Go back to work after a heart attack

Patients with a heart attack and wanting to go back to work can do it. This is the main message of an article published today in the European Journal of Preventive Cardiology, Journal of the European Society of Cardiology (ESC).

"Patients who believe they can still do their work and want to go back will do so successfully," said Dr. Rona Reibis, principal author of the University of Potsdam, Germany. "After a heart attack, it is very rare for patients to be physically unable to perform their previous tasks, including strenuous work."

Between 67% and 93% of patients with acute coronary syndrome, including a heart attack and unstable angina (chest pain), returned to work within two to three months. But after a year, one in four has stopped. Among those over 55, women are less likely than men to return to work. This document explains the reasons and gives practical advice on how to successfully re-enter the workplace.

The probability of returning to work depends mainly on the patient's decision: do they want to return or not? Then come the psychological factors, lack of self-confidence, depression and anxiety, all predicting the failure of return. The medical condition of the patient combined with the type of work can also have an impact. Blue-collar workers may have difficulty if they suffer from heart failure, instability of rhythm or ischemia that reduce their physical performance. People with implanted cardiac devices may need to avoid workplaces with electric fields.

With respect to gender differences, Dr. Reibis said, "There is still the traditional idea that man must return to work because he is the breadwinner. women can be reintegrated, depending on their will or not, tend to have more doubts about their ability to perform their previous tasks, such as blue-collar jobs.Women educated in white-collar jobs do not meet this. problem.

Similarly, blue-collar workers with low levels of education and higher socio-economic status are more likely to quit after one year. This is especially true for patients in their 30s who smoke and who are overweight or obese.

How to return to work successfully:

• Attend cardiac rehabilitation (half of the eligible patients do not do it) to get advice on a healthy lifestyle, as well as personalized advice from a cardiologist, a psychologist, a doctor, a cardiologist and a psychologist. a physiotherapist, a social worker and an occupational therapist to find a job.
• Do not change jobs.
• Take it gradually if necessary: ​​make fewer hours / days early, work from home once a week, take more breaks, delegate some of the responsibility.
• Stay in touch with your family doctor and / or doctor and adjust the workload if necessary.

"The best way is to get back to work you know," said Dr. Reibis. "Patients who have had a relatively small heart attack with full blood flow restoration, who are constantly taking their medications and who do not have an implanted device can do their job as before, without any precaution."

"Others may want to return to their former role," she continued. "In the first few months, if you can not manage your workload, change it, do not wait until it becomes unmanageable and you have to stop smoking, and try to reduce stress, for example giving up some responsibilities for: half a year. "

Regarding post-return follow-up, patients who show no signs of depression or anxiety, feel optimistic about their ability to work and who can meet physical demands, do not need counseling specific monitoring. Further observation is needed for people with work-related problems – in general, middle-aged blue-collar middle-aged men with a low level of education and a heavy burden of comorbidities such as HIV / AIDS. 39, obesity, tobacco and diabetes.

"Such patients need a continuous supply of coping and support strategies," said Dr. Reibis. "For example, they may follow a longer cardiac rehabilitation program.It is very important that they maintain contact with their general practitioner or their company doctor and modify tasks as needed."

The document was written by the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology (EAPC) of CES. It is published at the EAPC Annual Congress, EuroPrevent.