Safe sex when you have heart disease

The article was professionally consulted with Specialist Doctor II Nguyen Quoc Viet - Interventional Cardiologist - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.

Sexual activity is an important part of daily life and a concern for many cardiovascular patients. Cardiovascular patients sometimes feel chest pain, shortness of breath during sex. So should heart patients have sex? Knowing how to have safe sex will answer this question.

1.1 Effect of sex on heart disease For sex life, people with heart disease often ask, "Should I have sex with heart disease?" . In fact, sex affects heart rate, blood pressure and breathing rate. Specifically, the breathing rate will increase gradually, the skin will redden, both heart rate and blood pressure will increase. These are normal body responses, but for people with cardiovascular disease, this change can sometimes be a burden on the heart.
The effect of sex on heart disease causes symptoms such as: Chest pain during or after sex, shortness of breath during sex, extreme fatigue, very fast or irregular heartbeat...
Risk myocardial infarction or any other cardiovascular event such as: chest pain, arrhythmia or exacerbation of heart attack, depending on the risk group.
1.1.1 Low-risk group The majority of patients are in the low-risk group, including:
Asymptomatic and less than three cardiovascular risk factors (except gender) Controlled hypertension Mild angina stable in patients being treated for erectile dysfunction with phosphodiesterase-5 inhibitors. Successfully recanalized coronary artery. Six to eight weeks after myocardial infarction, there are no symptoms or signs of myocardial ischemia on exercise testing. Mild valvular disease 1.1.2 Moderate risk group The moderate risk group includes patients:
Asymptomatic and with 3 or more cardiovascular risk factors (regardless of gender), sedentary Movement is also considered a risk factor. Stable, moderate angina 2 to 6 weeks after myocardial infarction, with no symptoms, no coronary revascularization, and no signs of myocardial ischemia on stress testing. NYHA II heart failure or heart failure with an ejection fraction less than 40%. Peripheral vascular disease, transient ischemic attack or atherosclerotic stroke. 1.1.4 High-risk group This group includes patients who:
Resistant angina or unstable angina Uncontrolled hypertension Heart failure NYHA III/IV Myocardial infarction within the last 2 weeks High-risk arrhythmias Obstructive cardiomyopathy Moderate or higher valvular disease, especially aortic stenosis. 1.2 Effects of heart disease on sex Sex and heart disease are interrelated. So does heart disease affect physiology?
There are two factors that greatly affect sex life in patients with cardiovascular disease: physical health and mental health (anxiety, depression, emotional control disorders).
Sexual dysfunction is common in patients with cardiovascular disease often due to physical health problems. This stems from concerns about the risk of myocardial infarction, side effects of drugs (beta blockers, diuretics, lipid-lowering drugs), comorbidities such as: dyslipidemia, high blood pressure, diabetes, smoking.
After myocardial infarction, all patients have decreased ability to have sex as well as decreased satisfaction when having sex. Sexual dysfunction after myocardial infarction (usually erectile dysfunction) occurs in about 50% to 75% of patients. If the patient undergoes coronary artery bypass surgery, it is also possible but with a lower rate. The cause may be due to psychological obstacles, fear from the patient or partner.

“Should I have sex with heart disease?” . Knowing how to practice safe sex with someone with heart disease will help lead to a healthier sex life. There are many ways to prepare for the restoration of sexual activity.
2.1 Time to have sex again For people with cardiovascular disease, sex requires a lot of energy, increases heart activity, so it usually takes 1 to 3 weeks after discharge for the body to recover. rehibilitate. When ready, the person can begin sexual activities.
If there are no symptoms of myocardial ischemia in a patient with successful coronary revascularization, sexual intercourse is possible 3 to 4 weeks after myocardial infarction.
However, it is necessary to avoid excessive exertion as well as avoid strong impacts on the chest. If during sex, the patient feels very tired, has difficulty breathing during sex, feels palpitations, feels pain, heaviness, or pressure in the chest, jaw, neck, arms, or abdomen, they should stop immediately and rest. Rest and take medication as directed by your doctor.
2.2 Exercise Physical exercise will help increase the endurance of the heart as well as improve the general condition of the body.
For example, in the practice of walking, the patient will increase the stamina and confidence to be ready for sexual activity. The energy required for intercourse is equivalent to walking briskly or taking the stairs up two floors. With regular exercise, heart rate rarely rises above 120 beats per minute, and blood pressure increases only slightly during sex and is temporary.
2.3 Exercise control of emotions For a short time after a cardiovascular event or after an open heart surgery, the patient's emotions are unstable, agitated, and moody. You need to encourage the patient to try to control his emotions every day, help the patient feel comfortable, happy, and adjust his sexual needs to fit the patient.
2.4 Drugs There are many cardiovascular drugs that can affect sexual function. Among cardiovascular drugs, thiazides diuretics, beta-blockers, and lipid-lowering drugs can cause sexual side effects.
One thing to note is that phosphodiesterase-5 inhibitors to treat erectile dysfunction should not be used with nitrate drugs in any form.
Phosphodiesterase-5 (PDE-5) inhibitors such as Sildenafil, Tadalafil, and Vardenafil are widely used to treat erectile dysfunction and can cause cardiovascular effects. These agents may improve erectile function in patients with stable ischemic heart disease, hypertension, diabetes mellitus, or psychological causes.

For cardiovascular patients, PDE5 drugs have two important effects: Lower blood pressure and interact with the nitrate group. The mechanism causing hypotension is the drug vasodilator, reducing systemic vascular resistance. When interacting with nitrate drugs, PDE5 can lower blood pressure. Vardenafil and Tadalafil are contraindicated for use with nitrates because of the prolonged interaction time of 24 hours and 48 hours, respectively.
Drugs that reduce the risk of myocardial infarction after sex such as:
Beta blockers: Reduce myocardial oxygen demand, reduce heart rate, reduce chest pain during sex, reduce the risk of infarction blood during stress. Aspirin: Is an antiplatelet drug that reduces the risk of myocardial infarction when stressed or when walking in the morning, reducing the risk of myocardial infarction during sex. "Can heart disease be related". The answer is yes. However, to limit the risk of possible cardiovascular events, people with cardiovascular disease should have regular health checkups. With problems related to sexual activity, people with heart disease should not decide on their own level of activity before being examined and advised by a doctor. In addition, mentally, both husband and wife need to understand each other, closeness and frankness will help both have a better sex life and feel more comfortable to deal with cardiovascular disease.
Cardiovascular patients can choose to be examined and treated at Vinmec International General Hospital. There is a team of Cardiologists, including experienced professors, doctors, specialists, and masters in the field of internal medicine, surgery, interventional cardiac catheterization. . Vinmec also focuses on the application of advanced techniques in the diagnosis and treatment of cardiovascular diseases, using a system of modern medical equipment that meets international standards. With problems related to sexual activity of people with cardiovascular disease, the doctor will examine and advise on sexual measures and give an appropriate diet and exercise regimen depending on the patient's condition.