title: Sex, the heart, and heart failure.
abstract: In the modern era of pharmacologic treatment of erectile dysfunction, men with heart disease increasingly approach their physicians regarding the possibility of restoring sexual activity. At the same time, patients are also frequently aware of public figures that have reportedly died during coitus, often in the arms of their mistresses or prostitutes. Added to this is the perception of patients, and oftentimes their physicians, that coitus and orgasm are associated with a near maximal or even "supermaximal" cardiac workload and therefore may be hazardous for a diseased heart. Accordingly, knowledge of the cardiovascular effects of sexual activity, the risks of triggering a cardiovascular event, and the potential risks inherent in the use of drug therapy of male impotence is important to properly advise patients and their spouses regarding this sensitive issue.
authors.affiliation: Heart and Vascular Center Zürich, Klinik im Park, Zürich, Switzerland. wolfgang.kiowski@hirslanden.ch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kiowski
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Brunner
authors.forename: Christoph
authors.initials: C
authors.lastname: Schalcher
mesh_terms: D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D000075202:Contraindications; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006321:Heart / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology*; D009566:Nitrates / Q000009:adverse effects / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D012725:Sexual Behavior / Q000502:physiology*; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D009566:Nitrates; D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents; D015106:3',5'-Cyclic-GMP Phosphodiesterases