Exercising With Heart Pain

If there is plaque building up in the walls of the heart arteries (coronary arteries), they start to get narrow in that area. This means that the amount of blood trying to flow past that area is reduced compared an artery that is clean and clear.

These coronary arteries are what deliver oxygen carrying blood to the heart muscle. If an artery is narrowed, the blood flowing down that artery is limited. This means that a smaller amount of oxygen carrying blood can get to that area of the heart muscle. If that area of heart muscle isn’t getting enough oxygen, it will often send a pain or discomfort signa as an alert that something isn’t right. This pain or discomfort is called Angina.

Many people with heart disease have narrowings, which for multiple reasons, cannot be fixed with a medical procedure like angioplasty/stenting or bypass surgery. Often people in this situation are given medications to help manage these narrowed arteries.

Exercise is important in order to keep the heart muscle strong, and pumping as efficiently as possible. It is also important to keep the other muscles of the body in shape because the stronger our body is, the easier it is to move, which means the easier it is on the heart too! The harder the body has to work, the harder the heart has to work.

With exercise, the heart beats faster in order to pump more blood to the body where it’s needed. When the heart beats faster, the muscle of the heart itself also needs more oxygen carrying blood as compared to when it’s at rest. So if there are narrowings in the heart arteries limiting the amount of blood feeding the heart muscle, and the heart is being asked to work harder, that Angina discomfort may come on more quickly.

So what do you do? You want to exercise your heart and your body, but the Angina comes on quicker when you exercise.

The trick is to start slow and work at an exercise level below where we start to get discomfort.

  • Take time to have a longer warm up – By moving nice and slow for 10 mins before asking your heart to work hard, it gives your blood vessels a chance to dilate (get bigger), which can help make sure your heart is getting enough blood (oxygen) and reduces how quickly the Angina comes on.
  • Increase your exercise intensity slowly and gradually – slowly bring up the pace of your walk, or make your movements in the exercise class bigger gradually. Take your time as you increase how hard you are working.
  • When you start to feel symptoms of Angina coming on, slow your pace slightly and maintain your exercise intensity there for as long as you feel comfortable. Try to continue for 30 mins.
  • Don’t forget to cool down after your workout – slow that pace back to where you started to allow your heart rate to slowly come back down to normal. You should cool down for at least 5 mins before stopping.

The idea is now you are exercising just below what’s called the Angina Threshold, just below where that Angina discomfort comes on. As your heart and body get stronger, you may be able to push yourself a little harder before reaching your Angina Threshold.

Along with exercise, maintaining a healthy diet, and taking your medications are also really important to do what you can to keep those narrowings from worsening.

If you have questions about exercising with Angina, contact us!

Shawna Cook

Shawna Cook

Shawna is a Certified Clinical Exercise Physiologist through the American College of Sports Medicine, who has been working in Cardiac Rehabilitation for over 10 years. Her years in the health and fitness field however have spanned over the past 2+ decades. As an elite level athlete she fell in love with understanding the human body, and how the choices she made, affected how it performed. This led to a degree from the University of Winnipeg in the stream of Athletic Therapy, and the passion towards helping others recover from injury and "be their best selves" grew.

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