(Health.com) -- If you've recently had a heart attack or heart surgery, you might be concerned that revving up your pulse during a moment of passion could be dangerous. Rest assured: Resuming sexual activity is perfectly safe for most heart patients, according to new guidelines from the American Heart Association (AHA).
Certain patients, such as those with severe heart disease who have symptoms while at rest, should put off sex until their condition has stabilized. But if you can walk briskly or climb two flights of stairs without experiencing chest pain, abnormal heart rhythms, or shortness of breath, you're almost certainly ready to start having sex again, the guidelines say.
The authors stress, however, that all heart patients should check with their doctor before resuming their sex life. Just as important, the guidelines encourage patients -- and their partners -- to discuss any feelings of sex-related anxiety or depression with a health professional.
"Both patients and the patient's spouse or partner often have anxieties about resuming sexual activity after the patient has been diagnosed with heart disease or has undergone a heart procedure," says Glenn N. Levine, M.D., the lead author of the guidelines and a professor of medicine at Baylor College of Medicine, in Houston. "Sometimes it is actually the partner who is more anxious than the patient."
Heart Attacks, Death During Sex Very Rare
The research review confirmed that these widely publicized cases are very much the exception and not the norm.
Sexual activity was found to be the cause of less than 1% of all heart attacks and less than 1% of all cases of sudden death related to heart ailments or stroke.
Having sex was associated with a two- to threefold increase in heart attack risk among heart patients, but Levine characterizes the risk to the individual patient as "extraordinarily low."
"It is important to remember that the vast majority of heart attacks occur when people are not having sex," he says.
In one autopsy study involving 5,559 people who died suddenly from heart arrhythmias (a disruptive heart rhythm), just 34 (0.6%) of the deaths reportedly occurred during sexual activity. Two other studies reported similarly low rates of sudden death associated with sex.
Most of these cases occurred in men, and three out of four of these deaths involved extramarital sex, most often with a younger partner in an unfamiliar setting.
"One could speculate that higher anxiety or higher adrenaline might have been involved in these deaths, but because the numbers were so small I wouldn't want to read too much into this," Levine says.
Chest pain associated with sexual activity, known medically as coital angina, was also uncommon, accounting for less than 5% of all angina attacks.