Sexual Activity in Patients With Angina

Sexual Activity and Cardiovascular Disease

“…28 It is rare in patients who do not have angina during strenuous physical exertion and more prevalent in sedentary individuals with severe coronary artery disease (CAD) who experience angina with minimal physical activity. If a patient can achieve an energy expenditure of Ն3 to 5 METs without demonstrating ischemia during exercise testing, then the risk for ischemia during sexual activity is very low.…”

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners

“…156 It is rare in patients who do not experience angina during nonsexual physical exertion. Coital angina occurs when there is an imbalance between myocardial oxygen supply and demand.…”

“…A decrease in oxygen supply often will not resolve spontaneously or in response to nitroglycerine and may proceed to an acute MI; therefore, health professionals should advise patients who have not used PDE5 inhibitors and are experiencing postcoital angina to use nitrates and to call emergency services if the angina is still present after 5 minutes. 156 If nitrates are not available, postcoital angina that lasts >15 minutes should prompt a call to emergency services. For patients using PDE5 inhibitors who experience postcoital angina, emergency assistance should be summoned promptly and emergency response staff informed of PDE5 inhibitor use, because nitrate use is contraindicated.…”

Sexual dysfunction in the medically ill

“…Many cardiac patients worry about the recurrence of angina or worse during sexual activity. It is important to emphasize to these patients that less than 1% of all acute myocardial infarctions (MIs) are caused by sexual activity, whereas 5% and 3% of acute MIs are attributed to nonsexual physical exertion and anger, respectively [21]. There is a slightly increased risk of MI within the first 2 hours after sex but not beyond that time [22].…”