Working Hearts

Roused from his sleep by shortness of breath and a feeling of pressure on his chest one night six years ago, Sidney Schwartz of Manhattan sensed that it was a heart attack. Even as he called his doctor he began to worry about how his illness would restrict his activities. That anxiety proved baseless. At 63, Schwartz today is doing everything he did before his coronary--and then some. Says he: "I feel great."

The reasons for Schwartz's well-being are attitude and exercise. Three times each week, Schwartz and 15 fellow coronary alumni meet at New York City's West Side Y.M.C.A. to participate in an unusual exercise class that could produce charley horses even in the healthy of heart. But so fit have the participants become that they take the routine in easy stride.

Road Test. The Y.M.C.A. class owes its existence to Schwartz and Dr. Lenore Zohman, a cardiologist at Montefiore Hospital, where Schwartz recuperated. Knowing that Zohman was interested in rehabilitation work, Schwartz asked her to set up a regimen for people like him. They then asked the Y to provide the facilities.

Started in 1966, the Y's program is a unique combination of physical education and physiology. Prospective participants must get clearance from their own physicians as well as from Zohman. Before giving her approval, she puts an applicant through "stress testing"--exercising while hooked up to an electrocardiograph. "It simply isn't enough to run an electrocardiogram on a heart at rest," says she. "We have to road-test it to see how well it performs under a work load." In this examination the patient pedals a bicycle-like device against increasing resistance. Meanwhile, his oxygen consumption is being measured, and the electrocardiograph is tracing heart reaction. The test continues until the heart reaches 85% of its maximum rate or until the patient-experiences some distress. The procedure allows Zohman to weed out people who are not up to any strenuous activity. For those who do qualify, Zohman writes an individual "prescription" of exercise based on how the heart has performed.

The supervised workouts that follow are anything but easy. The members of the class warm up with a series of calisthenics, then pause, eyes on the clock and fingers pressed to their neck arteries to check their heart rates. Then they jog around the gym, each member following the plan designed to bring his heart up to the desired rate. The class then goes into more strenuous calisthenics, and ends with walking to cool down. The effect is to retrain and strengthen the heart muscle so that it can work harder without fatigue.

Helpful Guilt. Some post-cardiac patients have followed the lead of SPORTS ILLUSTRATED Senior Editor Tex Maule and jogged their way back to health on their own. But as Maule acknowledges in his recently published Running Scarred (Saturday Review Press; $6.95), unsupervised exercise is dangerous. For one thing, few doctors --or cardiac patients--are as familiar with the physiology of exercise as the Y's trained instructors. For another, most people need constant encouragement to remain with any calisthenics program. Says John Bazikian, 68, a retired New Yorker who suffered from mild angina pectoris three years ago: "With a class, you start feeling guilty if you don't show up."

Zohman, who keeps track of patients' progress through annual physical checkups, is pleased with the results. All those who have stayed with the program for extended periods have experienced measurable improvement. Most have also avoided new attacks. Since the chances of a second heart attack are one in 20 each year after the first seizure, Zohman could have expected five heart attacks among the 38 people who have participated regularly in the class since its establishment. There have been only two--and both were mild.

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