S

sexual activity and cardiovascular disease
HEART ATTACK, STROKE, major HEARTsurgery such as
CORONARY ARTERY BYPASS GRAFT (CABG) or HEART
TRANSPLANTATION, or the diagnosis of a cardiovascu-
lar condition such as HYPERTENSION(high BLOOD
PRESSURE) or CORONARY ARTERY DISEASE(CAD) often
causes worry and fear that sexual activity may
harm the heart. Such concerns are common
though generally have no medical basis. Sexual
intercourse requires about the same level of car-
diovascular response from the body as walking up
three flights of stairs. Following a cardiovascular
event, most people may resume sexual activity
when they regain interest.
These preparations may make the return to
sexual activity more enjoyable:

• Plan sexual activity for when both partners are
  well rested, relaxed, and have no time con-
  straints.


• Plan sexual activity to take place two to three
  hours after eating a meal, to allow digestion to
  take place. Digestion diverts more of the body’s
  blood supply to the gastrointestinal tract.


• Choose a location that is comfortable and free
  from distractions such as the telephone or
  interruptions.


• Choose less strenuous positions and have extra
  pillows available for added support.


• Be patient and focus on the intimacy of being
  together.

People who have had OPEN HEART SURGERYor
who have residual complications resulting from
stroke may feel unsure of their physical attractive-
ness. Open, honest communication between part-
ners can help put these concerns in perspective

and allow each partner to express his or her feel-

ings.

See also LIVING WITH CARDIOVASCULAR DISEASE;

QUALITY OF LIFE.

sick sinus syndrome A collective term for

ARRHYTHMIAdisorders that arise from dysfunction

of the SINOATRIAL(SA) NODEand the electrical con-

duction network within the HEART. The SA node

may stop functioning, or there may be a disrup-

tion in the pathway for the electrical impulses the

SA node generates. Generally sick sinus syndrome

results in bradycardia (slow HEART RATE). Key

symptoms include fatigue and SYNCOPE(fainting).

Sick sinus syndrome may also be present without

symptoms, in which case it does not usually

require treatment. ELECTROCARDIOGRAM (ECG)

reveals the abnormal electrical pacing impulses

and provides the diagnosis. Treatment is nearly

always an implantable PACEMAKERto maintain an

adequate heart rate.

See also ATRIOVENTRICULAR (AV) NODE; BUNDLE

BRANCH; BUNDLE BRANCH BLOCK; LONG QT SYNDROME

(LQTS); WOLFF-PARKINSON-WHITE SYNDROME.

sinoatrial (SA) node A small cluster of special-

ized NERVEand MUSCLEfibers located in the upper

wall of the heart’s right atrium. The SA node initi-

ates the electrical pacing impulse that causes the

HEARTto contract. In the healthy heart the electri-

cal impulse spreads in an orderly and synchro-

nized pattern through the two atria, causing them

to contract. The ATRIOVENTRICULAR(AV) NODE, a sec-

ond small cluster of specialized nerve and muscle

fibers located in the wall of the heart between the

atria and the ventricles, picks up the impulse,

amplifies it, and sends it through the ventricles to

cause them to contract.

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