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Heart Disease & Sexual Health

Heart Disease & Sexual Health

Is sex dangerous?
After proper medical evaluation, most stable cardiac patients can maintain their usual sex lives. This includes both men and women with chronic angina, after suffering a heart attack, or following cardiac surgery.

Many spouses worry about having sex with a partner who has a heart condition. This fear is largely unfounded. Sex is very unlikely to cause a heart attack and death during intercourse is extremely rare. Anger or emotional upset occurring as part of daily living is likely to pose a greater risk than sexual activity.

Sex is a relatively modest form of exercise. Healthy men having intercourse with their usual partners average a heart rate of 110-127 beats per minute. A traditional recommendation is that sexual activity requires about the same effort as walking up two flights of stairs.

The risk of coronary insufficiency during sex can be predicted by exercise testing. A 1995 study published in the American Journal of Cardiology found that all patients who had coronary insufficiency during sex also had abnormal stress tests. Conversely, a normal exercise test predicted adequate coronary blood flow during intercourse.

Guidelines exist to separate men into high, low and intermediate risk for sexual activity.

High risk. This includes men with a recent heart attack (< 2 weeks), decompensated congestive heart failure, uncontrolled angina, or severe valve disease such as aortic stenosis.

Low risk. Men with mild, stable angina, heart failure, or valve disease are considered low risk. Also included are those with successful angioplasty or bypass surgery, past heart attack (> 6-8 weeks), and other common conditions such as a trial fibrillation or controlled hypertension.

Intermediate risk. This includes all other men who require further evaluation to determine their risk. Exercise testing is usually needed to place them into another category.