How many times have we seen this Hollywood scene: an older
man dies or has a heart attack while having sex with a younger woman. This common perception has put largely unfounded fear and
intense anxiety into the lives of millions of patients with heart disease and
their partners as well.
As a matter of fact, the wife of one of my heart-attack patients
asked me if it was safe for her husband to have sex. They were so worried that sex would be fatal
that they had refrained from all intimacy for several months since the heart
attack. How incredibly sad that
something so intimate and binding in a stable marriage relationship was avoided
due to an unsubstantiated fear that it could result in death.
Is there any evidence to support this fear and anxiety?
Despite what Hollywood would lead us to believe, having a
literal heart attack during or immediately following sex is an incredibly rare
event. During sex, for both men and
women, it is common for the heart rate and blood pressure to rise. However, sexual activity is equivalent to only
mild to moderate physical activity in the range of 3-5 METS which is similar to
a brisk walk or climbing two flights of stairs.
Thus, if you can walk briskly or climb two flights of stairs
without any troubles your heart should hold up just fine during sex. Indeed, studies have shown that even in
patients who have already had a heart attack that there was no increased risk
of a heart problem during sex as long as they were otherwise physically active.
There have been several published studies evaluating people
who actually died from a cardiac arrest while having sex. What they found from these studies is the
- Most were older men having sex with younger
- 75% of the cardiac arrests were from
- Sex was in a new location
- Sex generally followed excessive eating or
So what are my recommendations when my cardiac patients ask
me if it is OK for their hearts to have sex?
As long as you are not having any heart symptoms or your
heart condition is under control under the care of your doctor, you are
physically activity, and sex occurs within a safe monogamous relationship then
it is actually very healthy for the heart.
Those people who are suffering from heart symptoms or who
are not physically active should discuss with their physician whether it would be safe or not to
 American Heart Association Sexual
Activity and Cardiovascular Disease, Circulation. 2012;125:1058-1072
 Mo¨ller J, Ahlbom A, Hulting J,
Diderichsen F, de Faire U, Reuterwall
J. Sexual activity as a trigger of myocardial infarction: a
analysis in the Stockholm Heart Epidemiology Programme
 Ueno M. The so-called coition death [in
Japanese]. Nihon Hoigaku
 Krauland W, Underwarteter T. Herzinfarkt
und Sexualita¨t aus der Sicht
Rechtsmediziners [in German]. Sexualmedezin. 1976;10:xx–xxiii.
 Parzeller M, Raschka C, Bratzke H. Sudden
cardiovascular death during
intercourse: results of a legal medicine autopsy study [in