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Heart Failure: Activity and Exercise

Heart Failure: Activity and Exercise


When you have heart failure, it's very important to exercise regularly. If you are not already active, your doctor may want you to start an exercise program.

Of course, what's safe for you depends on how bad your heart failure is. But even if you can only do a small amount of exercise, it's better than not doing any exercise at all.

  • Have a checkup before you start an exercise program. Your doctor probably will do an electrocardiogram (EKG or ECG) and maybe an exercise stress test to see how much activity your heart can safely handle.
  • Your doctor may recommend a cardiac rehabilitation ("rehab") program at a local hospital or clinic. Rehab will give you education and support that help you build new healthy habits, such as exercise.
  • Start out slowly, exercising for only a few minutes at a comfortable rate. Then each day, slowly try to increase the length of time and the intensity of your workout.
  • You should not exercise during times when your heart failure is not under control.
  • Set goals that you can reach. If you expect too much, you are likely to get discouraged and stop exercising.

How can you get started on an exercise program?

If you are in a cardiac rehab program, it will be designed just for you, based on your health and your goals. You will be supervised by doctors and other specialists. You will learn how to get started on an exercise program and how to exercise safely. You will also get support to help you succeed.

If you are not in cardiac rehab, talk with your doctor before you start exercising. To get started:

  • Have a physical exam before you start any exercise program. Your doctor may do an electrocardiogram (EKG or ECG) and maybe an exercise stress test.
  • Make a list of concerns to discuss with your doctor. An exercise planning sheet can help you do this. This sheet can include things like exercises you should not do, whether you need to change how you take your medicine, and your activity goals.
  • Make an exercise plan with your doctor. An exercise program usually consists of stretching, activities that increase your heart rate, and strength training. Visit a library or bookstore for information on exercise programs. Join a health club, walking group, or YMCA. Many cities have senior centers that offer exercise programs that don't cost much.
  • Learn how to check your heart rate. Your doctor can show you how to take your pulse and how fast it should be (target heart rate) when you exercise.
  • Start out slowly. Try parking farther away from the store, or walk the mall before you shop. Over time, you will increase your ability to do more.
  • Keep a record of what you do. Now and then, read entries from months ago to see your progress. It's okay to cut back on your exercise if you are too tired or not feeling well.

Tips for exercise success

  • Set realistic goals. If you expect too much, you are likely to get discouraged and stop exercising.
  • Choose a type of exercise that you enjoy.
  • Give yourself time. It can take months to get into the habit of exercising. After a few months, you may find that you are looking forward to it.
  • Stay with it. It can be hard to stay with an exercise plan. Try exercising with a friend. It is much easier to continue an exercise program if you are doing it with someone else.
  • Reward yourself. Build in rewards along the way that help you stay with your program.

When starting an exercise program

  • Pace yourself by switching exercises. Rotate light workouts, such as short walks, with more intense exercises, such as low-impact aerobics or swimming.
  • Avoid exercising outdoors in extreme weather or high humidity. When the weather is bad, try exercising indoors at a gym or walking at a mall.
  • If you get palpitations, chest pain or pressure, trouble breathing, or dizziness or lightheadedness, stop exercising and try to rest. Call 911 if your chest pain does not go away. Call your doctor if your other symptoms don't go away.
  • Don't take naps or lie down after exercise, because that reduces your ability to exercise. Instead, sit down to rest.
  • Take your pulse often or wear a heart rate monitor, and keep your pulse within the range your doctor sets. Watch your pulse when walking up hills or stairs.
  • Be aware of how you feel during exercise. You should be able to talk easily without being out of breath.

Other things to think about

  • Avoid exercises that require or encourage holding your breath, such as push-ups, sit-ups, and isometric exercises. Also avoid heavy lifting.
  • Do not take hot or cold showers or sauna baths after you exercise. Medium temperatures are best—very hot or very cold temperatures can be dangerous.
  • Ask your doctor if you need to change how you exercise if your medicines change. New medicines can affect how fast your heart beats and how you feel when you exercise.
  • Get back to exercise slowly if you've stopped your workouts for more than just a couple of days. Slowly increase to your regular activity level as you are able to.

Related Information


Current as of: October 10, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine

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