Sexual dysfunction following a myocardial infarction (MI) or the diagnosis of coronary heart disease has been noted by the majority of patients.1 Studies to date have suggested that a substantial number of these cases are due to the patient's (or spouse's) fear of a catastrophic cardiac event during coitus.2 In addition, patients may limit sexual activity because of angina or dyspnea during coitus, or because of drug-related reduction in libido or erectile or ejaculatory function.
See also p 1745.
The physician caring for the patient who has had an MI is reponsible for assessing his or her functional capacity with respect to the anticipated demands of coitus and to appropriately counsel the patient and spouse with regard to resuming sexual activities. Essential to such an assessment is an accurate estimate of the patient's functional capacity (from an exercise ECG examination) and an understanding of the expected cardiac demands