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Entries in heart attack (4)


This Week in the Fitness Industry: Cardiac Patients Encouraged to Hit the Gym

Cardiac Patients Encouraged to Try HIIT at the Gym
In the 1950s, cardiac patients were told that rest was the key to recovery, but now physicians educate patients about the benefits of aerobic exercise, which help the heart become more efficient over time. "The goal is to raise and sustain that elevated heart rate in what we call a training heart rate zone," Dr. Jonathan Whiteson, medical director for cardiac rehabilitation at NYU Langone Medical Center, told CNN. High-intensity interval training (HIIT) has been one of the most popular methods for patients to reach the training heart rate zone since Mayo Clinic began recommending it to those diagnosed with heart attack or heart failure in 2009. Patients are often scared to push their hearts soon after a heart attack, but most trust their doctors enough to try, said Ray Squires, program director of cardiac health and rehabilitation at Mayo Clinic. Among the several thousand patients who have gone through Mayo's 36-week program, "we have never seen a single event during HIIT," he said.

IHRSA 2017 Is Almost Here!

Fitness professionals around the world are preparing to travel to IHRSA 2017, taking place in Los Angeles on March 8-11. We’ll be providing exclusive event coverage here on the IHRSA blog, as well as on our Facebook, Twitter, and Instagram accounts. If you can’t join us in LA, we hope you’ll follow along!

Obesity Linked to 11 Cancers
Obesity has long been thought to increase the odds of developing a wide variety of tumors, but a new study has found “strong evidence” supporting the connection between obesity and 11 types of cancer, Reuters reports. “Researchers analyzed results from 204 previously published studies exploring the connection between obesity, weight gain, waist circumference and 36 different cancers,” the article states. “They found the strongest links were between obesity and malignancies of the digestive organs and for hormone-related tumors in women, according to the report in The BMJ.”

PHIT Introduced in Congress
PHIT, the fitness industry’s top federal legislative priority, was introduced today in Congress. On the national front, IHRSA’s advocacy team has been actively engaging with Congress, the Administration, and allied organizations to promote physical activity and advance the interests of health club businesses, which are instrumental in building a healthier and more prosperous America. As a result of our efforts, the voice of the health club industry is being heard. PHIT (H.R.1267/S.482) was introduced in Congress. Read our full blog post about PHIT.


Healthy cities see less heart attacks

Metropolitan areas with higher well-being see less adults having heart attacks, according to findings in a recent Gallup-Healthways Well-Being Index.

The factors considered for the study include life evaluation, emotional health, work environment, physical health, healthy behaviors, and access to basic necessities. 

The top 10 areas with highest well-being index saw only 2.8% of adults reporting having had a heart attack, compared to 5.5% in the lowest well-being areas - almost double.

For more, read the Gallup story.


What are the best steps to take for exercise after a heart issue?

This week's Best Practices question, taken from the IHRSA page on, is one that is extremely important for those who have had a heart health issue.

And the variety of experts - a fitness director and master trainer; wellness director; and professor of sport and exercise physiology - should give a wide range of answers and tips.

This question is part of a new feature in Best Practices. Once a month we will be taking a question from and then ask our leaders.

Q: "How do you advise someone to begin exercising after a heart health crisis?  What precautions need to be considered?"

A: First and foremost, the individual needs to obtain a medical release from their cardiologist and their physical therapist. The personal trainer will need to personally visit with the physical therapist to determine their protocol for exercise. The individual will need to wear a heart monitor during their work out and notify the personal trainer of the medications they are currently taking that might affect their heart rate during exertion (ie: beta blockers). The goal for the cardiac rehabilitation patient would include: aerobic activity (ie: cycling or walking),  low-intensity start, smooth progression, < than 120 bpm heart rate, low levels of resistant training exercise and avoid a lot of overhead exercises initially.  On the Borg RPE scale (Borg 1998), their intensity should range from 11-13. Duration of exercise should last approximately 30-60 minutes per day for five days per week. Progression can take place as appropriate for the client’s cardiovascular and muscular responses. If the trainer is hesitant regarding progression, it is highly recommended that the physical therapist be contacted for further direction. Exercise should cease if the individual becomes dizzy, light headed, short of breath, chest pain, or heart rate becomes higher than 120 bpm.

Wendy Williamson
Williamson Wellness Center, LLC 



A: After a heart attack, the damaged heart muscle needs time to heal. It takes about 6 weeks to become strong enough to handle moderate to heavy work so excess physical and emotional stress should be avoided during this period.  After the 6 week recovery period, exercise is critical in rehabilitation as activity will decrease the heart’s need for oxygen. The heart will then work more efficiently, pumping fewer times while still meeting the body’s need for oxygen-rich blood. Triglyceride and LDL (bad cholesterol) will reduce as well as blood pressure, insulin resistance and blood sugar levels in diabetics.  HDL (good cholesterol) is increased and blood vessels will expand during times when more blood flow is needed. Vessels will in turn clear themselves of blood clots and plaque build-up, reducing the risk of further heart conditions.

Aerobic exercise will allow those with heart  conditions to return to an active lifestyle.  Light resistance training can be incorporated to strengthen major muscle groups and burn extra calories.  Upon clearance from the Cardiac Rehab staff, blood pressure and heart rate should always be monitored during activity. 

