Many heart specialists are hardly Dr Ruth - sex is not something they relish bringing up with patients. But new guidance says they should, early and often, to let survivors know intimacy is often possible after a heart attack.

Discussions should involve everything from when and how to resume sex, to what position might be best for some conditions or not advised for others, according to a consensus statement released on Monday by the American Heart Association and the European Society of Cardiology.

It's billed as the first scientific statement with detailed guidance on resuming sex after a heart attack, stroke or other cardiac condition and is based on a review of medical literature.