Patients should change their lifestyle after an nstemi. Here are some important tips about lifestyle that should follow the patients after an attack.
All patients with nstemi should intake such diet that does not produce weight gain. High fiber diet with vegetables and cereals should be taken. Antioxidant vitamins such as vitamin C and vitamin E are helpful that prevent oxidation of LDL- cholesterol (harmful cholesterol) in blood vessels wall. Patients should receive monounsaturated fatty acids (main sources are olive oil, safflower oil and canola oil) and omega-3 polyunsaturated fatty acids (main sources are fish oils and some nut) and avoid saturated fatty acids (main sources are meat products, dairy products, palm oil and coconut oil).
All patients should take complete rest for first six weeks after a heart attack. During this time, the death tissue of the heart muscle healed completely with fibrous tissue.
Regular daily exercise should be taken after six weeks home rest. Initially patients take two short walks (15-20 minutes) per day with prophylactic oral or sublingual glyceryl trinitrate if chest pain occurs. The distance of walk should be increased weekly. Swimming is allowed with some precautions. Patients should not swim alone, should get into water that is only within their depth, should not dive into cold water and should prefer heated pools.
All patients with nstemi should consider returning to work two months after an attack. A few occupations including large lorries and buses drivers, airline pilots, air traffic control personnel and divers cannot be restarted after an attack. Several occupations including furniture removers, steelworkers, bricklayers, scaffolders, dockers and miners should be considered hazardous for the post attack patients, and if possible the patients look for a lighter job.
Patients should be control their weight and maintain an ideal body weight after an attack. Body mass index between 18.5 to 24.9 kg/m2 indicates an ideal body weight (body mass index is the weight in kilograms divided by the height in meters, squared. For example, a person weighing 70 kilograms with a height of 1.8 meters has a body mass index of 70/1.82=21.6 kg/m2).
Smoking should be stopped. Patients who started smoking again after an attack of nstemi, increased five-fold risk of death than who successfully quit.
Sexual intercourse should be avoided for one month after an attack. If chest pain occurs on sexual intercourse, patients should be used prophylactic oral or sublingual glyceryl trinitrate. Initially a passive role in sexual intercourse should be taken.
Female patients should be avoided oral contraceptive pill and used alternative methods.
It is better to avoid drink alcohol after nstemi. If not possible, the patients should drink to a smaller amount per day (two glasses of wine or a double whisky). Several pints of beer should be avoided because of its water load effect.
Patients should be avoided travel abroad for the first two months after an attack. They should not carry heavy luggage during travel abroad and should be well insured for hospital care abroad.
All patients should receive secondary prevention drugs therapy including antiplatelet (aspirin, clopidogrel), beta-blocker (atenolol, metoprolol, bisoprolol), ACE inhibitor (enalapril, ramipril, captopril) and statin (atorvastatin, rosuvastatin, simvastatin, lovastatin, fluvastain) after nstemi. All drugs should be taken indefinitely if there are no unwanted effects. Low dose aspirin (75 mg daily) reduces the risk of further heart attack by approximately 30%. If patients are intolerant to long-term aspirin, clopidogrel is an alternative. Beta-blocker reduces long term mortality and further heart attack by about 25%. ACE inhibitor reduces future heart failure and heart attack. If patients intolerant of ACE inhibitor, angiotensin receptor blocker (valsartan, candesartan, losartan or olmesartan) is alternative and better tolerated. Statin is a cholesterol-lowering drug that also reduces mortality and further attack.