#AskDrKK:What sexual advice to give to a patient with stable angina?

#DrKKAnswers:
1. Patients with angina often become symptomatic during sexual act (1,2).
2. 65 percent ends up with heart chest pain enough to stop activity (2).
3. Beta blockers and/or prophylactic sublingual nitrates, can prevent heart pain in these patients and permit a normal sex life (2).
4. Post angioplasty and bypass surgery patient do not carry excess risk
5. Asymptomatic chronic heart blockage patients also do not have an increased risk of symptoms during sexual act.

References
1. Arch Intern Med 1970; 125:987.
2. Int Rehabil Med 1981; 3:35.

#AskDrKK: Which position is better for sex in heart patients?

#DrKKAnswers:
There is no difference in heart rate (114 vs 117) or blood pressure (163/81 vs 161/77 mmHg) between man on top or man on bottom [1]. However there is slightly lower minute oxygen consumption for men in the supine position, but this lasts only for a brief period during orgasm [2].

References
1. Am Heart J 1976; 92:274.
2. Arch Intern Med 1984; 144:1745.