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Among heart attack survivors, average risks for another heart attack or sudden death are about 10 in 1 million per hour; having sex increases that to about 20 to 30 in 1 million per hour of sexual activity, the new report says. People without heart disease face lower overall risks for a heart attack, but similar risks for a sex-related attack.
The updated advice was released online Thursday in the heart association journal, Circulation.
Dr. Keith Churchwell, chief medical officer of Vanderbilt University's Heart and Vascular Institute, said the guidance is important for patients, and that questions about sex are the most common ones he hears from heart patients.
Ohio State University heart specialist Martha Gulati praised the recommendations for emphasizing that sexual counseling is important not just for patients but also their partners, who she says are often just as nervous about resuming sexual activity.
Day-care operator Tammy Collins of Reynoldsburg, Ohio, one of Gulati's patients, says the advice is reassuring.
She had a heart attack last year on Sept. 11, during a trip to Cincinnati to celebrate her wedding anniversary.
Collins' mother died of a heart attack at the same age, on her 51st birthday. With high blood pressure and high cholesterol, Collins knew she was at risk. She developed symptoms a few hours after having sex. She dismissed it at first, until she felt a sharp pain in her upper back and had trouble breathing. She was rushed to the hospital and doctors used stents to open blocked arteries.
Collins said she wasn't embarrassed to ask Gulati about sex, who told her it was unlikely that her night of romance had caused the heart attack. After several weeks of cardiac rehab, she was cleared to resume sexual activity - advice that surprised her friends. But Collins said the exercise sessions have made her feel fitter than ever.
"A heart attack does not have to be the end of living," Collins said.
Chicago cardiologist Dan Fintel, a professor of medicine at Northwestern University, said he routinely gives heart patients a sex talk on their last day in the hospital, knowing that it's likely on their minds.
"Resuming sexual activity is safe and emotionally part of the healing process, with a few caveats," he tells patients.
Those caveats elicit nervous chuckles when he explains that includes no philandering, given evidence about that causing extra stress.
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