I have a heart condition. Are there BDSM activities I need to avoid?

This is not medical advice. The appropriate level of physical and emotional exertion for your specific cardiac condition must be discussed with your cardiologist.

Heart conditions vary enormously in severity and in what they mean for physical activity. The key principle is that BDSM, like any physical and emotionally intense activity, places demand on the cardiovascular system, and the appropriate response to that depends on your diagnosis.

Electrostimulation is the most important specific contraindication. E-stim, violet wands, and any electrical play are absolutely contraindicated for anyone with a pacemaker, implantable cardioverter-defibrillator, or any other cardiac implanted electronic device. Electrical current can interfere with device function in ways that are immediately life-threatening. This is not a matter of caution, it is an absolute.

Beyond e-stim, the most relevant activities are those that spike heart rate and blood pressure: intense impact play, breath restriction, fear play and intense psychological dynamics, and physically demanding bondage positions. Whether any of these are appropriate for you depends on your specific condition and current functional capacity. Someone who has been cleared for moderate exercise by their cardiologist is in a different position from someone with poorly controlled arrhythmia or recent cardiac events.

Certain medications used for heart conditions are worth discussing in the BDSM context. Beta-blockers blunt the adrenaline response and can affect how you experience intense scenes, including reducing the physiological intensity of fear play. Medications affecting blood pressure may interact with the positional changes involved in some bondage or suspension.

Tell your partner your condition. If you are playing with a new person, tell them in negotiation. Ensure someone present at any scene knows about your condition and where any medication is.