Matters of the Heart
Reclaiming Intimacy After a Heart Attack
By Mary Damiano

One of the biggest issues caregivers face when their loved one is recovering from a heart attack is resuming intimacy. One reason for this is the myth that sexual activity can bring on another attack. 

While there are cases—the most famous perhaps, is ex-Vice President Nelson Rockefeller having a heart attack and dying while in the act with his mistress—cardiologists agree that sexual activity for people who have had heart attacks is no more strenuous than climbing two flights of stairs.

But many caregivers and their loved ones recovering from heart attacks don’t know this because they don’t ask their doctors, and doctors often don’t take the initiative to bring it up. 

When Robin Baxley, 47, had her heart attack in April 2001, her main concern was with getting better. “I had a hematoma, which you get after surgery, so I wasn’t myself for a month,” she says.

The Miramar, Florida resident spent a week in the hospital and says that initially, sex was not a priority. “That was the last thing on my mind,” she recalls.

Shyness prevented Baxley from asking her doctor specifics about resuming intimate relations with her husband. “I really took it upon myself,” she says. “I did not ask the doctor because I felt funny asking him.” 

According to the Journal of the American Medical Association, a 1996 study conducted by James E. Muller, M.D. of Deaconess Hospital and Harvard Medical School, found that there was minimal risk associated with having sex after a heart attack.

Researchers conducting the study interviewed a national sample of 858 heart attack patients who were sexually active in the year before their heart attacks. The researchers discovered that while there is an increased risk of having a heart attack during the two hours following sexual activity, that risk is about the same for everyone, whether or not there is a history of cardiac disease. 

The researchers cited previous data indicating that the risk of heart attack in a healthy person is about one in a million, and the risk of heart attack in a person with a history of cardiac disease is about two in a million.

The study also found that the risk of heart attack caused by sexual activity rises to about two in a million for a healthy person and 20 in a million for a person with a history of cardiac disease.

Researchers also report that “regular exercise can reduce, and possibly eliminate” the slight increased risk of a heart attack associated with sexual activity.

In an editorial published with the study results, Robert F. Debusk, M.D., Stanford University School of Medicine, Palo Alto, California, wrote about the study as well as physicians reluctance to talk sex with their patients. "The prospects for a rapid and complete recovery from acute MI [heart attack] and avoidance of future cardiac events have never been better. However, despite these favorable prospects, physicians and patients are too often burdened by the misconception that sexual activity after acute MI is dangerous." 

Baxley says that her doctor never addressed the subject of sex directly, but once her doctor said it was safe to resume normal activities, she figured that meant all activities.

Still, there was some trepidation. “I went to him for another follow-up. He wanted me to exercise at a gym, and he said I could resume my normal activities, and without asking him that question, I just took it upon myself,” she says. “I was still a little afraid, but since he said I could resume my regular activities, I went ahead and everything was fine.”

Like many caregivers, Baxley says her husband, Jesse, had his own concerns. “He was a little concerned. He kept asking me if everything was all right, if I felt all right to go ahead. In my mind, if the doctor said I could exercise and do all my activities, that would not hurt. Then I felt better about it. I felt more secure about it.”

Debusk also wrote that his desire for doctors to be more open with their patients as the result of Muller’s research. “It is hoped that the valuable study by Muller et al will also embolden physicians to overcome their reticence to discuss this vital aspect of human functioning with their patients. After all, patients are interested not only in the years in their lives, but also in the liveliness of their years.”
Nearly a year later, the Baxleys enjoy the kind of relationship they had before the heart attack. 

Tips For Intimacy After a Heart Attack

  • Don’t have sex if you’re upset or angry. Stress makes the heart beat faster, and having sex at that time will only burden the heart further.

  • Don’t take medication right before sexual relations unless your doctor has advised. Some people think this will help prevent a heart attack, but taking medication in a way other than the doctor prescribes is not advised.

  • Talk to your doctor. People recovering from heart attacks often allow their sense of modesty to keep them from discussing this subject with their physicians. 

  • Wait several hours after a full meal to allow for digestion..

  • According to the American Heart Association, fears about sexual performance, coupled with general depression can reduce sexual interest. Caregivers should be aware that their loved ones may feel depressed during their recovery period. This is normal, and in 85 percent of the cases, the depression goes away within three months. Try not to let this cycle magnify any previous sexual problems between partners.

  • Don’t rush things. Choose a time when you and your partner are relaxed and can put the stress of the day behind you.

  • Choose a setting free from interruptions and distractions

  • Sexual activity is usually no more strenuous than climbing two flights of stairs

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