June 26, 2000 -- Albert and Mary Zarlengo of Denver, Colo., both 61, always
counted their sex life as one of the pluses of their marriage.
Then came Albert's heart
attack and his bypass surgery. The otherwise loving couple, scared of
inducing another attack, quit having sex. It got worse. Albert, a trial lawyer
who was in his early 50s when the attack occurred, became so obsessed with
counting fat grams and minutes of exercise that he started to neglect Mary.
They grew apart because of his heart attack, says Mary. "Everything was
for him -- his diet,
his exercise, his problems. I heard constantly about his heart attack and the
surgery. I gave him support, but I started to feel left out."
The Zarlengos' story is a common one. Fear of a heart attack is one of the
biggest obstacles that comes between a heart patient and an active sex life,
according to Wayne Sotile, PhD, a Winston-Salem, N.C., sex therapist and author
of Heart Illness and Intimacy. The topic was also discussed in depth at the
European Society of Cardiology Conference in Barcelona, Spain, in late
Fears of having another heart attack are understandable, especially when you
don't know the statistics. There you are, in the middle of a passionate moment:
What if your heart starts to act up? You can imagine all sorts of embarrassing
scenarios with paramedics rushing into your bedroom. Then there's the emotional
trauma you'd cause your spouse if you were to die in the middle of sex.
But excessive fear is unfounded. The risk of a subsequent heart attack
caused by sex is less than 1%, according to a study of nearly 2,000 men
published in the Journal of the American Medical Association in May
1996. Regular exercise (as prescribed during cardiac rehabilitation) can reduce
the risk even further, the study found.
Despite the increased heart rate that accompanies sex, it is often only as
strenuous as gardening, experts say. If you can climb two flights of stairs,
you will probably be cleared by your doctor to have sex with your spouse,
according to Robert Kloner, MD, PhD, a University of Southern California
professor and director of the Good Samaritan Hospital Heart Institute, Los
The Importance of Sex
Understandably, survival is the first order of business for someone who has
had a heart attack. After that, other aspects of life need attention, too.
"Sex is one of the first things that should be addressed after a person has
a heart attack," says Dean Ornish, MD, author of Love and Survival:
Eight Pathways to Intimacy and Health, and founder of the Preventive
Medicine Research Institute in San Francisco.
Many doctors don't address sexual issues for several reasons, says Ornish.
"Sexuality isn't valued in our culture," he says. "Doctors weren't
trained to deal with sexual issues, and they often don't have the time to talk