Heart attack - consequences

and Martina Feichter, medical editor and biologist

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

A heart attack often has consequences that change the life of the person affected. These include, for example, chronic heart failure or depression. Proper aftercare after a heart attack helps prevent such consequences. The patient's cooperation is also crucial: a healthy lifestyle can often prevent the consequences of heart attacks. Read more about the possible consequences of a heart attack and how to prevent them.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. I22I21I23

Acute consequences of myocardial infarction

Cardiac arrhythmias are the acute consequences of myocardial infarction in a large number of patients. They are the most common complication after an acute heart attack. The arrhythmias often occur in the form of a very fast, irregular heartbeat (tachyarrhythmia). This can develop into atrial fibrillation or life-threatening ventricular fibrillation.

Acute heart failure (especially left heart failure) is one of the possible consequences of a heart attack. The heart then cannot pump enough blood around the body.

Heart attacks rarely cause part of the heart wall to tear.

The first 48 hours after a heart attack are the most critical period for threatening complications. In around 40 percent of those affected, the heart attack leads to death within the first day (often from ventricular fibrillation).

Long-term consequences of myocardial infarction

Quite a few patients develop temporary depression after a heart attack. A healthy and active lifestyle can prevent the persistent low mood.

If a lot of muscle mass dies as a result of the heart attack, chronic heart failure develops over time (chronic heart failure): the dead heart muscle tissue is replaced by scar tissue, which impairs heart function. The larger the scarred area, the worse the heart pumps. Many small heart attacks can also lead to cardiac insufficiency over time (“small vessel disease”).

The scarring of heart muscle tissue after a heart attack can also lead to a bulging of the heart wall in the affected area (heart wall aneurysm): In contrast to healthy heart muscle tissue, the scar tissue cannot properly follow the heart's movements. It becomes overstretched and bulged over time.

Blood clots can easily form in this area. If these are carried away with the bloodstream, they can clog a vessel somewhere in the body (embolism). If this happens in the brain, a stroke occurs. Medicines that inhibit blood clotting can reduce the risk of such heart attack consequences.

Rehabilitation after a heart attack

Rehabilitation (in short: rehab) is intended to help people with heart disease to become healthy and productive again as much as possible - physically and mentally. In this way, the patients can return to their everyday and social life. The risk of heart attack consequences, as described above, should also be reduced through rehab.

Rehabilitation is also aimed at relieving the burden on the health system: for example, the care and training of heart attack patients should prevent avoidable hospital stays and enable them to return to work.

Four therapy fields of heart rehab

Rehabilitation patients are cared for in four areas, which are closely linked:

1. Somatic (physical) area: People with heart disease are treated and monitored by a heart specialist (cardiologist). This also includes the treatment of risk factors for another heart attack (high blood pressure, high cholesterol levels, etc.). Individually designed physical training is also useful: a heart attack is often followed by a reduction in physical performance and endurance. Regular exercise can help and improve the patient's resilience and heart health. So-called aerobic endurance training is suitable for this. For some heart patients, controlled strength training is also recommended.
2. Educational (educational) area: Experts (mostly doctors and psychologists) advise heart patients on a healthy lifestyle. They give tips for a healthy diet, for reducing excess weight and for quitting smoking. In addition, those affected learn why it is important to take medication regularly and what complications and side effects can occur. This point is especially important for people who take anticoagulants. Overall, the measures are under the motto: Promote adherence to therapy and strengthen the heart!
3. Psychological area: Frequent consequences of heart attacks are psychological problems (such as fears for one's own health or relationship problems). Therapists help the person concerned to process the heart attack mentally and to cope with possible conflicts. This is very important because emotional problems damage the heart. The treatment of mental illnesses such as depression is also part of the therapy concept. Sometimes relatives are also included in the therapy.

Social area: Social medical care is intended to help patients get back into social and professional life after a heart attack. The therapists provide information and tips on a wide variety of areas such as driving, air travel and sexuality. The life partner can also take part in the counseling.

This is how cardiac rehab works

Rehabilitation for heart patients after a heart attack is usually divided into three sections:

Phase I begins in the (acute) hospital. The aim is to mobilize the person affected as quickly as possible after the heart attack. If the course is uncomplicated, the stay in the acute hospital lasts about seven days.

Phase II (follow-up treatment) takes place either as an inpatient in a rehabilitation clinic or as an outpatient in a therapy center. The program includes, for example, exercise therapy, the reduction of fears, a healthy lifestyle, preparation for reintegration into work and stress testing.

Phase III includes lifelong follow-up and care for heart attack patients at home - usually by resident doctors. The person affected should participate in everyday and professional life again and be restricted as little as possible by the consequences of a heart attack. Outpatient cardiac groups are a good opportunity for contact and exchange with other patients. Medical treatment methods that are designed to avoid early retirement or the need for care are also important.

Diet after heart attack

Heart-healthy food doesn't have to taste like prohibitions or boredom. If the tongue is tempted with Mediterranean cuisine, this food tastes like vacation and sun. The secret of this cuisine is: The food from the Mediterranean countries contains many plant-based foods (pasta, vegetables, herbs, garlic, fruit), few animal products and high-quality vegetable fat (e.g. olive oil).

For a heart-healthy meal, you can also orientate yourself to the east: Chinese cuisine, for example, is mostly prepared in a wok with low fat content and is predominantly vegetarian.

With various so-called secondary plant substances, fruits and vegetables have a heart-protecting effect. Lycopene, for example, is a real care product for damaged blood vessels. It's found abundantly in tomatoes. The so-called polyphenols in red wine have a similar positive effect. However, you should discuss with your doctor whether and how much alcohol you can drink after a heart attack.

Exercise after a heart attack

Sport is very effective in treating the consequences of heart attacks, such as reduced stamina and reduced muscle strength. Discuss with your doctor how much and which cardiovascular exercise you should be allowed to do. Ball gymnastics, walking, swimming and training on a bicycle ergometer are, for example, suitable.

You can also join a cardio exercise group and train with other patients. Heart groups guarantee safety because there is always a doctor with you. They are also a shelter in which anyone can improve their limited performance without shame. In this way you can slowly increase your physical fitness for everyday life, for example for climbing stairs, where the pulse rises.

One of the consequences of a heart attack is the fear of many sufferers of overloading themselves during sex. From a physical point of view, sex is comparable to exercise. The cardio exercise is therefore the ideal preparation to enjoy this beautiful exertion again without fear.

Follow your feeling!

Doctors recommend for everyday life after a heart attack: Follow your feelings! It has long been proven that unhappy people cover up their insecurities and unmet needs with substitute actions. This could be, for example, heavy food, smoking, alcohol, or burying in work. Such supposed aids against unhappiness can quickly become a habit and endanger health.

So listen inside and dig into your real needs and desires. They can often be fulfilled almost as easily as the substitute acts. A long postponed conversation with your partner, a vacation in your favorite country, time for yourself and others, all of this is good for the soul and helps to avoid the harmful consequences of heart attacks.

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