1. Sex and the broken heart

3. When can I start having sex again?

4. When can I start having sex again? • After myocardial infarction or CABG • After angioplasty or stent

5. When can I start having sex again? • After myocardial infarction or CABG • After 2-3 weeks • After angioplasty or stent • After 2-3 days

6. What about sex with my angina?

7. What about sex with my angina? • If stable anginaand • Can walk 1 mile in 20 minutes on the flator • Can walk down 13 steps in 10 seconds No change

8. What happens if I get angina during or after sex?

9. What happens if I get angina during or after sex? • Stand up or sit down to reduce cardiac output • Take a measure of brandy or whisky to vasodilate

10. What about sex with a regular partner?

11. What about sex with a regular partner? • Heart rate rises to 110-130 per minute • BP rises to 150-180 systolic • Workload rises to 3-4 metabolic equivalents (1 mile in 20 minutes on the flat) orVigorous sex : 4-5 metabolic equivalents(a round of golf)

12. What about sex with someone else?

13. What about sex with someone else? • Casual or extramarital sex • Heart rate rises to 200 per minute • BP rises to 210 systolic • 80% of sudden cardiac death after sex

14. Remember Erectile dysfunction can be a marker for cardiovascular disease

15. Reference British Journal of Sexual Medicine 2007: Vol 30 No 2 p 3