Sex after a Heart Attack: New Guidelines

Sex after a Heart Attack

The European Society of Cardiology and the American Heart Association has come up with a document based on a consensus between doctors on how to resume a healthy sex life after having suffered a heart attack.

Many patients with implantable defibrillators worry about the device firing during sex. One study found that the percentage of patients receiving a shock during sex was 13 per cent.       

Elaine Steinke, lead author of the statement and professor of nursing at Wichita State University in Kansas said “It is the first scientific statement to offer detailed guidance for patients. Patients are anxious and often afraid sex will trigger another cardiac event – but the topic sometimes gets passed over because of embarrassment or discomfort.”

Sex after a Heart Attack
  • The statement issues a strict no for extramarital sexual encounters after heart disease. It says sexual activity should be in a comfortable room temperature and with the usual partner as it adds less stress to the heart. Patients with heart disease must not try sex in unfamiliar surroundings. “It is presumed that secret sexual activity in an unfamiliar setting may significantly increase blood pressure and heart rate, resulting in sudden death or cardiovascular events. The risks, however, appear to be very low, and the increase in risk attributed to coitus was found to be far less than that associated with anger and unaccustomed physical exercise,” the document said.
  • Doctors should discuss the health risks of embarking on an affair, which has been shown to increase the risk of dying from heart problems.
  • All patients who have had a heart attack, heart transplant, stroke or other heart condition, or who received an implanted heart device, should undergo some type of sex counseling.
  • Heart attack patients who have no complications, and who don’t experience chest pain or other symptoms when they walk briskly, can typically engage in sexual activity after one week. Those who have undergone heart bypass surgery can generally safely resume sexual activity after six to eight weeks if their incision is fully healed, the guidelines say.
  • Heart patients can start gradually with  activities such as hugging, kissing and fondling to gauge their tolerance for sex, building up to intercourse. Warning signs, such as chest pain, shortness of breath, rapid or irregular heart rate or dizziness should be reported to doctors. Angina, or chest pain during sex that doesn’t go away on its own within 15 minutes, or five minutes after the use of nitroglycerin, should be treated as an emergency.
  • To assess if a patient is healthy enough for sexual activity, experts have suggested that they undergo an exercise stress test, which involves walking on a treadmill to test how much the heart can handle. Heart attack survivors who can climb two flights of stairs briskly are likely ready to resume sex.
  • During sex, patients should be encouraged to assume their usual sexual positions, or one that is comfortable. Those who’ve had coronary artery bypass surgery are recommended to avoid being ‘on top’ as this may require more exertion, and to use pillows for support if needed.
Sex after a Heart Attack

Conversations about sexual activity should start before a patient leaves the hospital, and continue throughout the rehabilitation process.


The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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