When I first started working in cardiac rehabilitation as a new college grad, one of my Phase 3 cardiac rehab patients had a heart attack when he was only 35 years old. If that wasn’t unsettling enough, he had his heart attack the DAY AFTER he “passed” his treadmill test. Back then, I couldn’t understand how that could possibly happen, but I now know better.
How Sensitive Is Your Treadmill Test?
Here’s what you need to know. Currently, the exercise ECG is the most cost-effective first-line screening tool, but its accuracy relies on the ‘sensitivity’ of the test. Sensitivity refers to the percentage of cases in which exercise testing accurately identifies the presence of coronary artery disease (CAD). Unfortunately, the exercise ECG it is not 100% sensitive to detecting coronary artery disease.
Per the American College of Sports Medicine, the current sensitivity for detecting CAD using the exercise stress test is only about 70%. In other words, if you test 100 cardiac rehab patients with documented coronary artery disease, only 70 patients would show evidence of CAD per the stress ECG test. If you’re one of the 30 remaining patients, where does that leave you?
Well, don’t start your celebratory dance (or meal) just yet. It just means that you may fall in either of the following groups:
You have a negative stress test. That is, you actually “passed” and show no signs of coronary artery disease.
You have a false-negative finding. This means you’ve been given a negative stress test result (normal) where no CAD ‘appears’ to be present, but you actually have CAD.
The bottom line… a negative exercise ECG test is no guarantee that you do NOT have coronary artery disease (CAD) even if your cardiologist tells you, “Everything looks great! See you in a year.” So sorry to burst your bubble, but that’s the reality. Cardiac events that occur after a negative stress test happen all too often, but it’s not so perplexing to me anymore.
After your heart attack or some other “cardiac event”, such as a coronary artery bypass graft and/or stent placement, you may have received conflicting advice as to what level of activity is acceptable. Some of the things you may have heard are:
Don’t lift anything over 5 lbs.
Don’t lift anything over 10 lbs. “for a while”.
Don’t lift anything for a week.
Don’t drive more than 30 minutes.
Don’t “get exhausted” for a month.
Don’t exercise for a few weeks.
Don’t lift over 5 lbs. for a period of time — or ever.
Go back to whatever you were doing before.
These guidelines can be confusing and promote anxiety and inactivity. Physicians generally prescribe aerobic/endurance exercise, such as walking, to strengthen your cardiorespiratory system, but in order to return to activities of daily living (ADLs), resistance training is necessary to accomplish everyday tasks, such as:
Mowing the lawn
Carrying your children, groceries, or suitcase
Loading and unloading the trunk of a car/truck
Bending over to pick up the newspaper or toys off the floor
Lifting your grandchildren
Placing or removing items from a high shelf
Closing the trunk of a car or van
Opening a heavy door (e.g., door of a car, building, refrigerator, freezer, or dishwasher)
Resistance training enables you to perform these daily tasks safely, independently and more efficiently. By having a stronger musculoskeletal system, you decrease the cardiac demands of daily activities and increase your endurance capacity for other activities. Strength training has also been shown to maintain and buildstronger bones as well as slow or prevent bone loss. A strong structure will reduce your risk for developing other debilitating diseases (e.g., osteoporosis) and ultimately help you live a longer, stronger and happier life.
Muscular strength and endurance are important to prevent falls and safely return to vocational and recreational activities as well as activities of daily living. Most people need to do some type of lifting, carrying, or pushing in their daily routine. Your body has nine (9) fundamental human movement patterns. The foundation of your workouts should develop these movements: Continue reading “Weight Train After Your Heart Attack and Live Longer”→
Following an eating plan that centers around whole-grain foods versus refined grains can help you reduce belly fat and other health risks. See Eat Your Way to a Trimmer Waist. But shopping for whole grains can be confusing with all the varying descriptors. So here’s a guide to help you decipher what’s whole grain and what’s not.
To qualify as a whole grain, 100% of the original kernel – all of the bran, germ, and endosperm – must be present. All grains start out whole, but during the refining process, the bran and germ are removed. As a general rule, look for the key word “whole”, such as “whole grain”, “100% whole grain”, or “whole wheat” when shopping for a whole-grain product and see that it’s listed as the first ingredient on the food label.
Metabolic syndrome, also known as syndrome X or obesity syndrome, is the name of a group of risk factors that increases your risk for:
Coronary artery disease (CAD) also known as atherosclerotic heart disease – Atherosclerosis is a condition in which plaque (a waxy substance) builds up inside your coronary arteries and hardens and narrows your arteries. The narrowing reduces blood flow to your heart muscle and can result in chest pain, a heart attack, heart damage, or even death.
If you’re a cardiac patient, dieter ordiabetic on a low-carb eating plan and you CRAVE pasta, House Foods® Tofu Shirataki is a tasty (and gluten-free) alternative you can get excited about. It has a unique texture, but it’s still very ‘noodle-like’ and satisfying to the pasta-deprived palate.
Shirataki noodles are Japanese slippery glass noodles made with konnyaku (a member of the Japanese yam family). “Tofu Shirataki” is made by blending tofu and the flour of konnyaku to soften the texture and make it more appealing to traditional pasta fanatics.
So if you’ve missed eating noodles, you can eat them now — guilt free. I have to agree with the products’ marketers on this one in that Tofu Shirataki is a “pasta lover’s dream”. It has little flavor on its own which makes it a versatile element in any dish. They’re packed in water and there are four different shapes to choose from: fettuccine, elbow, angel hair, and spaghetti. (I prefer their larger, flat fettuccine shape over the spaghetti.)