Running after a heart attack

Getty Images

Joe asks: I was running my 14th half marathon in February and suffered a sudden cardiac arrest at mile nine. I was revived after several minutes of CPR, but suffered a second cardiac arrest once I arrived at the hospital. I have finally been cleared to start running again. I recently tried a light jog but was spent after about 10 seconds. I feel like I am starting running for the first time again. Any advice?

It is great that you have been cleared to run again. Fortunately, you are one of a growing number of cardiac arrest survivors. The survival statistics for an out-of-hospital arrest are about five percent in most U.S. cities. However that rises to the 30 to 80 percent range if you have your cardiac arrest at a large road race. It is widely known that the risk of cardiac arrest is greatest while exercising, but people who exercise regularly are at much lower risk than people who aren't active. Why the reduced risk at road races? My guess is generally healthier “victims” at a site that is fully prepped for cardiac arrest intervention. So, you chose the right place and time for your arrest.

I do not know the full set of circumstances surrounding your cardiac arrest, so I will generalize from some of the Twin Cities Marathon survivors. You were technically dead for a while, you had prolonged CPR, and you may have had anaesthesia with stent placement and/or surgery. Along with this there was a period of bed rest and reduced activity, during which time you were losing muscle mass, strength and endurance. All of this adds to the toll on your body and adds up to a difficult return to running.

My advice is to not give up, start slowly, and advance slowly. This is basically the advice I give to sedentary patients who are trying to get active. As Barry Franklin, who is well known in cardiac rehabilitation, says when trying to encourage patients, “Can you give me five minutes?” I think you should start with walking - five minutes or so - and add a minute or two every day. When you can walk comfortably for 30 minutes, start to "jog a block, walk a block," and build up until you can run for 30 minutes. There is no rush or particular timeline other than to gradually improve until you can run comfortably for the time you would like to commit to fitness.

I do know runners with your story who are back running long distances, although that is not necessarily the goal you should set or expect to achieve. Please do not be discouraged by the need to start over. Recovering from a major medical event like surgery or a cardiac arrest can be a one- to two-year process. If you find that you cannot build up your endurance and strength, you should check in with your doctor. I wish you the best in your safe return.