Sex and Heart Attacks - What a Way to Go?

Nelson Rockefeller died while having sex with his mistress. Even the mighty Attila the Hun fell victim to a heart attack that caused his early demise … on his wedding night no less.


And while people might kid about it being a great way to go, fear of heart attack during sex significantly reduces the amount of sexual activity patients with known heart problems have.


Other than making your heart go “pitter-patter,” what are the cardiac effects of sexual activity?


Volunteers having sex in a laboratory setting have a significant increase in  pulse, blood pressure and respiratory rates. In other words, the heart works harder, pretty much along the same level as with a moderate work out.


What’s really interesting is when similar studies are conducted among married couples in their own bedrooms; heart rates don’t increase during sex! In fact, on average, married couples had  a LOWER heart rate than recorded during normal daily activities. I actually find it pretty depressing that having sex with your spouse in your own bedroom requires the same amount of exertion as a 2-4 mile per hour stroll on a level surface for a few minutes. That is why studies show that sexual activity is rarely responsible for a myocardial infarction (MI). Risks are even smaller in men and women who are routinely sexually active, and have participated in a regular post-MI exercise program.


This was confirmed by an article that was published in the Journal of the American Medical Association last month. Researchers looked at 14 studies regarding risk of cardiac death during sex. They found that the risk of death was 2.7 times more likely to occur, but ONLY if someone rarely had intercourse or exercised. In fact, engaging in some form of exercise once a week decreased the risk of cardiac death by 45%.


They concluded that the risk of death during sex with your spouse is small, especially if you exercise and/or have sex regularly.


There is another problem associated with sex if you have heart disease. Up to 75% of men and women experience sexual dysfunction after MI.  Fear is not exactly an aphrodisiac and it’s hard to relax during sex if you don’t know if you are going to come … or go. If you continue to avoid intimacy due to a fear of dying or having a repeat MI, it may help to have an exercise stress test to assure you that your heart can take it.  In general, most cardiologists say you are safe to have sex if you can climb up two flights of stairs without having chest pain or becoming out of breath. Many cardiac rehab programs also have psychologists specifically trained to help you address anxiety regarding resuming your sex life.


Obviously, it’s important to check with your own doctor before initiating exercise or sex after a heart attack, but overall, patients who have no symptoms, have mild, stable angina, controlled hypertension, and do not have exercise-induced ischemia, should feel free to have sex 6-8 weeks post MI with his or her partner or spouse.


But caution: Post MI is not the time to have an affair or join the Mile High Club unless you are willing to suffer the fate of Nelson Rockefeller.