<P> Physical exercise is an important part of rehabilitation after a myocardial infarction, with beneficial effects on cholesterol levels, blood pressure, weight, stress and mood . Some patients become afraid of exercising because it might trigger another infarct . Patients are encouraged to exercise, and should only avoid certain exerting activities . Local authorities may place limitations on driving motor vehicles . In most cases, the advice is a gradual increase in physical exercise during about 6--8 weeks following an MI . If it doesn't feel too hard for the patient, the advice about exercise is then the same as applies to anyone else to gain health benefits, that is, at least 20--30 minutes of moderate exercise on most days (at least five days per week) to the extent of getting slightly short of breath . </P> <P> Some people are afraid to have sex after a heart attack . Most people can resume sexual activities after 3 to 4 weeks . The amount of activity needs to be dosed to the patient's possibilities . </P> <P> Cocaine associated myocardial infarction should be managed in a manner similar to other patients with acute coronary syndrome, except that beta blockers should not be used and benzodiazepines should be administered early . The treatment itself may have complications . If attempts to restore the blood flow are initiated after a critical period of only a few hours, the result may be a reperfusion injury instead of amelioration . </P> <P> In wilderness first aid, a possible heart attack justifies evacuation by the fastest available means, often meaning the initiation of a MEDEVAC . The suspicion or provisional diagnosis of an MI means that it is inappropriate for the patient to walk out of the wilderness setting and will require them to be carried or conveyed in a vehicle . Aspirin, nitroglycerin, and oxygen can all be given with relative ease in a wilderness setting and should be administered as soon as possible in suspected cases of MI . Wilderness management of cardiac arrest differs slightly from that carried out in an urban setting in that it is generally considered acceptable to terminate a resuscitation attempt after 30 minutes if there has been no change in the patient's condition . </P>

Why does restoration of blood flow provide dramatic relief of chest pain