Abstract

SANTOS, José Agostinho. Early intervention in the infarction of a relationship. Rev Port Clin Geral [online]. 2011, vol.27, n.6, pp.541-546. ISSN 0870-7103.

Introduction: Patients with coronary artery disease may seek advice from their general practitioner (GP) regarding sexual activity. However, this advice might sometimes be deficient. Case Description: A 56 years-old man presented with a history of class I stable angina. In March, 2010, in his first consultation with his current GP, he had no complaints. His wife stated that he had been irritable since 2009, the date of the diagnosis of coronary artery disease. In September, 2010, his wife complained of his worsening of irritability with progressive social isolation and deterioration in the marital relationship. In October, 2010, he confirmed that this behavioral change coincided with the diagnosis of ischemic heart disease. He was counselled at this time regarding exercise, leisure, sexual activities and the resumption of his social life. A week later, he returned to the clinic with questions about permitted activity including sexual relations. He said that he has been told by a doctor in the past that he was at increased risk of acute myocardial infarction associated with sexual activity and had been told to “be careful”. He then received an additional explanation of the low absolute risk of infarction associated with sex and reassurance regarding the safety of sexual activity in the class I angina patient. The couple returned to the clinic at subsequent visits reporting increased confidence in their sexual activity. Comment: The impact of ischemic heart disease on sexual activity is believed to be due to both diminished self-esteem and the side effects of pharmacotherapy. Counseling is an important part of non-pharmacological therapy. Inadequate counselling can be harmful. Sexuality is compared to an artery serving as an emotional conduit for a couple. Ineffective counseling may be a trigger blocking this pathway causing infarction of the marital relationship. Counselling is like thrombolysis performed to eliminate the thrombus of fears. Revascularization of the relationship was achieved subsequently.

Keywords : Sexual Activity; Coronary Heart Disease; Counseling.

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