You are looking after a 75-year-old man who was admitted 3 days previously with an anterior STEMI and underwent primary PCI to his LAD. He has made a good recovery and his echocardiogram shows that he has only mild LV impairment. He is asking about safe levels of physical activity once he goes home.
What should you advise him?a. To return immediately to his previous (pre-admission) level of activity
Following an acute MI patients should be referred to the CR team for assessment, and in the meantime they are advised to be physically active for 20–30 minutes a day to the point of slight breathlessness. A warm-up period of 6–0 minutes should be encouraged as it allows the body to adjust to increasing demand. The main 20–30 minutes of activity should be at a moderate level of exertion and is best followed by a cool-down period which is often similar to the warm-up. Patients who are not achieving this should be advised to increase their activity in a gradual step-by-step way. After completion of their CR programme patients should be given long-term advice to continue with at least 20–60 minutes of moderate aerobic exercise three to five times a week.