What to Expect After a Heart Attack

A caregiver's guide to common physical and emotional concerns -- and what you can do to help

Quick summary

When someone suffers a heart attack, it can turn his world upside down. Although a heart attack always presents challenges, keep in mind that every heart attack is different. Symptoms vary, causes differ, and treatment depends on many factors. There's no set timeline for recovery, and a patient may experience all, some, or none of the following issues.

Weakness, fatigue, and shortness of breath

What you can expect:

Nearly all patients recovering from a heart attack will experience weakness, fatigue, and shortness of breath.

What you can do:

As soon as you get the doctor's okay, encourage the patient to get moving. Just getting out of bed, taking a shower, and dressing may be exhausting at first. In the first week, he should begin walking five minutes, five times a day. Although this won't seem like much activity to you, it may be very difficult for him. Acknowledge that he's having a hard time while encouraging him to continue. After a few days, you should notice a significant reduction in fatigue and shortness of breath.

Be patient and encourage him to do the same. He's just been through a major ordeal and you should both expect his recovery to take time.

Within a few weeks, he should be able to begin a modified exercise program. If he has always been fairly sedentary, he may resist this idea. You might motivate him to exercise by helping him set specific, realistic goals; exercising with him; keeping a journal of his progress; getting him moving first thing in the morning; and helping him find exercises he likes to do.

Recognize that it's not all up to you. You can encourage him to exercise, but ultimately he'll have to decide he wants to do it.

Leg swelling

What you can expect:

Leg swelling is very common, especially after bypass surgery. If the surgeon removed veins from the patient's legs for use as bypass grafts, fluid may accumulate in his ankles and lower legs. The swelling can be very uncomfortable and even painful.

What you can do:

While he's resting on the bed or couch, place several pillows under his legs to elevate his feet higher than his heart. Do this for an hour at a time, at least three times a day.

Encourage him to walk as much as he can. Even short jaunts around the house or yard can promote circulation.

Support stockings can minimize swelling. You can buy these at any medical supply store and at some drugstores.

If his leg swelling worsens significantly, notify his doctor immediately. Fluid buildup in the lower extremities is also a symptom of heart failure.

Abnormal heart rhythms and palpitations

What you can expect:

After a heart attack, a patient may develop a slow or abnormal heart rhythm, or he may be at risk for developing one. The abnormal heart rate may improve as the heart muscle heals, or it may be permanent.

What you can do:

Palpitations are the most common symptom of arrhythmia. If the patient is experiencing palpitations, notify his doctor immediately in case treatment is necessary.

Try not to panic. Palpitations can result from too much caffeine, tobacco, and even some over-the-counter medications such as cold and cough remedies. Stress can also be a culprit -- and the person you're caring for has been through an extremely stressful experience.

Learn CPR. Some arrhythmias show up as cardiac arrest, when the heart suddenly stops pumping. By promptly applying CPR, you can keep a patient alive until an emergency medical team arrives. Courses in CPR are available in virtually every city in the United States. Ask his doctor or nurses for information, or contact a local branch of the American Heart Association or the American Red Cross.

Congestive heart failure

What you can expect:

In some cases, a heart attack may damage the heart muscle so much that it can't fully recover. If a patient's heart can no longer adequately pump blood, he may experience shortness of breath, edema (buildup of fluids), and coughing. In some cases, heart failure can improve as the heart muscle heals, but more often the condition is permanent.

What you can do:

Don't panic. Although the term "heart failure" may sound like a death sentence, what it means is that the heart isn't pumping efficiently enough to keep up with the body's needs. But with the proper treatment and lifestyle changes, people with heart failure can lead relatively active lives for many years.

Talk to the doctor about lifestyle changes. The person in your care will need to limit his intake of salt, fluids, and alcohol; exercise lightly; and quit smoking.

Discuss medications with the doctor. Several drugs are useful in treating heart failure. Among other medications, the doctor may prescribe diuretics and/or aldosterone blockers to reduce fluid buildup, digitalis to help the heart contract more vigorously, or ACE inhibitors to make it easier for the heart to pump.

Emotional issues after a heart attack

Anger and anxiety

What you can expect:

It's normal to feel angry and fearful after a heart attack. A patient may be frustrated that he can no longer perform tasks that were once easy for him. He may feel anxious and worried that he'll have another heart attack. He may also feel depressed.

