Is Exercise Safe When You Have Pericarditis?

By increasing your heart rate, exercise can cause friction between the two thin layers of tissue that make up the pericardium, says Nishant Shah, MD, an assistant professor of medicine at Duke University School of Medicine in Durham, North Carolina. This may lead to several problems for people recovering from pericarditis, including increased inflammation and oxidative stress, he says, which can cause cell damage, affect your immune function, and prolong healing.

“The sports analogy I use is that you’re on the injured reserve list,” says Allan Klein, MD, a cardiologist at Cleveland Clinic in Ohio. This can be uncomfortable for people who are accustomed to being active, are athletes, use exercise as a tool for weight management or stress reduction, or teach fitness as a career. “It’s the biggest fight in the office with patients,” he says.

“I recommend my patients with pericarditis not do anything more intense than walk the dog until their symptoms and inflammation are completely under control,” says Gregory Katz, MD, a cardiologist at NYU Langone Health in New York City.

Low-intensity walking, swimming, and yoga are generally safe activities. But err on the side of a gentle yoga practice, and avoid hot yoga if you have active inflammation, says Dr. Katz. The intensity and heat of the activity can increase your heart rate too much.

Before adding any physical activity back into your daily routine, it’s important to talk with your doctor. Ask about what activities may be healthy and safe for you to do, based on your symptoms and overall health history.

Return Gradually

Slowly increase the intensity and duration of your activity over several weeks. For example, you might add some brisk walking to your routine before speed walking or going on a five-mile run in the first few weeks of your return to exercise.

• Stage 1 Rest, which should take place for at least 2 to 4 weeks after initial diagnosis
• Stage 2 Light activity, which takes place over 2 to 4 weeks
• Stage 3 Moderate activity, which includes structured aerobic and resistance exercises and takes place over 1 to 2 weeks
• Stage 4 Return to normal training

During the final stage, it may take a month or more before you feel that you’ve returned to the fitness level you had before you experienced pericarditis. As you begin to add any physical activity back into your routine, be sure to check in with your doctor about any symptoms you may be experiencing.

Watch Your Heart Rate

“I give patients a heart rate limit of 180 bpm minus their age until they are three months post pericarditis episode,” says Katz. So, for example, a person who is 45 years old and returning to physical activity would want to aim for a maximum heart rate of 135.

Wearing a heart rate monitor or using a smartphone that tracks your cardiovascular activity can help you make sure you’re not overdoing it and are within this doctor-recommended target range.

Monitor Your Symptoms

“It is important to listen to your body to make sure you don’t have symptoms during the activity,” says Shah. If you experience any discomfort, stop your activity and contact your doctor right away.

Pericarditis can recur in up to 30 percent of cases, says Klein, often four to six weeks after the initial episode. If you experience recurrent episodes of pericarditis, your risk of it returning again increases, he says.

• Sharp, stabbing chest pain
• Shortness of breath
• Heart palpitations
• Swelling of your abdomen, legs, and feet
• Low-grade fever
• Dry cough
• Lightheadedness, dizziness, or fainting

Exercise isn’t the only activity that increases your heart rate. Any stressful or strenuous activity, from doing chores to having sex, can strain your heart while you’re in recovery. “Patients ask me if they can travel, for example, and I let them know that they can have an exacerbation just lifting their suitcase. It can also happen if you’re having a party and stressed out about people coming over or while pushing the lawn mower,” says Klein.

Generally, non-exercise activities are okay to do as long as you’re not experiencing symptoms during them, says Shah. “Overall, it’s important to listen to your body and stay in touch with your providers to better understand your specific limitations,” he says.

• Pericarditis is inflammation of the sac surrounding the heart. It can cause severe chest pain, shortness of breath, heart palpitations, and swelling around the abdomen, legs, and feet.
• Exercise restriction is a key component of pericarditis treatment. Health experts generally recommend avoiding exercise for one to three months until inflammation subsides. But your doctor can advise you on when it’s healthy and safe to return to exercise.
• Low-intensity walks and yoga generally are safe activities while you’re recovering from pericarditis treatment, as long as your doctor clears the activity and your heart does not get past 100 bpm.
• After your doctor okays it, return to exercise gradually. If pericarditis symptoms return, stop the activity and contact your doctor right away.