I’m 63, and about 12 weeks out from a heart attack and a stent. I am doing “cardiac rehab”, about 30 minutes of monitored aerobic exercise 3x a week, and went back to lifting about five weeks ago. Before I started lifting again, I got a consultation from a knowledgeable clinician, started very light, but progressed quickly. I’m now at about 85% of my pre-heart attack weights. I did a set of 5 deadlifts at 300, felt good about it, and shared it with a physician friend who asked how my recovery was going. He became quite alarmed, and said something about the risk of internal pressure and the vulnerability of the walls of my heart because of the MI.
I guess I’m just asking for some reassurance. He got into my head. If I lift a heavy weight, will I burst the walls of my heart? Is that even a thing?
Ventricular wall rupture can be a complication of severe heart attacks, particularly in the immediate aftermath (e.g., from the time of the event through the first week).
For obvious reasons I cannot provide you with specific / individualized advice on this particular topic. However, it is important to consider your course so far, having gone through cardiac rehabilitation, gradual progressive overload to facilitate adaptation (versus acutely loading things far beyond your level of adaptation), the evidence with respect to resistance training in this situation, and the comparative risks of not training. It is important to note that ALL forms of exercise increase your blood pressure while you are doing them – aerobic included – and this requires your heart to work.
MB, I am 59 and obviously interested in what happens to lifters in their 60s. How would you characterize your training up to the point that you had the heart attack, and what would you say were the contributing factors to it?
I was a smoker, fat, lived for pizza, until I was about 50. I stopped smoking, changed my diet (low carb/paleo), lost about 40lbs while exercising. Discovered CrossFit and weightlifting. Trained continuously, but about 1.5 years ago started feeling a lot of fatigue, started putting on some fluff around the middle. I’d had a life insurance physical with a stress treadmill that I had passed with flying colors, so I figured my heart was fine. Cholesterol, blood sugar etc was all in a good place. Attributed the fatigue to low testosterone and getting old. Changed my programming but continued to lift and HIIT 2-3 x a week when I could drag myself out to the garage to workout. Boom. Widow-maker heart attack. Now I know why I was fatigued. My main artery was blocked, but everything else was pretty good. Cardiologist said genetics, but I think I did some damage in the fat and smoking stage of life. I’m back at it, and my energy levels are great. I’m recovering just fine and feel like my lifting is going to go aces. I believe that if I had not been fit and a lifter, I might have died from the heart attack. Ironic, and I have no way to know, but I compare myself to the other folks in cardiac rehab and I am at a very different level. Hope that helps. If you’re nervous (and I still am a little) as the doc said, go slow, progress in a steady manner. That’s what I’m doing, and I’m still here.
MB, thanks for sharing that. I’m wondering, and maybe this is a question for the doctors – is there some sort of test which would have shown the extent of your blockage, before anything happened? One reason I’m asking is because I frequently tell my older friends that weight training may be good for them. But one of my friends (68) recently “died in his sleep” after a day of some pretty good “yard work” activity. I’m wondering if he just worked a bit too hard (remembering his younger days) without being fully aware of his condition?
Sorry to hear about this. Unfortunately it is not possible to confidently tie the death in his sleep to the physical activity during the day.
Sometimes people presenting with symptoms concerning for coronary artery disease (like chest pain or shortness of breath with exertion) might get referred for cardiac stress testing and/or coronary angiography, but in an individual with no symptoms at all, pursuing that type of diagnostic evaluation of the coronaries is not usually recommended. Standard recommendations would include blood lipid screening and management as well as other standard lifestyle approaches (not smoking, exercise, maintaining a healthy weight, etc.). In certain intermediate-risk situations a coronary artery calcium score may be obtained as well, although this is something to discuss with a physician on an individual basis.
I was about 13 years into a healthy lifestyle, but my family history made me nervous so I went for a coronary calcium test and saw a cardiologist to read the results. He noted that there had been some damage, but my cholesterol was good and I was otherwise fit and healthy. He recommended a baby aspirin just to be sure. When my life insurance was up for renewal about 1.5 years ago, I got a stress treadmill, and was on it for about 14 minutes. That’s really good. Nevertheless, my Left Anterior Descending artery (the one you really need not to be blocked) was 100% blocked. My new cardiologist said I will have a “nuclear” stress treadmill at the six month mark so they can see how I’m doing. It uses contrast dye (i think) to see how the heart is functioning. I don’t know why it’s not standard. I would have done it, and perhaps saved myself the heart attack (although not the stent).
The decision to pursue stress testing, as well as the choice of test, is quite complicated.
I would recommend listening to our screening podcast to help understand the nuances of this sort of testing in general.
Nuclear stress tests come with a hefty dose of radiation and the potential for false positives, which then precipitates further invasive testing, that make it generally inappropriate to perform on a large scale among asymptomatic individuals.