It might seem that a steady regimen of rest and relaxation is the best course of action for someone with heart disease, but staying active is essential for the heart and overall health.

Elijah Behr, MD, a cardiologist at Mayo Clinic Healthcare in London, explains why and how even people whose conditions put them at higher risk of cardiac arrest can exercise safely. “Even in patients with quite damaged hearts that are causing heart failure, exercise can be important for improving quality of life,” Dr. Behr says. There is a caveat: “This has to be within reason and care should be taken to avoid exacerbating the underlying condition.”

What should people consider when exercising with a heart condition?

The underlying heart condition should be considered when developing an exercise plan. “For example, if someone has coronary artery disease, meaning furring, or blockage, of the arteries due to cholesterol, then overexercising may cause chest pain and increase the risk from the underlying condition,” Dr. Behr says. “On the other hand, patients with conditions that are not worsened by exercise, such as some heart rhythm problems, may exercise as much as they wish.”

What type of exercise is advised? Does it exclude cardio?

“Patients can undertake cardiovascular exercise and indeed this can be very good for their well-being and prognosis. However, the intensity and period of the exercise must be tailored to their condition,” Dr. Behr says. In general, if the condition is negatively affected by exercise, high-intensity, endurance or competitive sports are best avoided and a personalised approach from a cardiologist is advised, he adds.

What are actions people can take to reduce the risk of cardiac arrest while exercising? What are the warning signs?

Avoiding excessively intense or prolonged exercise or competitive sports is usually the key to minimising risk while maximising benefit from exercise in patients with conditions that place them at risk of cardiac arrest, Dr. Behr says. If patients have chest pain, breathlessness, palpitations, or dizziness during exercise, they should stop exercising immediately and seek medical help, he advises.