Cardiology>>>>>Cardiac Rehabilitation
Question 6#

You are working in a general cardiology clinic and are just finishing a consultation with a 69-year-old man who had been admitted with an NSTEMI 6 weeks previously. He has recovered well and has good LV function on a recent echocardiogram. His medications include aspirin, clopidogrel, bisoprolol, ramipril, and simvastatin. On the way out of the door he mentions some concerns about sexual dysfunction.

Which one of the following statements is incorrect?

A. You are usually fit enough to have sex if you can comfortably walk about 300 yards on the flat, or climb two flights of stairs briskly without getting chest pain or becoming breathless
B. Patients can resume sexual intercourse 4 weeks after an uncomplicated MI
C. Erectile dysfunction is often due to underlying vascular disease, but can also relate to a patient’s use of beta-blockers and/or ACE inhibitors
D. Phosphodiesterase type 5 inhibitors (e.g. Viagra/sildenafil) could now be considered for use in this patient
E. Patients on nitrates and/or nicorandil should avoid taking phosphodiesterase type 5 inhibitors because this can lead to dangerously low blood pressure

Correct Answer is D

Comment:

Whilst the rest of the advice given in the options in the question is correct, phosphodiesterase type 5 inhibitors may be considered in stable patients who have had an MI more than 6 months earlier.