot be stented. I will be taking Atenolol and Lipitor. What restrictions to activities should I be aware of?
Dr. Gordon Fung responds:
You ask a very good question. The overall management of a patient with coronary artery disease where the three major arteries have significant blockages and are not amenable to the new stent procedure is dependent on how symptomatic you are. By this I mean, how frequently do you get chest discomfort – many times a day? Weekly? Or monthly? What types of activity bring it on: very strenuous activity or just walking to the bathroom; just getting out of bed or even while resting in bed and sleeping? How long does each episode of chest discomfort last in minutes or seconds? These answers will help your cardiologist design your rehabilitation program for you. In the extreme case where one might be having many episodes of pain in a week and with very little activity – e.g., a walk to the bathroom – your cardiologist would increase your medication and consider other procedures. This could include bypass surgery or newer interventions with the goal of relieving the discomfort that comes with mild activity. In the other situation where the discomfort episodes are few and require fairly strenuous activity – e.g., running or jogging – then medications and an activity program are appropriate. The best activity is walking. By walking, I mean walking at a brisk pace so that you feel that your breathing is slightly faster and that you are just beginning to perspire. You might even feel your heart beating faster. Work up to this brisk pace gradually so that you can ultimately begin a walk and achieve this pace within three to five minutes. Once you reach this level, continue to walk at this pace for up to 45 minutes. Remember not to rush yourself and try to reach this level of activity too quickly. The goal is to have daily walks but no less than five times per week. After you have walked for about 45 minutes, then gradually cool down by tapering off your speed and continue at a more relaxed pace for up to ten to 15 minutes. The benefits of walking are many but most importantly, walking allows you to exercise your heart and lungs while developing your leg and back muscles. Additionally, you can speed up or slow down whenever the need arises, and stop if you experience discomfort. Other activities that would be helpful to the heart are light housework, gardening, shopping or walking in a mall. The usually limiting factor to this activity is chest discomfort. If chest discomfort should occur, remember to slow down or stop your activity. If necessary, sit down and wait for the discomfort to resolve. If the discomfort resolves within two-to-three minutes, then gradually resume your activity. If it lasts for more than two-to-three minutes, then remain seated and take a nitroglycerin as directed by your doctor. Good Luck. Please get back to us. I’d love to know how it works out. Dr. Fung -- Dr. Gordon Fung, MD, MPH, is a cardiologist and associate clinical professor of medicine at the University of California at San Francisco Medical Center at Mt. Zion.
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First published October 29, 2004
Last updated May 6, 2008
Copyright © 2003 Consumer Health Interactive
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