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Coronary heart disease and sexual activity
  1. Paolo Emilio Puddu1,2,
  2. Joachim Alexandre2,3,4
  1. 1Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy
  2. 2EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, Caen, France
  3. 3Department of Pharmacology, CHU de Caen, Caen, France
  4. 4Université de Caen Basse-Normandie, Medical School, Caen, France
  1. Correspondence to Dr Paolo Emilio Puddu, Laboratory of Biotechnologies Applied to Cardiovascular Medicine, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico, 155, Roma 00161, Italy; paoloemilio.puddu{at}

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Human quality of life in contemporary societies is heavily influenced by sexuality. When coronary heart disease (CHD) occurs, both the affected individuals and their partners are concerned that sexual activity could exacerbate the cardiac condition, possibly causing myocardial infarction (MI) or sudden death.1 Although MI might be triggered by various factors, such as physical exertion, stressful events or heavy meals, when triggers are ranked from the highest to the lowest odds ratios (by calculating attributable fractions at the population level), traffic exposure poses at least a threefold higher risk than positive emotions or sexual activity.2 However, post-MI patients and their partners have limited access to information and/or counselling about sexual issues during the post-hospitalisation phase, despite an ascertained need for sexual counselling by healthcare professionals and the importance of sexual concerns in early, middle, and later recovery after MI.3

Sexual activity post-MI

Sexual activity post-MI is not regarded by most cardiologists as a major responsibility in the management of their patients. Indeed, among the 53.9% respondents to a 31-itemed anonymous questionnaire mailed to 980 members of the Netherlands Society of Cardiology, only 16% stated that they discussed sexual function regularly with their patients, whereas 70% never or seldom advised patients about resuming sexual activity after MI.4 While time constraints (43%) or lack of training (35%) were given as reasons for not discussing sexual function with patients, a lack of initiative on the part of the patients themselves (54%) was also found to be an important obstacle.4 Clearly, room exists for action in this area as intermittent discussions between healthcare providers and post-MI patients have led to improved resumption of sexual activity, which is safe among those patients who have no or mild angina and those who can exercise ≥3–5 METS (metabolic equivalents) without angina, excessive dyspnoea, or ischaemic …

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  • Contributors Both authors have contributed equally to the writing of this editorial.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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