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Guide to safe exercise when you have congestive heart failure

Exercise for women with chronic heart failure

Yes, you can still work out after you’ve been diagnosed with this long-term health condition. One key is to start slow.

Think of your heart as a pump pushing blood to every cell in your body. When you have a chronic condition called heart failure (also called congestive heart failure), the pump doesn’t work as well as it should. As a result, your cells aren’t getting enough blood.1  

You might experience this as shortness of breath. Or you may get winded simply climbing a flight of stairs. 
Let’s say you were a regular gym-goer or jogger before your diagnosis. It might make you wonder if exercise is a good idea. Should you really be putting more pressure on your heart and lungs?  

The short answer: Yes, exercise is still good for you. Here’s why—and what to know so you can stay safe and healthy. 

The facts about exercising with a heart problem 

First, a little background. “There’s a general concern that if you have a heart problem, you have to take it easy,” says Michael Almaleh, MD. He’s the chief of cardiology and specialty care at Optum in San Antonio, Texas. 

You might assume, he adds, “that if there’s something wrong with your heart, you don’t want to stress it or overexert yourself.” And in the past, doctors were hesitant to recommend exercise to patients with heart failure, says Dr. Almaleh. 

But in recent decades, it’s become clear that moderate-intensity exercise can be safe and healthy, even when you have heart failure.2 That’s because regular exercise can lead to a stronger heart and bones. It may help you lower your body weight, blood pressure, blood sugar and cholesterol. And it can help cut down on heart failure symptoms, such as fatigue and shortness of breath.4 

Your Optum doctor or specialist will help create an exercise plan that’s safe for you based on your heart health and other medical conditions. Or they might refer you to a structured rehabilitation program known as cardiac rehab, says Dr. Almeleh. Either way, it’s important to start out slow. And to talk to a doctor to understand your limitations rather than doing it on your own.  

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Step #1: Build good habits 

Just getting back to exercising after a heart failure diagnosis? That’s a big step in the right direction. But it’s good to start with the right habits. Those will help you stay consistent without injuring yourself (or worse).  

Here are some tips that will help increase your odds of workout success:3 

  • Warm up with five minutes of light movement before exercising.  
  • When you’re done, give yourself five minutes to cool down. (One option: Continue your workout activity, but do it at a slower and less intense pace.) 
  • Drink fluids before and during your workouts to stay hydrated. 
  • If it’s uncomfortably hot or cold outside, move your workout indoors. For instance, you can walk at the mall, on a treadmill or even around your home. 
  • Take rest breaks as you need them.  

If you feel any heart-related symptoms before, during or after exercising, stop immediately and contact your doctor. You could also check with your doctor ahead of time about which symptoms need immediate medical care or a call to 911.  These symptoms could include:3 

  • Chest pain, tightness or pressure 
  • Gas pain or indigestion 
  • Lightheadedness 
  • Loss of color 
  • Pain or pressure in your arm, neck or jaw 
  • Numbness in the arms 
  • Shortness of breath 

Workouts can be challenging, but you don’t want to put your health at risk. 

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Step #2: Walk, don’t run 

When it’s time to get moving again, do it slowly and follow your doctor’s recommendations. Avoid doing a difficult workout before your body is ready for one. Walking is one safe way to start.3  

You can also do active things around the house. Things that count as physical activity include raking leaves and climbing stairs. 2  

The Cleveland Clinic also recommends some other low-impact options:4  

  • Start walking slowly and increase to a moderate pace over three-minutes. You should be breathing heavier but still able to hold a conversation.  
  • Once you can walk comfortably at that pace for three minutes, try doing it for 5 to 10 minutes. Then keep adding one or two minutes until you can walk for 30 to 45 minutes every day.  

Step #3: Branch out 

Let’s say you start walking. As it becomes more a part of your daily routine, you may want to add some new exercises. Try exercising at least three or four times a week if your doctor gives you the green light.3 It’s important to find activities you enjoy. 

If walking isn’t your thing, think about:3  

  • Biking 
  • Slow jogging 
  • Swimming  

Also, you might consider adding one these types of exercise to your routine: 

Resistance training. This is also known as strength training or weight training. It involves using weights or your own body weight to strengthen and build muscle. And it may make day-to-day activities safer and easier.3  

Research shows that resistance training may help people with heart failure in several ways. It can lower their cholesterol and blood pressure. It may also improve their sleep and quality of life.5  

Mind-body exercises. These combine physical activity with mindfulness, or awareness of your internal state and surroundings.6 They can also be gentler on your body.  

Researchers have studied the positive effects of two mind-body exercises for people with heart failure, according to the American Heart Association:7 

  • Tai chi. This is a type of Chinese martial art that uses slow, intentional movements and deep breathing. 
  • Yoga. This uses stretching, dedicated poses and deep breathing to help improve flexibility and balance. 

It’s normal to be nervous about exercising when you have heart failure. You want to protect your heart at all costs. But by starting slow, being safe and working with your Optum care team, you’ll be on the path to success. And that’ll be good for you, your health and your heart.    


  1. American Heart Association. What is heart failure? Last reviewed March 22, 2023. Accessed December 15, 2023.  
  2. American Heart Association. Lifestyle changes for heart failure. Last reviewed July 10, 2023. Accessed December 15, 2023.  
  3. National Library of Medicine: MedlinePlus. Being active when you have heart disease. Last reviewed August 16, 2022. Accessed December 15, 2023.  
  4. Cleveland Clinic. Heart failure: exercise and activity. Accessed December 15, 2023.  
  5. Circulation. Resistance exercise training in individuals with and without cardiovascular disease: 2023 update: A scientific statement from the American Heart Association. Published December 7, 2023. Accessed January 18, 2024. 
  6. American Psychological Association. Mindfulness. Published August 2022. Accessed December 15, 2023. 
  7. American Heart Association. Complementary and alternative medicines in the management of heart failure. Last reviewed July 12, 2023. Accessed December 15, 2023. 

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Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine. 

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