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Feel free to have sex after heart attack

Feel free to have sex after heart attack, study says
Worried about having sex after a heart attack? There is good news.

The American Heart Association's latest guidelines say if you are healthy enough to walk up a few steps exhaustion, you're fit enough to have sex.

The guidelines say sexual activity with a person's usual partner is comparable to mild to moderate physical activity in the range of three to four metabolic equivalents (METS), or the equivalent of climbing two flights of stairs or walking briskly for a short duration.

In such cases, heart rate rarely exceeds 130 bpm and systolic blood pressure rarely exceeds 170 mm Hg.

Research published in the journal Circulation says those with stable symptoms generally have a low risk of adverse cardiovascular events with sexual activity.

However, it advises that patients with serious heart ailments to get a medical check up done before deciding to have sex.

"Sexual activity is reasonable for patients who can exercise for more than three to five METS without angina, excessive dyspnea, ischemic, cyanosis, hypotension or arrhythmia," it says.

Interestingly, an analysis of 5,559 instances of sudden death found that 34 (0.6%) reportedly occurred during sexual intercourse. However of the subjects who died during coitus, 82% to 93% were men, and the majority (75%) was having extramarital sexual activity, in most cases with a younger partner and/or after excessive food and alcohol consumption.

Dr Aashish Contractor, who heads preventive cardiology at The Asian Heart Institute (Mumbai), said, "The study clearly shows that fears of having sex after a heart attack is unfounded. Within a few days of angioplasty and around six-eight weeks of a bypass surgery, if you feel stable, having sex is perfectly alright."

Dr Praveen Chandra, chairman of interventional cardiology at Medanta Medicity, said, "Patients and his families think that having sex after heart attack or heart surgeries can have serious repercussions. However it is safe to have sex if the patient's heart condition is stable. If they want to take tablets like viagra, they shouldn't be heart medicines like nitrates as it can lower blood pressure."

AHA recommends that women with cardiovascular diseases (CVD) should be counseled regarding the safety and advisability of contraceptive methods and pregnancy. "It is reasonable that patients with CVD wishing to initiate or resume sexual activity be evaluated with a thorough medical history and physical examination. Sexual activity is reasonable for patients with CVD who are evaluated to be at low risk of cardiovascular complications. Exercise stress testing is recommended to assess exercise capacity and development of symptoms, ischemia or arrhythmias. Patients with unstable, decompensated, and/or severe symptomatic CVD should defer sexual activity until their condition is stabilized," the recommendations say.

Although sexual activity is associated with an increased risk of cardiovascular events, the absolute rate of events is miniscule because exposure to sexual activity is of short duration and constitutes a very small percentage of the total time at risk for myocardial ischemia (MI) or a painful heart condition caused by lack of blood flow to the heart. Sexual activity is the cause of less than 1% of all acute MIs.

Angina or heart pain that occurs during the minutes or hours after sexual activity, which represents less than 5% of all anginal attacks. It is rare in patients who do not have angina during strenuous physical exertion and more prevalent in sedentary individuals with severe coronary artery disease (CAD), who experience angina with minimal physical activity.

If a patient can achieve an energy expenditure of three to five METs without demonstrating ischemia during exercise testing, the risk for ischemia during sexual activity is low.

AHA recommends "Sexual activity is reasonable for patients with no or mild angina, It is also reasonable 1 or more weeks after uncomplicated MI if the patient is without cardiac symptoms during mild to moderate physical activity. Sexual activity is reasonable for patients who have undergone open heart surgery and may be resumed six to eight weeks after the procedure."
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