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Concerns about sex and the heart
We’ve all seen it on TV—someone dies of a heart attack brought on by sexual activity. But can this really happen?

Although fear of a heart attack may be one of the biggest obstacles to come between a heart patient and romance, researchers say it rarely actually happens.

“For men and women who have suffered a heart attack or had heart surgery, the risk of a subsequent heart attack caused by sex is less than 1 percent,” says Palmetto Health Heart Hospital cardiologist Dr. Donald Alexander.

“Fear of a heart attack is understandable, especially if the patient previously has suffered one,” says Alexander, who is the medical director for Palmetto Health Richland’s Cardiac Rehabilitation program. “This is why it’s so important that the physician talk to the patient, especially after a heart attack or heart surgery, about sexual matters. Heart patients often have concerns and are too shy to mention them to their doctor. Not seeking information and remaining anxious about your love life can lead to unnecessary problems in relationships.”

Concerns about the dangers of sexual intercourse for heart disease sufferers have faded through the years as researchers have discovered the benefits of exercise on the recovering heart. Doctors now recommend that all but the sickest patients should be able to resume normal sexual activity without problems.

From a physical standpoint, cardiac patients can resume sexual activity with their spouse as soon as they feel able, which traditionally is two to three weeks after a heart attack or four to six weeks after open heart surgery.

A general rule of thumb used by cardiologists is if you can climb two flights of stairs without distress, you can probably perform physically.

“For some patients, even though they’ve passed that period of recovery time where it’s safe to resume sexual activity, they may not desire so,” Alexander says. “Many heart medications affect desire and ability, especially blood pressure agents and beta-blockers.

“For heart patients with erectile dysfunction, the drugs most people know by name are Viagra, Levetra and Cialis. These can cause dangerous falls in blood pressure in those who take nitrates,” he adds. “Some heart patients are able to take them safely, depending on their underlying conditions and the other medications they are taking. It is especially important that any heart patient considering these medications first talk to his physician.”

For heart disease patients, alleviating fears about performance and general depression about being ill are equally important as being physically ready.

“After a heart attack or surgery, simple touching helps the person begin slowly and work up in stages,” Alexander says. “I encourage my patients to do what makes them feel good and relaxed. With common sense, they will be able to do most, if not all, of the things they enjoy.”

Rekindling the Romance
Even though your cardiologist has cleared you for romance, your libido may not be where you want it. Try some of these tips:

Focus first on recreating an intimate relationship.

Discuss all anxieties and fears openly.

If you suspect medication could be contributing to sexual difficulties, consult your physician.

If feelings of depression persist, seek professional counseling.