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Heart Attack During Sex

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Updated January 23, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Heart Attack During Sex
What Are the Chances of Having a Heart Attack During Sex?
Answer:

People who have been diagnosed with heart disease or who have had a heart attack often worry about the safety of resuming sex after a heart attack. Even if their fears are sometimes unfounded, you can see why they have them.

But what are the chances of a "perfectly healthy" person having a heart attack, or myocardial infarction (MI), during sex? We've all seen it in a TV show or movie -- usually an older man is with a younger woman, the sex becomes overly passionate, and boom, he keels over. His heart gave out. But how much of that is true, and how much of it a shocking or entertaining story?

To find out the real risk of having a heart attack during sex, I turned to an article from UpToDate, an electronic reference used by many physicians and patients looking for in-depth medical information. Here’s what they report:

“Although sexual activity can trigger an MI, what is important to the individual is the absolute increase in risk (i.e., the risk from sex minus the risk at all other times, referred to as the "attributable risk"). Since sexual activity is a transient trigger that increases risk for only a two-hour period, the absolute increase in risk is very small. Based upon the result from the Determinants of Myocardial Infarction Onset Study, a 50-year-old man free of cardiac disease with an annual baseline risk of MI of 1 percent would increase his annual risk of MI to only 1.01 percent from weekly sexual activity. Even a person with a high annual risk for an MI of 10 percent would increase the annual risk to only 10.1 percent from weekly sexual activity.”

In other words, the increase in risk of having a heart attack during sex is very low. But it isn’t random. Your risk of having a heart attack during sex is related less to the sex you're having and more to your heart health, or overall risk of having a heart attack at any time -- not just during sex.

According to another source, the Framingham Heart Study (which has been studying cardiovascular disease by tracking groups of participants since 1948), the chances of a non-diabetic, non-smoker having a heart attack during sex are about one in a million. And the chances that someone who has heart disease but has passed a basic stress test will have a heart attack during sex is 10 in a million. Again, put another way, the chances are very small.

In 2012 the American Heart Association released a scientific statement paper with new recommendations on sexual activity following heart attack or stroke. In it they review the literature on sex and sudden death and find that among autopsies only around 1% report that death occurred during sex. It's worth noting that in the majority of those cases the sex was identified as "extramarital" and over eating and drinking was also noted.

If you’re worried about the possibility of having a heart attack during sex, talk to your doctor and learn more about your heart health and what risk factors you might have for heart disease. If you are at risk, the two most important things you can do to manage risks are exercise and, when appropriate, medical therapy. Cutting out all sexual activities isn’t necessary or recommended. If you are in a high-risk category, it’s possible that some sexual activities would be ill-advised, but remember, sex isn’t just intercourse, and most of the research in this area uses intercourse as the definition of sex.

In some ways, the topic of sex and heart attacks or heart disease is like a double taboo. Most of us are raised with the idea that sex isn’t a topic of “polite” conversation, and certainly not something to talk to strangers about. The same is often true of illness and disease. Because there is a lot of shame around sex, and around the idea of being sick, we may not be inclined to talk with our partners or health care providers if we have concerns.

For example, erectile dysfunction in men can be an early sign of heart disease, or risk of heart disease. The best thing to do is to speak with your doctor about it, because it is often treatable and also because it may be an early warning sign. Yet because of embarrassment, many men don’t talk about it. It’s too bad because by not talking about it, they miss an opportunity to possibly improve both their overall health and their sex life.

The bottom line:
Stories of people having heart attacks during sex may be exaggerated. The overall risk is very low. If you’re concerned, talk with your doctor and find out about your risk of heart disease. If you’re at risk, then there are things you can do to reduce your risk -- but cutting out sex, in most cases, is not one them.

Want to learn more? See UpToDate's topic "Sexual activity in patients with heart disease" for additional in-depth medical information.

Source:

Chapunoff, E. Answering Your Questions About Heart Disease and Sex. New York: Hatherleigh, 2007.

Sauer, W.H. & Kimmel, S.E. “Sexual activity in patients with heart disease.” UpToDate. Accessed: December 2009.

American Heart Association: Sexual Activity and Cardiovascular Disease : A Scientific Statement From the American Heart Association

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