Begin with 5 minutes of walking 3-4 times per day. Add 1-2 minutes each session each day. As time is added, the number of sessions can be decreased. For instance, when 10 minutes of exercise are completed, the routine can be decreased to 2 sessions per day. When 30 minutes are completed, frequency is decreased to 1 session per day. Use a heart rate monitor, the rate of perceived exertion scale or talk test to evaluate difficulty throughout progression. Once 20-30 minutes of moderate exercise becomes relatively easy,  intensity can be gradually increased or the exercise mode can be changed up. (for example switch from walking to light cycling)

The following symptoms are NOT normal and should result in a stop to exercise or call to emergency or physician:

  • severe heart pain (angina)
  • excessive shortness of breath or inability to speak
  • excessive sweating
  • frequent skipped beats
  • dizziness, light-headedness
  • nausea
  • unexplained fatigue
  • cramping of arms and legs


Jennifer L. Muzzey, CSCS, MTS, USAW, NASM-PES
Fitness Director
Master Trainer & Movement Specialist River Valley Club





Dr. Haley Perlus, PhD
Professor of Sport & Exercise Psychology at University of Colorado
Published Author and International Speaker


To see the more answers for this question on, click here.

One of the most frequently consulted sections of IHRSA’s Website,, is “Best Practices,” which features answers from industry experts to a wide range of thought-provoking questions. Beginning this month, we’ll highlight some of them in this new CBI column.

Visit to read responses to more than 100 questions such as these or to submit a question of your own to be answered.


Death? Or Life? 

By Craig R. Waters

© JohanSwanepoel - Fotolia.comLast month, a New York appeals court issued a ruling that could have significant and far-reaching consequences for health clubs nationwide.

The Appellate Division, Second Department, unanimously concluded that clubs have a legal duty to use an automated external defibrillator (AED) on a member experiencing sudden cardiac arrest (SCA).

New York’s existing General Business Law 627-a requires clubs to have AEDs on-site, along with an employee trained in their use, but the December ruling was the first to posit an “affirmative” requirement to use them in the case of a cardiac emergency.

The finding could, conceivably, set a precedent for court decisions in other states that have mandated the placement of AEDs in health clubs.  

The New York case grew out of a 2008 motion filed on behalf of Gregory Miglino, who had collapsed and died after playing racquetball at a club in Lake Grove, New York. Court records indicate that another member alerted the front desk, which immediately called 911. While several employees, including one trained in AED use, soon brought the AED to Miglino and checked his pulse, they didn’t utilize the device. Minutes later, an ambulance arrived and took Miglino to a local hospital, where he was pronounced dead on arrival.

The records didn’t indicate why the AED hadn’t been employed.

Conversely, not a month goes by when there aren’t several reports of club members’ lives being saved by the prompt use of an AED.

© - Fotolia.comIn December, George Besheres, 65, of Lynn, Massachusetts, found himself among that fortunate group. The retired contractor was beginning a workout at the Latitude Sports Club, an IHRSA-member facility in Peabody, Massachusetts, when he suffered cardiac arrest, passed out, and, falling on his face, gashed himself badly. Within seconds, though, he became the focus of a concerted rescue attempt involving both club staff and members.

Among those who came to his aid were employees Judith Bennett and Kristin Hoffman; trainer Keith Leblanc; yoga instructor Alice Odachowski; and members Dr. Carol Warfield, a physician; Cheryl Seaman, a hospital ER nurse; and John Salvanelli, a firefighter.

CPR and mouth-to-mouth resuscitation were administered, and, when the club’s AED arrived, it was used immediately. The first shock failed to restore Besheres’ heartbeat, but a second one succeeded.

Rushed to a hospital, Besheres subsequently had triple bypass surgery and is now recovering at home. “I’m felling very, very well,” he told The Salem News. “I can’t say enough about the club and all the help I got from the members and the staff.”

While the ramifications of the New York ruling have yet to play out, one thing is clear: clubs must pay attention to the evolving legal issues relating to AEDs in health clubs. 

IHRSA supports AED legislation that contains necessary liability protections —including reasonable legal protection for clubs who do not use the AED —for club owners and their employees, reasonable staffing requirements for staffed and unstaffed clubs, and adequate compliance time.

Andy Roeder“Clubs should certainly take note of the ruling and its implications,” suggests Andy Roeder, the president of CardioReady, of Malvern, Pennsylvania, an independent review board that certifies cardiac emergency readiness programs in public venues. “The court has indicated that the expected duty of care cannot be met by merely acquiring and installing AEDs… We believe that the best approach for clubs to take in managing this risk is to position themselves beyond reproach by implementing emergency response programs that conform with best-practice standards. Vibrant, documented plans can certainly help insulate clubs from liability, and, more importantly, better safeguard human lives.

“The costs of implementing comprehensive programs pale in comparison to the expenses of litigation and the value of a club’s customers,“ he told CBI.

CardioReady, an IHRSA associate member company, notes that if an AED is used within 3-5 minutes of collapse, a victim has a more than 70% likelihood of recovery. If, however, an AED isn’t used within five minutes, their chances fall to under 5%.

“The emotions run the full spectrum from devastation with a lost life…to elation with a saved one,” explains Roeder. “When describing our program, we refer to ‘reputational protection’ and the fact that an SCA event can lead, in the extremes, to either negative or positive press. The SCA save story isn’t just a great human-interest piece. It’s also a great business-interest piece.”

 - Craig R. Waters is the editor-in-chief of CBI and can be reached at