What you can do:

  • Let him talk about his fears. Don't brush off his concerns; keeping his feelings bottled up will make him feel worse. If it's difficult for you to listen to his worries, help him find a support group or an online community.
  • Encourage him to keep a journal. Sometimes just writing about negative feelings can defuse them.
  • Remind him -- and yourself -- that his anger and anxiety are most likely temporary. As recovery progresses, he's likely to feel more like himself again.
  • Encourage him to get back into a normal routine as soon as possible. Dressing first thing in the morning, getting out of the house and walking, and resuming favorite hobbies and social activities are all excellent strategies for relieving fear and anxiety.
  • If his anger and anxiety persist for more than four weeks, talk to his doctor. The doctor can arrange for counseling or antidepressant treatment.


What you can expect:

Depression is one of the most common emotions to affect people who have had a heart attack -- even if they've never been depressed before. One out of three patients reports feeling anxious or depressed after a heart attack or heart surgery. Sometimes it takes time for symptoms of depression to appear; it may be a while before the implications of a patient's heart attack really sink in. He may feel his life is over or will never be the same, or he may feel the recovery process is taking too long.

What you can do:

  • Watch for these common warning signs of depression: frequent crying episodes; feelings of hopelessness or worthlessness; poor appetite or increased appetite; sleeping too much or not enough; increased agitation and restlessness; loss of interest in life; expressing thoughts of dying or suicide.
  • Notify the doctor if you believe the person in your care is depressed, as it's a serious problem that requires evaluation and treatment.
  • Help him be as physically active as possible. Talk to the doctor and rehabilitation team about what exercises are appropriate.
  • Structure the day around activities that give the patient pleasure and a sense of purpose. For example, meet friends for lunch or enjoy a leisurely walk through the mall.
  • Try to stay positive and upbeat, but don't foster unrealistic expectations. Instead of saying, "You'll be hiking again in no time," you might say, "If we keep walking together every day, you'll notice that it gets a lot easier."

Decreased mental function

What you can expect:

After a heart attack, a patient may not seem as mentally sharp as he once was. Heart attack can seriously stress the entire body, including the brain. Bypass surgery has also been associated with cognitive decline, although recent studies have called this finding into question.

What you can do:

  • Give the patient time to recover. The changes in his mental function are most likely temporary. Don't expect him to perform mentally stressful tasks, such as balancing a checkbook, in the first weeks of recovery.
  • Talk to the doctor. Some medications, including beta-blockers, can decrease mental function. His may be able to prescribe another medication.

Sleep problems

What you can expect:

Sleep problems are common during recovery from heart attack. A patient may experience insomnia or fragmented sleep because of discomfort, stress, and a change in routine. But rest is an essential part of recovery, so the more you can help him get a good night's sleep, the better.

What you can do:

  • Minimize pain and discomfort at night. Arrange pillows to help him find the most comfortable sleeping position. Ask the doctor if the patient can take analgesics such as aspirin or ibuprofen 30 minutes before bedtime.
  • Keep him busy to prevent his napping too much during the day , but try not to let him get overtired.
  • Eliminate caffeine in the late afternoon and evening.
  • Play relaxing music.

Stephanie Trelogan

Stephanie Trelogan writes about heart disease, stroke, and depression issues that concern people caring for their aging parents. See full bio

over 1 year, said...

My husband had a heart attack and had 4 stints put in .He is now diagnosed with congestive heart disease. He is 55 and has always done manual labor. It has been nearly three months now and has not been able to return to work. He experolience sob and pains in he is carotid arteries and chest if he does Anything the leaste bit strenuous. I think he needs to consider applying for disability he says he will be able to return to work soon. Says he can't imagine not working. NY advice

about 2 years, said...

My father had a triple bypass in 2012, he continues to keep a positive outlook on life and learning new computer skills through courses offered in his community. I'm so proud of him and he's my hero, and I'll alwAys be a daddy's girl at heart❤️❤️❤️. I'm now experiencing pain and respiratory illness and dental problems too, I've made appointment for my yearly and 6 month dental exam a sap .

over 2 years, said...

I have a friend that recently suffered a heart attack had stints put in but hasn't wakened up. It's been 5 days. He was without oxygen to the brain a short time is this normal?

almost 3 years, said...

