A Brief Introduction to Drug Treatment for Coronary Artery Disease and Guidance on Sexual Life

**5.7//Introduction to Drug Treatment for Coronary Artery Disease**

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① Drug prevention.

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Patients with coronary heart disease can take low-dose aspirin orally for a long time, namely 0.3g of aspirin once a day and 50mg of dipyridamole three times a day, which can reduce blood viscosity and prevent or reduce the incidence of myocardial infarction.

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> ② Treatment of angina attacks in patients with coronary heart disease.

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All activities should be stopped immediately. Administer 0.3–0.6 mg of nitroglycerin sublingually. The medication will begin to take effect in 1–2 minutes and the effect will disappear after about half an hour.

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Its effectiveness rate is 92%, and 76% of patients experience relief within 3 minutes.

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If symptoms do not improve after 3 minutes of sublingual administration of 0.3 mg nitroglycerin, another 0.3 mg of nitroglycerin can be administered every 5 minutes, with a total dose not exceeding 1.2 mg within 15 minutes. If symptoms do not improve, seek immediate medical attention to determine if myocardial infarction is present.

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③ Commonly used drugs for treating coronary heart disease.

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A. Nitroglycerin is a nitrate drug that primarily acts on the coronary arteries. It can reduce the workload on the heart and improve blood supply to the heart.

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Nitroglycerin taken sublingually can be rapidly absorbed through the oral mucosa, taking effect in 2-5 minutes, reaching its peak effect in 3-10 minutes, and lasting for 20-30 minutes.

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Side effects: Temporary facial flushing, headache, and high doses may induce orthostatic hypotension.

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It should be noted that the daily interval between doses of nitroglycerin must be greater than 8 hours, meaning that there must be at least 8 hours without taking the medication each day.

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> B. Propranolol, indolol, timarolol, etc. belong to the β-adrenergic receptor blockers.

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It is primarily used to treat stable and unstable angina, and can reduce the frequency of attacks. It is especially suitable for patients with hypertension or arrhythmia.

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These types of medications should be used under the guidance of a doctor.

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> C. Nifedipine, chemically known as Adalat, is a calcium channel blocker. It dilates coronary arteries, increases coronary blood flow, and improves myocardial ischemia. It is mainly used for variant angina, but can also be used for stable and unstable angina.

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The absorption rate is 79% when taken orally or sublingually. Oral administration takes effect in 15-20 minutes, while sublingual administration takes effect in 2-3 minutes, with a duration of action of 4-8 hours. The dosage is 10-20 mg per dose, three times a day.

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Side effects: Temporary facial flushing, headache, low blood pressure, and numbness in the limbs.

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> D. Isosorbide dinitrate: It belongs to the same class as nitroglycerin. Isosorbide dinitrate has a weaker effect and a slower onset of action, but its effect lasts longer.

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The drug is administered sublingually at a dose of 5–10 mg. It takes effect in 15 to 30 minutes and can last for 2–4 hours. There are significant individual differences in the dosage range of this product. In general, the use of sustained-release formulations can reduce adverse reactions and increase the duration of drug action. It is generally suitable for the prevention of angina pectoris and the long-term treatment of myocardial infarction.

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> 5.8 // What are some other treatment options for coronary heart disease?**

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> (1) Massage

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A. When angina occurs, pressing a 5-cent coin or your finger on your temple can quickly relieve the pain. Pressing for 3-6 minutes daily can prevent angina attacks.

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> B. Gently massage the Lingdao acupoint with your thumb for 1 minute, then press firmly for 2 minutes, and finally finish with gentle massage for 1.5 minutes.

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Massage once a day, 15 times as one course of treatment.

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(2) Treatment with Traditional Chinese Medicine Prescriptions

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A. Pain-relieving powder: 3 grams of centipede and 3 grams of scorpion, dried and ground into a fine powder.

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Take 2 grams each time, 3 times a day, dissolved in warm water. Suitable for refractory angina.

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> B. Take 0.3g of pearl powder, 1.5g of Panax notoginseng powder, and 3g of Fritillaria cirrhosa powder as a daily dose, divided into two doses, for one month. This is suitable for refractory angina pectoris.

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(3) External treatment in traditional Chinese medicine

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> Angina Pectoris Relief Ointment is composed of Salvia miltiorrhiza, safflower, and other ingredients.

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Apply the plaster to the chest once a day to reduce angina and the frequency of angina attacks.

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**Coronary Artery Disease and Sexual Life**

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As people age, the likelihood of developing coronary heart disease and undergoing coronary artery bypass surgery increases, which is an unpleasant and unavoidable fact in life.

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Because men face greater social pressures and risk factors than women, they have a higher rate of heart disease.

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Sexual activity places higher demands on men's cardiac function than women's. Even a minor heart problem can affect sexual life. During sexual activity, the quality of sex may be poor due to concerns about its impact on heart disease. This is especially true for patients with coronary heart disease, as such a serious issue may cause them to restrict their sexual activity out of fear of danger.

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Many people who are diagnosed with coronary heart disease feel deeply uneasy about their physical condition and become depressed. This complete loss of confidence can reduce sexual interest and libido.

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When you are feeling anxious or depressed, it is very difficult to fully experience sexual pleasure.

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However, the resumption of sexual activity can help patients with coronary heart disease alleviate their anxiety about their health, help them regain their lost confidence, adjust their negative emotions, and allow them to rediscover the meaning and joy of life.

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> 6.1 // How should we properly address the relationship between coronary heart disease and sexual life?

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Among patients with coronary heart disease, about one-quarter completely give up sex, about 50% reduce the frequency of intercourse, and only the remaining quarter maintain their sex life as before.

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This is regrettable, because giving up sex after experiencing a coronary heart disease attack is neither advisable nor necessary.

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Continuing sexual activity can increase a patient's confidence, enhance their sense of masculinity, strengthen their sense of success, and give them a more comprehensive experience of life.

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Among patients with coronary atherosclerotic heart disease, approximately 80% are able to continue having normal sexual activity without worrying about taking serious risks.

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The remaining 20% ​​of patients do not need to abstain from sex completely; all they need to do is adjust their sexual practices according to their individual tolerance levels.

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**6.2//Can patients with coronary heart disease experience sudden death during sexual intercourse?**

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People diagnosed with coronary heart disease often worry: Will sex become too strenuous?

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Can a rapid heart rate occur during sexual intercourse?

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Can angina occur?

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Is sex safe for me?

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Some people even worry about dying during sex.

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In fact, there is no need to worry.

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Cases of death during sexual intercourse are extremely rare.

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Recent studies on coronary heart disease patients who died suddenly show that less than 0.5% of these deaths occurred during sexual intercourse, far fewer than those who died during sleep. Moreover, it must be pointed out that among the very few who died during sexual intercourse, the majority died after consuming large amounts of alcohol.

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In this situation, the extra stress can cause heart rate and blood pressure to rise significantly above normal levels, thus putting an extra burden on the heart.