Returning to work after a heart attack

Most people can resume employment following a heart attack

You can go back to work one month after an acute myocardial infarction if there were no complications during hospitalisation or rehabilitation. Returning to work after a heart attack is an important indicator of recovery. Younger women are more likely to quit their job than similarly aged men, indicating worse recovery.

How long you stay off work should be decided by your cardiologist based on several issues. These include the duration between onset of chest pain and inserting a stent (tube to open the blocked artery), location of the heart attack, the heart’s pumping capacity, whether there are other narrow coronary arteries that either need to be opened or have inaccessible narrowing, heart rhythm stability, duration of hospital stay, complications in hospital, psychological assessment, and participation in cardiac rehabilitation. The type of job should also be considered (manual labour versus office work).

It is crucial to follow a comprehensive cardiac rehabilitation programme after hospital discharge to recover functional capacity and receive a tailored exercise prescription. Most programmes last three to six weeks.

For jobs requiring low or moderate physical effort, getting back to employment in one month is the rule if the heart’s pumping function is normal and there were no complications during hospitalisation or rehabilitation.

Patients with physically demanding jobs should undergo a maximal stress test at one month. If there is no restricted blood flow (ischaemia) or symptoms the patient can return to work.

A golden rule is to avoid high levels of physical exertion during the first month after a heart attack. Equally important is to remain physically active to improve recovery and quality of life. Extended sick leave is not usually beneficial and light to moderate physical activity after discharge is encouraged.