Heart failure and exercise

Regular exercise is important for people who have heart failure. Exercise means physical exertion for the purpose of strengthening and conditioning your muscles, including your heart.

Talk with your health care provider about what kind and how much exercise you should be do if you have heart failure.
Never start an exercise program before talking with your health care provider.

Basic exercise guidelines

Start your exercise program slowly and work up to your abilities. Choose an exercise you enjoy doing (such as walking, riding a stationary bike, swimming, gardening). If you can tolerate your exercise, slowly increase what you are doing by adding 1 minute each day. If you skip more than 2 days of exercise, restart your program at a lower level and gradually increase again.

Use the following general exercise guidelines.

Wear layers of loose-fitting clothing. Wear comfortable athletic shoes.
Wait up to 2 hours after eating a full meal and after taking most medicines to exercise.
Do your exercising in comfortable temperatures. If the weather is too hot or cold, exercise indoors.
Warm up for 5 to 10 minutes until low-level activity slowly raises your heart rate and increases blood flow to the muscles you’ll be exercising.
Drink 6 to 8 ounces of water before you exercise unless you are on a fluid restriction.
Stretch in slow, controlled movements that extend your muscle fibers and put your joints through their full range of motion. (Do not bounce while you stretch.)
Do aerobic exercise that continuously uses large muscle groups and raises your heart rate (like biking, walking and swimming).
At the end of your workout, do low-level activity and stretching that gradually allows your heart rate to return to normal and helps you cool down.
Drink 6 to 8 ounces of water after you exercise unless you are on a fluid restriction.
Do not exercise if you are not feeling well (such as a cold, the flu or a temperature higher than 100 degrees Fahrenheit).
If you smoke, quit! Your health care provider can give you information on smoking cessation. If you cannot quit, do not smoke 1 hour before or after you exercise.
Do not take a hot or cold shower or bath for at least 15 minutes before or after exercise.
Do not drink alcohol right before or after exercise.
Avoid exercises that involve straining, pushing, pulling or heavy lifting when there is little or no movement of your body or if you have to hold your breath.
Be careful of exercises in which both arms are above your head for a long time. This can lead to fatigue.

How to breathe while you exercise

Singers and athletes learn how to do this kind of breathing, using their diaphragm, to breathe better. You can use it this way, too.

Relax. Rest one hand on your abdomen and the other on your upper chest.
Breathe in through your nose and let your abdomen come out as far as it will. The hand on your abdomen should move outward and upward.
Keep your upper chest relaxed. The hand on your upper chest should not move.
Breathe out slowly through pursed lips. If you feel dizzy, wait for a few breaths before you try it again.

You may find yourself short of breath while you are exercising. Some of this is normal. You can rate your level of breathlessness on this scale:

mild (noticeable only to you)
mild difficulty (noticeable to someone else)
moderate difficulty (you can keep exercising)
severe difficulty (you cannot keep exercising).

You should stay within the first two on the scale. If you reach the third, you should cool down or stop if you need to catch your breath.

Signs you should stop exercising

You always need to be aware of the way your body responds to what you are doing. This will tell you if you are working at a level that is good for you. The following signs mean your body is not tolerating the exercise:

dizzy or lightheaded feelings
nausea and vomiting
cold sweat
shortness of breath that makes talking difficult
unusual fatigue or extreme exhaustion
feeling that your heart is pounding or racing
fainting or black-out spells
a feeling that your heart is skipping beats or has become irregular
chest pain or pressure
pain or pressure in your neck, jaw, teeth and arm or between your shoulder blades
any new orthopedic problems, such as joint or muscle pain.

If you have any of these symptoms, stop what you are doing and rest. If they do not go away after rest, or if they continue to limit your activity, call your health care provider.

If these symptoms are severe, call 911 and use your nitroglycerin as directed.