Tachycardia and Pain During Sex

[Dasobel]

Not to get too graphic on a "family" website, but...

39 year old male, non-smoker, good general health, some atypical chest pain for three years.  Stress tests, echo, bloodwork, etc. all checked out, no cardiac origin to pain detected. Occasional PVCS (about 5-6 per week), felt as mild pain.

My concern:  about 6 months ago, I noticed that a FEW times at the POINT of orgasm after intense sex, I felt chest discomfort. Feels like light pressure and general uncomfortableness.  Passes quickly, maybe after 10-15 seconds.  This only happens right as/after I have an orgasm, NEVER during the preliminaries.  

Second Concern: starting about same time, I OFTEN feel my heart speed up right at the POINT of orgasm.  It feels like it kicks up from, say, 135 to 160, not terribly racing, but enough to feel the difference in speed kick in from one beat to the next. Never felt that before. Also seems to take longer to slow down. Instead of 15-20 seconds, the hard, fast rhythm seems to last 60-90 seconds before tapering off until, after about 5 minutes, it's back to normal and I'm "unaware" again.

Once, when startled and frightened, I felt a squeezing sensation (classic angina sign) as my "fight or flight" response kicked in, and beat quickened; but squeezing only lasted 5-7 seconds.

I exercise often, and can do 30 minutes on a stairmaster w/ HR up to 160 at the end w/ no tachy and no pain. Lift weights, treadmill, etc. No tachy, nothing. Intense sex for 30 minutes, no prob. But the exact moment I climax-- off to the races for a minute or two.

Any thoughts?

[CCF-M.D.-MJM]

Hello,

Believe it or not this is not the first time I have heard a history like this.  First, if you can exercise 30 minutes with your heart rate around 160, I agree with your doctor that is unlikely to be ischemic chest pain.  It is not unheard of to have a little chest pain when someone scares you.  None of this sounds life threatening, but I am not sure you are going to get a concrete answer to your question.

If I saw you in clinic, I would probably give you an event monitor and send you home to repeat the activities that are causing the symptoms.  When the symptoms happen, you press a button to record the rhythm.  If there is any sort of arrhythmia, we would then have a recording.  If it isn't from an arrhythmia, I am as puzzled as you are.

I hope this helps.  Good luck.

[tickertock]

Never had any chest pain yet during sex,but a few years back for about 2 weeks straight every time I had sex and climaxed, I would get an intense headache that lasted about 20 seconds, it was almost unbearable, if it lasted more than a minute or 2 , I don't know what would have happened it was that bad. Anyhow it just went away thank goodness and I never experienced it since, I casually mentioned it to my internist, he said alot males experience these type of headaches just after having sex, unfortunately for some he told me it can be quite a problem that occurs very frequently. I have a few friends that mentioned the same happening to them maybe its similiar to what happens with your chest,just in a different area of the body, just a thought, hopefully it will disappear just as quick as it came, don't let it put a damper on a good thing. Good luck.

[Emmaj]

I have had angina kick in with tachycardia -- in fact, the worst angina I ever had (and I have had heart attacks) was actually during an episode of tachycardia that woke me up at night, so your symptoms sound to me like they could be cardiac related. I don't think angina is always linear -- that is, that the same stress (or hr) will always produce the same degree of angina. Also, it's a little different when you exercise, as perhaps your hr doesn't accelerate quite so fast as it does when you have an orgasm. I think I would go the event monitor route. I have read a lot of posts in which people describe chest pain and, unlike some descriptions, what you describe does ring true to my experience of angina. You could also experiment with nitro if the pain lasted a little longer -- I'm not sure you could tell if it helped with the pain lasting so briefly. Best of luck!

[Prof. ATP]

You wrote "I exercise often, and can do 30 minutes on a stairmaster w/ HR up to 160 at the end w/ no tachy and no pain."  The physician's comment was "I agree with your doctor that is unlikely to be ischemic chest pain."  Don't be so sure.  I did a triathlon last summer with an 80% blocked right coronary artery, and later exercised to 101% of my predicted maximum HR with no ischemic ECG changes or symptoms.  The blockage was detected through a thallium scan, not the treadmill.

There are several examples (check the forum archives) of people who are quite fit despite significant coronary artery disease.

[Fran71]

Does anyone get PVCs during sex? I get PVCs every time I'm thrilled,  excited, nervous....so also during sex! I guess that's common since sex causes lots of adrenaline...correct? Would take a beta blocker before sex help, or would that just make us tired? :-)

Fran

[Dasobel]

What were your symptoms? Why did you get the thallium done?

[Dasobel]

I get PVCs (maybe one or two) anticipating sex or during sex if I'm very excited. I have been told and read in many places that it's normal and nothing to worry about, as long as you don't have CAD or a serious rhythm problem. In fact, sexual activity is about the only trigger for my PVCs that I've ever detected. I seldom have PVCs while exercising. Usually, when I have one,(luckily, I've never had complex or multiple PVCs, just one misfire at a time) it's when I'm calm and resting, often at night lying down reading, etc., when my heart rate is low. But apart from that, sex can do it. I feel every PVC I have as a mildly painful stab on the ectopic beat, so I know when I have one! I think sexual excitement is a common trigger for PVCs.

[Fran71]

I've found many triggers for my PVCs. Any form of excitement, good or bad, will cause them if I'm in a bad PVC period. For instance, if I'm having a discussion with someone and I get angry or passionate about what I'm saying, I will get PVCs! As soon as the discussion stops, they go away. Similarly, with sex I too get them before and during sex but they disappear afterwards. Even when I'm very happy, laughing, etc., they may occur. Like you I don't get PVCs during exercise, actually if I start exercising having PVCs they disappear. I also know that alcohol brings on PVCs for me, so does tiredness and lack of sleep. So...a whole lot of causes!!! Basically all related to catecolamines - don't know if PVCs always are...I often experience sinus tachy with them. In my case, I get more PVCs when my HR increases, but not when it increases during exercise...This is something that really puzzles me.

[Prof. ATP]

I had no symptoms.  I had the thallium because I am a professional pilot with known CAD (CABGx2, 1998), so the FAA demands an annual checkfor my medical certification.  It had been three years since the previous thallium scan, with negative treadmill tests in between.