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    After a Heart Attack

    Can you have sex?

    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 about it."

    Getting the Help You Need

    In a perfect world, doctors would sit down and discuss the patient's concerns thoroughly. But in reality, it's often up to patients or their loved ones to press their doctors for information.

    A couple might consider asking which medications that boost sexual functioning are safe, if help is needed, Kloner says. For instance, Viagra, the erection-inducing drug, may or may not work for men with heart problems. For those who take nitrates, Viagra can cause dangerous falls in blood pressure. It is generally deemed safe, however, in stable heart patients when taken with other high blood pressure and heart medications, according to Kloner, whose research on the topic will be published soon in the American Journal of Hypertension.

    Sometimes, patients or their families also find it helpful to reach out to others who have had the same experience. Mary took action by joining a support group.

    Getting Back on Track

    As the bond between Mary and Albert began to dissolve, Mary sought help through a local support group for spouses of heart attack survivors and soon came home with some new rules.

    "She told me we had to talk about something other than my heart attack," Albert says. "At first I was hurt because I didn't think she cared whether I lived or died, but then I realized she was correct. It was a relief because I could sense the tension between us. We worked on putting the thrill back into our love lives."

    They continued to follow the doctor's orders, but they also tried to return their sex life and social life to normal. As the Zarlengos soon learned, Albert's heart attack was an opportunity to reconnect as an intimate couple. They also discovered that their improved sex life aided in his recovery, because intimacy has a positive effect on well-being, according to Ornish.

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