Sex IS safe after a heart attack: Most couples can begin kissing and touching a day after the event and have intercourse a week later

From quitting smoking to cutting back on alcohol, there are many lifestyle changes heart attack victims are forced to make.

Sex is completely safe for most heart patients, and should be encouraged, a leading cardiologist says Professor Claudio Soares de Araújo. He equates sex to 'a brisk walk' and says patients can begin kissing and touching the day after their heart attack (file photo)

But one thing they should definitely not give up is sex, a leading cardiologist has claimed. In fact, it is completely safe for most heart patients - and should even be encouraged.Professor Claudio Gil Soares de Araújo, of Instituto do Coração Edson Saad, Rio de Janeiro, reviewed the all the latest evidence on the topic to assess the risk.

Comparing sex to a ‘a brisk walk’, he has compiled practical recommendations to help couples begin to be intimate again.

Here, speaking to MailOnline, he busts common myths about having sex after a heart attack and explains why it's fine for heart patients to take Viagra...

'EXTREMELY LOW RISK OF DEATH'

Professor Soares de Araújo said his team’s extensive literature review, which looked at more than 150 papers, allowed them to dismiss several myths regarding sex after a heart attack.

Overall, the risk of death during sex is very low, and ever lower for women.

In fact, sex was responsible for less than 2 per cent of heart patients who died due to exercise.

Professor Soares de Araújo told MailOnline: ‘When I see patients in my office, I say have you resumed having sex? They say “no doctor”. 

'I say well, what about kissing and touching? They say “no doctor”.

‘There’s no reason for that. Heart patients are usually weak and depressed. Sexual activity can help them resume normal way of life.’

Viagra can actually help heart patients, as it reduces their anxiety about performing in the bedroom, putting less stress on their heart

WHAT CAN HEART PATIENTS DO?

Professor Soares de Araújo and his team said it is critical heart patients are correctly counselled on resuming having sex.

They said sex encompasses several behaviours including (Ki), touching (T), oral (O), masturbation (M) and vaginal/anal intercourse (I).

They therefore coined the acronym KiTOMI to represent all the behaviours covered in sex.

Then, the equated the various acitivities with walking at different speeds.

For example, kissing and touching is like a slow walk, while oral sex and masturbation is akin to walking at a regular pace.

The middle phases of intercourse are like walking quickly and orgasm is the equivalent to running across the street, researchers said.

Professor Soares de Araújo said being able to compare stages of sex to recognisable activities should reassure patients.

'Sex is exercise, but people aren't going to get fit from having sex three times a week', he said.

In fact, the average session of sexual activity lasts six minutes and uses up a paltry 21 calories, according to a paper published in the New England Journal of Medicine in 2013.  

HOW SOON CAN THEY START HAVING SEX?

Patients should be assessed by a doctors to see if having sex is risky.

For most patients whose heart disease is stable, there is no risk, Professor Soares de Araújo said.

These low risk patients can resume activity immediately.

On the day after the heart attack, couples can touch and kiss.

‘A few days later you can have oral sex, after a week you can start masturbating and have intercourse’, Professor Soares de Araújo added.

CAN HEART PATIENTS STILL TAKE VIAGRA?

Viagra can actually help heart patients, as it reduces their anxiety about performing in the bedroom, which means there is less stress on the heart muscle

Professor Soares de Araújo told MailOnline: 'They can perform better, they require less energy, they put less stress on the heart. So it’s beneficial, it reduces the anxiety to perform well.'

However, this would only be offered for men with impotence, and not as the first option.

He added the only drawback is that it can interfere with nitrates, a type of drug prescribed to some patients with heart problems.

Both Viagra and nitrates cause the muscles control blood vessels to relax, affecting blood pressure.

'So we may tell them to avoid nitrates or be very careful,' Professor Soares de Araújo concluded. 

DOCTORS SHOULD RECOMMEND SEX 

Specifically, they should offer advice on sex in the same way they counsel patients about going back to work or enrolling in an exercised programme.

Writing in the Canadian Journal of Cardiology, Professor Soares de Araújo said: ‘Kissing and touching should be a component of positive sexual behaviours toward a healthier sexual life and should be recommended for virtually all heart patients regardless of sexual orientation.

‘Often considered “taboo”, an objective discussion of sexual behavior in heart disease has often been put aside. Healthcare providers must break this vicious cycle.’

WHAT ARE THE WARNING SIGNS YOU SHOULD STOP?

If you have chest pain or find your heart isn't beating regularly, then you should speak to your doctor, Professor Soares de Araújo advised.

However, he reiterated that heart attacks rarely occur during sex.

He said: 'Heart rate increases during exercise. During sex, heart rate increases disproportionately higher because emotions are involved. 

'But after 10 seconds of orgasm everything returns to normal.' 

One study found a heart attack during sex is more likely to happen if people are having an affair

ARE YOU MORE LIKELY TO HAVE A HEART ATTACK IF YOU’RE HAVING AN AFFAIR?

A 2012 study published in the Journal of Sexual Medicine found men were more likely to experience 'sudden coital death' - a fatal heart attack during sex - while having sex with someone other than their wife.

One theory is the adrenaline-stimulating effects of sex may be heightened with a new partner, placing more strain on the heart.

This is a bit like the excitement of watching a football match, which has also been reported to lead to increased numbers of calls to emergency services because of cardiac problems.

But Professor Soares de Araújo said the study was not representative of the population as a whole, and its findings therefore cannot not be applied to all patients.

As he has demonstrated, if sex is akin to a brisk walk, then this shouldn't put people at risk.

Doctors should offer advice on sex in the same way the counsel patients about going back to work or enrolling in an exercised programme, he said