Healthy Heart Reports
Sex After A Heart Attack?
A series of articles in the American Journal of Cardiology confirm previous studies (1) showing that sexual relations are extraordinarily safe for the vast majority of men with heart disease. Men recovering from a heart attack have double the chances of suffering a heart attack during lovemaking, but twice almost nothing is nothing (16). Most of the time, heart rate rises only 4-8 beats per minute (17). The absolute risk for a heart attack during lovemaking for men who have had heart attacks is 2 chances per million per hour in healthy middle-aged individuals or 20 chances per million per hour in ''high-risk'' patients with ischemic heart disease (19).
After recovering from a heart attack, the average man makes love only half as often as he did before the heart attack, not because of any inherent problem in his heart, but because of the fear that it will cause another attack. Sadly, 70 percent of heart attack victims are given no advice about lovemaking after they have recovered. In a study from the University of Toronto, fewer than 12 percent of heart attack victims had chest pain while making love while more than 36 percent had chest pain while riding a stationary bicycle (8).
Making love does not require that you be in shape. It takes very little energy to make love. Chances are that you can make love safely if you can walk up 2 flights of stairs, an activity that requires the same amount of energy. If you have had a heart attack, check with your doctor, who will probably recommend an exercise electrocardiogram to find out how much exercise your heart can tolerate. Then you can start a controlled exercise program to strengthen your heart. Impotence is far more common in people who have had heart attacks or have angina and Viagra can help most (15, 18), but those on blood pressure medications must check with their doctors. Those on nitroglycerin cannot take Viagra.
The best way to prevent a heart attack during lovemaking is to stay with your regular partner. Guilt and excitement are far more important in provoking heart attacks than the extra work of making love. A study from Emery Medical School reported that when a man made love to his wife, his heart beats were regular and his pulse never went beyond 100 beats a minute (11). When he made love to his mistress, his heart beat irregularly more than l30 times a minute. A study in the Japanese Journal of Legal Medicine showed that more than 80% of men who died during lovemaking weren't making love to their wives (9). A famous heart researcher, David Kritchevsky, of the University of Pennsylvania writes:
Heart beats stay at normal rate,
When one beds down with legal mate.
But roosting in another's nest,
flirts with cardiac arrest.
1) Muller JE, Mittleman MA, Maclure M, Sherwood JB, Tofler GH. Triggering myocardial infarction by sexual activity. JAMA 1996(May 8);275:1405-1409.
2) Bohlen. Arch of Int Med 1984(Sept);144: 1745-1748.
3) Phillips Medical Times 1985(March;113(3):42-48.
4) Block. Am Heart J. 1975;90:536-577.
5) Hellerstein. Arch Int Med 1970;125:987-999.
6) Bohlen Arch of Int Med.
8) Kavanaugh et al. Can Med. Assoc J. 116:1250-1253,1977.
9) Ueno: Jap. J of Leg Med. 17:333-340,1963.
10) Johnson et al. Heart lung 7:1026,1978.
11) Cantwell. Med Asp of Hum Sex. 15(9):14-23, 1981. (Sept).
12) Skinner,J.S. Sexual Relations and the cardiac patient. in Heart Disease and Rehab. Pollack and Schmidt, Eds. Houghtom Mifflin Boston.
13) Nemec: Am Ht J. 92:274-277,1964.
14) Tuttle AM J Card. 13:140-153,1964.
15) RA Kloner. Cardiovascular risk and sildenafil. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 57F-61F.
16) JE Muller. Triggering of cardiac events by sexual activity: Findings from a case-crossover analysis. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 14F-18F.
16a) KE Andersson, C Stief. Penile erection and cardiac risk: Pathophysiologic and pharmacologic mechanisms. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 23F-26F.
17) RA Stein. Cardiovascular response to sexual activity. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 27F-29F.
18) G Jackson. Sexual intercourse and stable angina pectoris. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 35F-37F.
19) RF DeBusk. Evaluating the cardiovascular tolerance for sex. American Journal of Cardiology, 2000, Vol 86, Iss 2A, Sp. Iss. SI, pp 51F-56F
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Copyright 2000 www.DrMirkin.com
Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
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