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Making love is extremely unlikely to cause a second heart attacks in men who have had one, according to a report in the Journal of the American Medical Association. The men most likely to suffer a second heart attack during lovemaking are those who do not exercise.

After recovering from a heart attack, the average man makes love only half as often as he did before the heart attack, not because of any inherent problem in his heart, but because of the fear that it will cause another attack. Sadly, 70 percent of heart attack victims are given no advice about lovemaking after they have recovered. In a study from the University of Toronto, fewer than 12 percent of heart attack victims had chest pain while making love, while more than 36 percent had chest pain while riding a stationary bicycle.

Making love does not require that you be in shape. It takes very little energy to make love. Chances are that you can make love safely if you can walk up two flights of stairs, an activity that requires the same amount of energy. If you have had a heart attack, check with your doctor, who will probably recommend an exercise electrocardiogram to find out how much exercise your heart can tolerate. Then you can start a controlled exercise program to strengthen your heart.

The best way to prevent a heart attack during lovemaking is to stay with your regular partner. Guilt and excitement are far more important in provoking heart attacks than the extra work of making love. A study from Emery Medical School reported that when a man made love to his wife, his heart beats were regular and his pulse never went beyond 100 beats a minute. When he made love to his mistress, his heart beat irregularly more than l30 times a minute. A study in the Japanese Journal of Legal Medicine showed that more than 80 percent of men who died during lovemaking weren't making love to their wives. A famous heart researcher, David Kritchevsky of the University of Pennsylvania, wrote:

Heart beats stay at normal rate,
When one beds down with legal mate.
But roosting in another's nest,
flirts with cardiac arrest.

Gabe Mirkin, M.D.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in Sports Medicine and three other specialties.

Dr. Mirkin's daily features on fitness have been heard on CBS Radio News stations since the 1970's. He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. His latest book is The Healthy Heart Miracle, published by HarperCollins.

Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. A Boston native, Dr. Mirkin did his residency at the Massachusetts General Hospital. He has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine. He has run more than forty marathons and is now a serious tandem bicycle rider with his wife, nutritionist Diana Mirkin.