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Sexuality is one of the most important spheres of human life. Cessation of activity in this area, dictated by external factors, reduces the quality of life.
Most patients after a heart attack are afraid of resuming sexual activity. They are afraid of having another heart attack during sex or even dying. These fears lie on both sides – on the side of the patient and the partner. Studies have shown that sexual activity in the year after a heart attack decreases in both the group of women and men. This is especially the case when patients do not receive advice on this topic from their treating physicians. Less than half of the men surveyed reported having obtained medical advice from a doctor about sexual activity after a heart attack, and in the group of women this percentage was even lower. They don’t know when to resume sexual activity and with what intensity to keep it safe. Additional factors contributing to the cessation of sexual activity or its reduction in its frequency are anxiety and depression following a heart attack.
European and American cardiology societies have issued special recommendations regarding sexual activity after a heart attack. In 2012, the recommendations of the American Heart Association regarding this sphere of life were published. According to experts, sexual activity is safe for most patients after a heart attack. Patients after uncomplicated myocardial infarction and in a stable condition may return to it 10 days after the infarction.
Only patients with symptoms of unstable coronary artery disease, recent worsening of exertion coronary pains, or with little physical exertion, should be discontinued. Taking sildenafil (VIAGRA) is safe in patients with stable symptoms of coronary artery disease, and the only absolute contraindication to its use is concomitant medication from the mitrates group.
A special group of patients are those with heart failure, valvular heart disease, arrhythmias, hypertrophic cardiomyopathy, or an implanted pacemaker or defibrillator. These patients should receive detailed guidance from the attending physician. The overall risk of a heart attack during intercourse is only slightly increased and represents a small part of the overall risk of patients with coronary artery disease. It is believed that if a person after a heart attack can easily exercise moderately, sexual activity is safe for them.
It should be remembered that cardiac rehabilitation after a heart attack and regular physical activity may reduce the risk of further cardiac events. It has been shown that the risk of another heart attack or death is highest in the group of untrained people for whom physical activity is incidental (almost 3,5-fold increase in the risk of a heart attack and almost 5-fold increase in the risk of sudden cardiac death), and episodic sexual activity is associated with in them with a 2,7-fold higher risk of a heart attack. In the group of patients who exercise regularly, the risk of sudden cardiac death decreases by approx. 30%, and the risk of a heart attack is reduced by approx. 45%. Sexual activity is therefore safest in patients who exercise regularly.
Therefore, sexual intercourse for a patient after a heart attack is not only safe, but also reduces the risk of a repeat heart attack, provided that general physical activity is regular. Each patient should talk to their attending physician on this subject and receive detailed instructions to overcome their fears, to know what type of sexual activity is safe for them, so that contact with their partner would be a source of joy for them, not frustration.