I found this article very informative. My husband had an unexpected massive heart attack a week ago tomorrow. We had climbed to the top of Diamond Head two weeks ago tomorrow. He had no symptoms, no high BP, cholesterol was normal. Came as a complete shock. He had one stent placed in the LAD Artery, commonly know as the "Widow Maker." We feel so fortunate this event didn't happen in Hawaii or on the plane. He is doing pretty well considering. We'd just felt so good and happy at the age of 76 and 72 to still be active and able to do so much...hoping we still can after his recovery. God bless to all those who have had to experience this life changing event.

about 3 years, said...

Hello all I'm 32 in good shape and in may of last year I suffered a heart attack sitting on the couch while speaking with my wife... now almost a year later I'm very lethargic at home and work, like I just want to sleep. I can't seem to get out of this funk. Any help would be appreciated.

about 3 years, said...

Thank you for your article, it helped me a lot I had a massive heart attack 2 months ago, I was having other health problems before the attack, but my body is not wanting to heal as fast as I think it should, that are day's when I don't want to get out of the bed, I am so tired, am still having problems breathing and heaviness in my chest, and throat. Palpitations worry me because of the arrhythmia they said I had , am wearing a life vest it gets cumbersome. Reading your articles informed me more again thank you

over 3 years, said...

I had a heart attack I guess a couple of weeks ago. I am finding it hard to leave house, have positive attitude, Just plain like anything around me. I am 45 years old and I am not over weight. My family on dad's side has heart history, if fact both dad and fraternal grandmother died from the heart exploding. Des say my heart is strong with minimal damage but they did put two stints in within 36 hours of one another. Just don't know how to cope with my emotions

over 3 years, said...

My problem started when I had a hard time breathing,next thing I knew I came out of surgery with a triple by pass and wasnt told anything,I dont know if I had a heart attack or not was never told,had carodid artery done on both sides so thought I was doing ok..I have fibromyalgia and it is my biggest problem pain meds dont help,gov took the pain med that worked off the market..My son moved in to help but diagnosed with diabedies and cant do anything but stay in bed and get crabby and irritated at everything I do,Im tired all the time and hope my prayers for him are answered..I do hope I start feeling better soon I try to keep busy but it is hard..I pray for all to mend and get on with their lives and have family and friends who give them encouragement..God Bless

over 3 years, said...

I'm 44 and seven weeks post cardiac event due we think to coronary vasospasms. Not back at work yet as stressful job but back to study n struggling to keep up and very emotional and overwhelmed. Also very irritable, thought I'd be all better now! Will my emotions settle n anger subside? Luv to hear from others. Cheers, claire

almost 4 years, said...

I am a 50 year old female who suffered 2 heart attacks in one day. I had never before had cardiac issues. It has been almost 2 weeks now. With much prayer from family and friends, exceptional care from professionals at NAMC St Davids and ADC physicians I am recovering well. I find I am very emotional and still have a way to go but I am determined to recover quickly. The advice in this article is very good. Thank you for continuing awareness.

about 4 years, said...

My spouse has had Quadruple Bypass, Stroke, Stents, and Defibrillator inserted. He has gone through short term memory loss, periods of anger, and depression. He only worried about returning to work and driving, which he finally was told he could not do any longer by the neuro-opthamologist and a psychiatrist, which finally made it clear that it was not to be since he lost over half of his vision from the stroke, and was told not to use the computer more than 1 hour a day and he no longer drives. His career came to an end at age 64, He is now a teacher and pupil at the Braille Institute. He looks forward to volunteering there weekly,and at the local senior center, and at our Temple weekly. He also exercises frequently and became more social with his new friends.

about 4 years, said...

I'm surprised that you use the word " he " as a women who suffered a major MI at the age of 46, I learned that heart attacks kill more women as the symptoms are much different than in men...therfor treatment is usualy delayed and more deaths occur in women than men. My pain was in my shoulders and I was sweeting , nausius ,(forgive the spelling) but had a feeling something was wrong. went to hospl.and saw ekg with square instead of sharp vertical lines..tomb stones...98 % blockage in the lad artery...."the widow maker"..They said I had and hour window before I would have not made it. Scarry. So hopefully Go Red for Women will get the word out. More women die of Heart attacks than ALL cancers . Few people know that.

over 5 years, said...

my mom had a heart attack 4 months ago. Her heart rate has remained at 100 and above. It now is slowly dropping and is 88, 87, 86. Is this a sign it is healing, or a sign it is weakening? She appears ok and says she feels ok but her respiration is at 16 now.