Most people recover well after a heart attack, especially if they take their medicines every day and join a cardiac rehabilitation program. Don't stop your blood-thinning tablets unless your cardiologist tells you to, and call 000 if chest pain comes back and lasts 10 minutes or is severe.
What happened to your heart
A heart attack happens when blood flow to part of the heart muscle is suddenly reduced or blocked. Usually a fatty plaque inside a heart artery cracks and a blood clot forms on it. Without enough blood, some heart muscle is damaged.
STEMI
The artery is usually fully blocked. It shows a typical pattern on the ECG (heart tracing) and needs the artery opened as quickly as possible, usually with a stent.
NSTEMI
The artery is usually partly blocked. Blood tests show heart muscle damage, and most people have an angiogram within a day or two.
Some heart attacks have other causes, such as a tear in the artery wall (SCAD) or no major blockage at all (MINOCA). These are explained further down this page.
Having a stent? See Coronary angiogram and stent: what to expect.
The first weeks
How long you stay in hospital depends on how much the heart was affected and how you recover. Some people go home after a few days, and others need longer.
In hospital
Your artery is treated, your medicines are started and the team checks how well your heart is pumping.
Going home
You get a letter for your GP, a medicine list and a plan for follow-up.
First GP visit
See your GP within a week or two to check your medicines and blood pressure.
Cardiac rehab
A program usually starts within a few weeks and builds up your activity safely.
Feeling tired for a few weeks is common. Gentle walking each day, building up slowly, helps your recovery.
Your medicines
Medicines after a heart attack lower the chance of another one. Most people are offered these (NHFA/CSANZ 2025, ESC 2023):
- Two antiplatelet medicines (blood thinners that stop clots), usually aspirin plus a second one, for about 12 months if you had a stent or a plaque-type heart attack. This may be shorter if your bleeding risk is high. After SCAD or MINOCA your cardiologist will individualise this.
- A high-intensity statin to lower LDL ("bad") cholesterol. The Australian target is an LDL below 1.4 mmol/L and at least a 50% fall from your starting level. Other cholesterol medicines may be added to reach it.
- A beta-blocker where it helps, for example if the heart's pumping is weakened or you have angina or rhythm problems.
- An ACE inhibitor (or a similar medicine) where it helps, for example if the heart's pumping is weakened, or you have high blood pressure or diabetes.
- Glyceryl trinitrate (GTN) spray for chest pain, with a plan for when to use it.
- Extra heart medicines if your heart's pumping is reduced. If your heart's pumping function is reduced (LVEF, the share of blood pumped out with each beat, of 40% or less), especially with heart failure symptoms or diabetes, your cardiologist may add medicines such as an MRA, an SGLT2 inhibitor or an ARNI.
- A flu vaccine every year, and stopping smoking, are part of treatment too.
If a medicine gives you side effects, tell your GP or cardiologist. There is often another option.
Cardiac rehabilitation
Everyone who has had a heart attack should be referred to cardiac rehabilitation (rehab). It is a program of supervised exercise, education and support, usually over 6 to 12 weeks. It can be done at a hospital or community centre, by phone or video, or at home.
In large studies, exercise-based cardiac rehab lowered the chance of another heart attack and of going back to hospital, and improved quality of life (Cochrane 2021). It is also a good place to ask questions about exercise, eating, stress and returning to work. If you haven't been referred, ask your GP or use the Heart Foundation directory to find a program near you.
Driving, work and sex
Driving
Under the Australian fitness-to-drive standards (Austroads, Assessing Fitness to Drive, current edition), don't drive a private car for at least 2 weeks after a heart attack. Commercial drivers need at least 4 weeks and a medical review. Check with your doctor and the WA Department of Transport.
Work
Many people return to desk work within a few weeks. Physical or heavy work may take longer. Talk to your cardiologist or rehab team about timing and whether a gradual return would help.
Sex
Many people can return to sex within a week or two of an uncomplicated heart attack, once light to moderate activity, such as climbing two flights of stairs, doesn't cause symptoms. Check with your doctor before taking erectile dysfunction tablets, because with GTN they can cause a large drop in blood pressure. Don't use GTN within 24 hours of sildenafil or vardenafil, or 48 hours of tadalafil, and tell the paramedics if you have taken one.
Your mood
Feeling low, worried, irritable or teary after a heart attack is common. For some people this lasts and becomes depression or anxiety, which can make recovery harder. It can be treated.
Tell your GP if you feel down or anxious most days for more than two weeks, or if you lose interest in things you usually enjoy. You can also call Beyond Blue on 1300 22 4636 or the Heart Foundation Helpline on 13 11 12.
Warning signs
If angina (chest pain or tightness with effort) starts or comes back in the weeks after your heart attack, but settles quickly with rest, phone your cardiologist or GP the same day for advice.
See your GP within a day or two if you notice new swelling of the ankles, breathlessness that is slowly getting worse, bleeding that won't settle, or black stools.
SCAD (spontaneous coronary artery dissection)
SCAD is a tear or bleed in the wall of a heart artery that narrows or blocks it. It is not caused by the usual cholesterol plaque. Most people with SCAD are women, often younger than the typical heart attack patient and with few risk factors. It can happen during or after pregnancy.
- SCAD is usually managed with medicines, because most tears heal by themselves over weeks to months.
- Stenting is avoided where possible, because it is more difficult in a torn artery. It is used if blood flow is badly affected.
- Avoid very heavy lifting and heavy straining. Your cardiologist or rehab team can advise you on safe exercise.
