Staying informed, being aware of medication side effects and keeping active together are key to caring for someone who is recovering from a heart attack.

Victoria Heart cardiologist, Dr Andris Ellims, who practices at Epworth Richmond and Epworth Freemasons, says family and friends have an important role in rehabilitation after a heart attack.

Being aware of when medications are required, participating in mutual exercise and pursuing healthy lifestyles together are examples of how loved ones can help.

Being aware of medications and side effects

Dr Ellims says as soon as someone has cardiovascular disease, doctors dramatically lower their blood pressure and cholesterol targets to reduce the risk of future heart attacks and strokes.

“Even if someone’s blood pressure and cholesterol have been normal, if someone has a heart attack, our targets for blood pressure and cholesterol become much more aggressive,” he says.

“We know that the lower the blood pressure and lower the LDL, which is the bad type of cholesterol, then the better the long term cardiovascular prognosis.” - Dr Andris Ellims, Cardiologist, Epworth HealthCare

“They will usually be on blood pressure agents to minimise blood pressure levels. We are aggressive with reducing the blood pressure as low as possible whilst avoiding side-effects such as dizziness.”

“The cholesterol-reducing agents, such as statins, are essential for optimising cholesterol to reduce long-term cardiovascular risk. The risk of side effects increases with higher doses and include persisting muscle aches and pains.”

Dr Ellims says after a heart attack, patients will generally be on medication to thin the blood.

“There needs to be a very good reason not be on aspirin after a heart attack, particularly if someone has had a stent, they need to be on lifelong aspirin. The side effects of blood thinners include bleeding or gastrointestinal irritation. Aspirin or the equivalent of aspirin should only be ceased if the cardiologist gives the green light,” he says.

Many patients may also be prescribed a glyceryl trinitrate (GTN) tablet to place under the tongue.

“It’s a dilator of the coronary artery vessels, so it can relieve angina pain within a few minutes of being taken. We use that as a treatment should patients experience that chest discomfort,” Dr Ellims says.

“If someone is concerned about the possibility of a heart attack due to unexplained chest pain or discomfort, then they should seek urgent medical assistance by calling 000.”

Participate in cardiac rehab and support groups

Lifestyle and diet are important strategies to minimise the risk of future heart attacks. Outpatient-based cardiac rehabilitation and support programs, such as Epworth Cardiac Rehab, can help to educate patients about their heart, how to return to their normal activities and how families can assist.

“Patients who go through those programs have less anxiety about their condition and have more autonomy about its management,” Dr Ellims says.

Being active together

Dr Ellims says families and friends can help with rehabilitation by modelling a healthy lifestyle themselves and exercising together with their loved one, for at least half an hour most days of the week.

“Getting active in some way in a graduated fashion, as soon as practical after discharge, is really important,” he says. “There’s no reason why people can’t go for progressively faster and longer walks in the days after discharge.”

01 December 2019