Sexual activity and the cardiovascular patient: Guidelines

Modern cardiac rehabilitation is a comprehensive program of secondary preve ntion for patients with heart disease. Moreover, it is an important context in which to broach issues of impaired sexual function. Sexual problems pla gue a large portion of our cardiac patient population. Unspoken concerns ab out impotence, now more correctly called erectile dysfunction (ED), are com mon, as are concerns about the safety of engaging in sexual activity, espec ially after major cardiac events or therapeutic interventions. A large prop ortion of patients do not return to normal sexual activity after a cardiac event, Many factors, including normal age-related changes in sexual respons e, medication-induced dysfunction, and vascular changes associated with ris k factors (e.g., diabetes and dyslipidemia), as well as the emotional impac t of symptomatic heart disease, may influence sexual function in these pati ents. These factors, occurring alone or in combination, probably explain th e discouraging prevalence of sexual dysfunction in patients with manifest c ardiac disease, Because so few patients have specific cardiac reasons for l imiting sexual activity, a clear opportunity exists for cardiologists and t heir staff to help enhance the emotional well-being and overall quality of life of their cardiac patients, (C) 1999 by Excerpta Medica, Inc.