You may experience various types of emotional distress or behavioural disturbance. Problems such as depression and anxiety are especially common. These conditions not only affect your emotional state but can also impact on your symptoms of heart disease.
Fortunately, there are effective treatments for depression and anxiety available, including psychological interventions such as cognitive behaviour therapy (CBT) and antidepressant medication.
Addressing these problems will make it easier to follow your heart disease treatment plan. Your healthcare professional (including your GP or cardiac rehabilitation nurse) will be able to help assess any concerns you have regarding your psychological wellbeing.
For more information regarding the types of treatment options for stress, see:
Watch Chest Heart & Stroke Scotland's video on recovering from a heart attack
Many hospitals have a cardiac rehabilitation programme, run by cardiac rehabilitation nurses and physiotherapists, which will help you regain your fitness and confidence as well as providing you with information and advice after a heart attack, heart surgery or other heart procedure.
Watch this video from the British Heart Foundation on cardiac rehabilitation
A member of the cardiac rehabilitation team may visit you in hospital and give you information about your condition, the treatment you’ve had and your recovery.
You should also be invited to join a cardiac rehabilitation programme starting about four to eight weeks after you leave hospital.
You should be offered rehabilitation if you’ve had:
a heart attack
a coronary angioplasty
open heart surgery
angina or heart failure (for some people)
an ICD implanted (for some people)
Some programmes take place in a hospital or community setting. These sessions will give you and your family the information, support and advice you need to get back to everyday life as well as possible.
Cardiac rehabilitation helps you:
understand your condition
recover from your procedure, surgery or heart attack
make changes to your lifestyle to protect your heart
reduce the risk of further problems
You can find out where your nearest cardiac rehabilitation programme is by visiting Cardiac Rehabilitation or by phoning the British Heart Foundation Heart Helpline on 0300 330 3311.
Depending on your heart condition and individual circumstances, ongoing follow up and review will vary. You may see a cardiologist regularly and this may become less often as time goes by, or you may see different health professionals, including your GP.
It’s very important to continue to attend any appointments - these are a very useful way of keeping an eye on how you are, your overall health and your heart condition.
You’ll be asked general health questions, have your pulse and blood pressure readings taken, and your weight (and sometimes waist) measured. You’ll also be asked about your lifestyle, symptoms, and mental health and wellbeing. Usually, you’ll have annual blood tests taken, and this may be more frequent, especially after initial drug treatments.
Watch this British Heart Foundation video on having an ECG
You may have been prescribed medications for a heart condition. This can be challenging for some people, especially if you have never had to take medications before. There are many types of medications that may be prescribed. Although these can seem similar, it’s vital that you only take your own medications and don’t stop these without medical advice.
For some people, an episode of living with a heart condition may be short-lived. However, for most patients, it will change the way they live their life. It could also affect family and friends.
If you’re living with a heart condition, you may wish to make changes, either major or minor, to your lifestyle.
Support, care and treatment from formal health and social care services will be a crucial part of that long-term management. However, for the vast majority of the time, the patient will be managing their condition on their own, and with support from family and friends. This is self-management.
You may have a period of cardiac rehabilitation following a diagnosis of a heart condition or heart disease before returning to work. This will depend, mainly, on the type of work you do, and the physical and mental activity required - for example, manual labour or a desk job. You may need to talk to your employer before returning to work, as well as your medical team and occupational health department, to find out what’s best for you.
If you can’t return to your job following a diagnosis of a heart condition or disease, you and your family might find it helpful to discuss any benefits and support you’re entitled to. It can be traumatic to learn you may no longer be able to do your job, and it’s important to talk about this with your family or loved ones to support your anxieties and worries.
The Driver and Vehicle Licensing Agency (DVLA) provides the national medical guidelines on being fit to drive, as well as how soon you can drive after a new diagnosis or treatment of a heart condition.
Going on holiday
For most people, going on holiday following a diagnosis of heart disease poses no problems. However, you may be worried about going on holiday, travelling abroad or the cost of holiday insurance to ensure you have appropriate cover should you fall ill.
Many people worry about relationships following a diagnosis of a heart condition or heart disease. It can change the way you see yourself as a person, and your place in the home or within the family, and may lead to low mood.
Relationships with partners can be very important in supporting the person who is living with heart disease, as can relationships with friends and family.
Any serious health problem can impact on your sex life. Having a heart condition is no different. For anyone who was previously sexually active, this is an important issue. Talk to your partner and health professional if you’re worried.
Many people worry that sex isn’t safe following heart disease or heart condition diagnosis. For most people, sex is safe and can be thought of as a form of exercise, in terms of exercising your heart. It’s no more stressful to the heart than other forms of moderate exercise.
If you think of sex as a physical activity, making love raises the heart rate about as much as climbing two flights of stairs. Sex, like any exercise, raises your blood pressure but only briefly. Your blood pressure falls immediately afterwards. This temporary increase in blood pressure is normal and safe.
Watch this video from British Heart Foundation, discussing sex after a heart event, from a patient’s and a cardiologist’s perspective
If your sexual relationship had deteriorated prior to the heart attack, being close to your partner and supporting them in a close and supportive way may feel more like your previous relationship and is also very important.
If there are physical problems that are causing you problems achieving your normal sex life, such as erectile dysfunction (impotence), discuss them with your health professional. It’s very important following a heart attack - or living with heart disease - that no medication is taken without medical advice.
As in other long-term conditions, there are some people where heart disease advances despite treatments, and a different approach to ongoing care is required. If symptoms are becoming resistant to conventional treatment, supportive and palliative care symptom control measures may be needed.
As chronic heart failure advances, your health professional may wish to talk to you and your loved ones about your ongoing wishes for your heart management and your preferred place of care. This may lead to an advanced care personalised care plan to reflect your wishes.
This requires a supportive palliative care approach to:
improve the quality of life of patients and their families facing the problem of life-threatening illness
prevent and relieve suffering
identify, assess and treat pain and other physical, psychosocial and spiritual issues
affirm life and regard dying as a normal process
offer a support system to help patients live as actively as possible