Résumé
Sexuality in the post-cardiac infarction patient is an important, poorly approached area. For 43 non-diabetic, non-hypertensive patients with post- myocardial infarction sexual dysfunction; the erectile function [as measured by direct interrogation and specific questions], sex hormonal profile [radioimmunoassay], cardiac function [New York Heart association Classification], echocardiography and psychological status [as measured by standard tests] were evaluated. Patients mean age was 48.5 years [31- 65 range] and they suffered impotence for at least months. There was inconcordance between the degrees of cardiac dysfunction, sexual dysfunctions and sex hormonal changes. Psychologically, patients showed mostly two maladaptive coping styles; the denier and the cardiac invalid [myths about sudden death during intercourse]; 48% of patients were anxious and depressed. It was concluded that postmyocardial infarction sexual dysfunction is a multifaceted problem. In addition to the involvement of the penile arteries by the atherosclerotic process, the psychological status tops the list of causes which included medications, cardiac dysfunction and others. The communication gap between the patient and his physician who is embarrassed or unknowledgeable about the subject needs to be shunted. Patients should be advised as to the realities of their fears and provided with guidelines for facilitating a satisfying sexual relationship