Seksuele activiteit is wat betreft inspanning vergelijkbaar met het oplopen van 1 tot 2 trappen, tuinieren, stevig wandelen, een bed opmaken of schrobben. 103 Als de herstelfase van een
ongecompliceerd AMI voorbij is, hoeft coïtus niet te worden ontraden indien de patiënt zonder pijn op de borst stevig kan wandelen of bijvoorbeeld tuinieren; wel indien er sprake is van instabiele AP, ernstige angineuze klachten of ernstig hartfalen. 65 Uit prospectief onderzoek bij 258 patiënten die een AMI doormaakten, zonder ernstige complicaties, comorbiditeit of lichamelijke handicaps (leeftijd 70 jaar of jonger, 85% mannen), bleek dat 3 weken na het infarct ruim 50% van de patiënten seksuele activiteiten en activiteiten buitenshuis had hervat. 104 De kans dat de patiënt tijdens de coïtus een hartinfarct krijgt is erg klein; regelmatige lichamelijke inspanning vermindert het risico. 105106107
Mannen met hart- en vaatziekten kunnen last hebben van erectiele disfunctie ten gevolge van vaatlijden, ten gevolge van medicatie en door angst. Eventueel kan voor de coïtus een nitraat sublinguaal worden genomen. Ook vrouwen met een doorgemaakt ACS en partners kunnen angstig zijn voor seksuele activiteit.
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