Nothing gets your heart pumping like passionate sex, but if all that action leads to cardiac arrest, the outcome can be grim. New research has found that men are four times more likely to die if they experience a heart attack during sex than if they experience one at any other time. Why? Because their partners are more likely to delay calling for emergency help due to embarrassment or shock.

Time is of the essence for those experiencing a heart attack; a person's chances of survival go down for every minute that passes without professional care, The Independent reported. According to WebMD, the average delay between the start of heart attack symptoms and arriving at a hospital is about two hours, but longer delays lead to worse outcomes, and in some cases, death.

The average survival rate for a heart attack is about 50 percent, but only about one in eight of those who have a heart attack during sex go on to recover, The Independent reported. Study results revealed people who experienced a heart attack during sex waited twice as long for resuscitation and spent an average of 8.4 minutes without any assistance.

Although it's not certain why this delay exists, the researchers hypothesize that partners are more likely to delay calling for emergency help when heart attacks occur during sex. “Partners are shocked, they don’t know how to react,” said Dr. Ardalan Sharifzadehgan, The Independent reported. “The husband is naked, they are naked, maybe they’re afraid to call the neighbors. There’s big, big embarrassment.”

For the study, presented recently at the European Society of Cardiology, researchers looked at data on 3,028 individual who had suffered cardiac arrest. Of these, 246 had been physically active during their heart attack, and 17 had been having sex.

According to the National Institutes of Health, a heart attack occurs when blood flow to the heart is cut off, starving this important muscle of oxygen. This causes the heart to slowly die, and if an individual does not get help quickly, the damage could be serious and irreversible.

They are often the result of coronary heart disease, where the coronary arteries that lead to the heart become blocked and clogged over time with plaque. However, heart attacks can also occur in the absence of artery plaque, although these are less common.

The results bring new meaning to the concept of “safe sex,” but the team emphasize that those at increased risk of a heart attack don’t necessarily need to put off sex, but rather should approach it differently. For example, taking certain precautions such as avoiding too much alcohol before sexual activity and asking your partner to take a more active role in sexual activity could help reduce the risk of trauma during sex for those who have had a previous heart attack or heart surgery, The Independent reported.

So remember, have fun, but stay safe, and if by chance your partners does seem to be having some trouble mid-coitus, please swallow your pride and get them some help.

Source: Sharifzadehgan A., et al. Suddenly Cardiac Arrest During Sexual Intercourse. European Society of Cardiology. 2017