- You may have a scan of other arteries, because SCAD can be linked to a condition called fibromuscular dysplasia.
- Specialist follow-up is important, including advice about any future pregnancy.
(ESC SCAD position paper 2018, AHA scientific statement 2018)
MINOCA (heart attack with no major blockage)
Sometimes blood tests show a heart attack, but the angiogram shows no major blockage. This is called MINOCA (myocardial infarction with non-obstructive coronary arteries). It is still a real heart attack, and finding the cause guides treatment.
Possible causes
A small plaque that cracked without blocking the artery, artery spasm, SCAD, or a clot that travelled to the heart and then cleared.
Conditions that look similar
Inflammation of the heart muscle (myocarditis) and stress-related heart muscle weakness (takotsubo) can look like a heart attack in tests.
A cardiac MRI scan often helps find the cause. Treatment then depends on what is found (AHA scientific statement 2019).
For referring doctorsClinical notes for GPs
- Refer when: all patients after MI to cardiac rehabilitation; to cardiology for recurrent angina, new LV dysfunction or heart failure, uncertainty about antiplatelet duration or bleeding, unexplained MINOCA without a working diagnosis, or SCAD without specialist follow-up.
- Urgency: recurrent rest pain over 10 minutes, syncope or haemodynamic compromise: call 000. Rest pain, a crescendo pattern, or symptoms in the last 48 hours: emergency department / 000. New or recurrent angina in the weeks after a heart attack: phone for same-day advice.
- Send: discharge summary, angiogram and echo reports, current medicines and doses, recent LDL, eGFR and HbA1c.
- Medicines: DAPT usually about 12 months after PCI or atherothrombotic MI, individualised to bleeding risk; after SCAD or MINOCA, individualised by cardiology. Don't stop it without cardiology advice. High-intensity statin, LDL below 1.4 mmol/L and at least 50% reduction, adding ezetimibe and then a PCSK9 inhibitor if needed. Beta-blocker and ACE inhibitor or ARB where indicated (reduced LVEF, angina, arrhythmia, hypertension, diabetes). LVEF 40% or less with heart failure or diabetes: add an MRA; SGLT2 inhibitor if heart failure (EMPACT-MI and DAPA-MI were neutral on their primary endpoints without heart failure); consider an ARNI in place of the ACE inhibitor or ARB if heart failure. Annual influenza vaccine and smoking cessation for all. (NHFA/CSANZ 2025, ESC 2023; Australian HF consensus 2022)
- Recall: lipids at 4–12 weeks; repeat echo if LVEF was reduced.
- SCAD and MINOCA: SCAD is usually managed conservatively; screen for fibromuscular dysplasia and avoid heavy isometric exertion. In MINOCA, cardiac MRI helps identify the cause and guide therapy.
- Driving (Austroads, Assessing Fitness to Drive, current edition): private at least 2 weeks after MI; commercial at least 4 weeks, with specialist review.
- PBS/MBS: check current PBS criteria for PCSK9 inhibitors after ACS. A GP Chronic Condition Management Plan supports Medicare-rebated allied health visits where eligible. Screen for depression at follow-up.
General information for referring practitioners. Check current MBS and PBS criteria before acting.
Frequently asked questions
How long will it take to feel normal again?
It varies. Many people feel much better within a few weeks, and most improve further over 2 to 3 months, especially with cardiac rehab. Tiredness and low mood in the first weeks are common.
Will I need to take medicines for life?
Some, yes. Most people take a statin and one antiplatelet medicine long term. The second antiplatelet medicine usually stops after about 12 months, and your letter should say when.
Could it happen again?
The risk is higher than for someone who has never had a heart attack, but taking your medicines, joining rehab, not smoking and reaching your cholesterol and blood pressure targets lower it.
References
- Brieger D, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guideline for diagnosing and managing acute coronary syndromes 2025. Med J Aust. 2026;224(2). doi:10.5694/mja2.70127
- Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720–3826. doi:10.1093/eurheartj/ehad191
- Sindone AP, De Pasquale C, Amerena J, et al. Consensus statement on the current pharmacological prevention and management of heart failure. Med J Aust. 2022;217(4):212–217. doi:10.5694/mja2.51656
- Dibben G, Faulkner J, Oldridge N, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021;11:CD001800. doi:10.1002/14651858.CD001800.pub4
- Austroads. Assessing Fitness to Drive for commercial and private vehicle drivers (current edition). Cardiovascular conditions. Link
- Levine GN, Steinke EE, Bakaeen FG, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2012;125(8):1058–1072. doi:10.1161/CIR.0b013e3182447787
- Colquhoun DM, Bunker SJ, Clarke DM, et al. Screening, referral and treatment for depression in patients with coronary heart disease. Med J Aust. 2013;198(9):483–484. doi:10.5694/mja13.10153
- Adlam D, Alfonso F, Maas A, et al. European Society of Cardiology, Acute Cardiovascular Care Association, SCAD Study Group: a position paper on spontaneous coronary artery dissection. Eur Heart J. 2018;39(36):3353–3368. doi:10.1093/eurheartj/ehy080
- Hayes SN, Kim ESH, Saw J, et al. Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association. Circulation. 2018;137(19):e523–e557. doi:10.1161/CIR.0000000000000564
- Tamis-Holland JE, Jneid H, Reynolds HR, et al. Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association. Circulation. 2019;139(18):e891–e908. doi:10.1161/CIR.0000000000000670