Active sex is like other forms of exercise that increase the heart rate and blood pressure. Sex for men without heart problems may cause breathlessness. In men with coronary heart disease, it may cause angina and rarely cause heart attacks. It is difficult to know if, or how often, sex has caused death due to a heart attack because it is difficult to find out and not the sort of question that is volunteered or asked at the time. Although theoretically, vigorous sex can trigger a heart attack (like severe exercise or stress), heart attacks occur for many reasons we do not understand. Most heart attacks do not occur during or shortly after sex.
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