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What Causes Exhaustion And Low Libido In A Heart Patient?
Question: My husband had a myocardial infarction 6 months ago. He had stents put in. His job is physically demanding and he was back working 2 months after. He was very energetic and it seemed like everything was fine. All of a sudden he is exhausted all the time and has zero sex drive. He is on the usual line up of medications after a heart attack and is taking plavix for a year. He always has been a heavy beer drinker and only gave it up for a month following.
Brief Answer:
I would suggest some important clues to consider:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain some important clues to consider about his actual clinical symptomatology (excessive exhaustion, lowered libido, etc):
(1) First of all, it is necessary to investigate his remaining overall cardiac performance.
The most important long-term complication of a myocardial infarction is decreased cardiac performance leading to clinical heart failure, and hence to impaired overall physical capacity (impacting daily physical activity and sexual life).
It is important to investigate heart function by cardiac ultrasound 4-6 weeks after a myocardial infarction (to identify a possible implication in overall physical performance).
(2) Some anti-ischemic drugs, like beta-blockers, very important in myocardial infarction patients, may be responsible for decreasing further overall physical capacity. A discussion with his attending doctor should be done to adjust the most appropriate beta-blocker regimen (doses, intervals of administration, etc) to avoid as much as possible the potential implications of beta-blockers on physical status and sexual drive.
(3) A careful psychological interview by an expert (psychiatrist) should be done, as myocardial infarction patients have shown an increased level of clinical depression during the first year after suffering a myocardial infarction (up to 60%).
Depression may explain the current clinical impications on physical activity and sexual drive. A proper therapeutic strategy would avoid such symptoms from persisting.
(4) Alcohol abuse and also its withdrawal may affects several functional components (central and peripheral nervous system, liver function, cardiac function, sexual domain, psychological addiction, etc), leading to your husband's actual clinical scenario.
It is necessary to thoroughly investigate possible adverse alcohol consequences by performing a careful neurological status evaluation, liver function, etc.
You need to discuss with his attending doctor about the above mentioned issues.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
I would suggest some important clues to consider:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain some important clues to consider about his actual clinical symptomatology (excessive exhaustion, lowered libido, etc):
(1) First of all, it is necessary to investigate his remaining overall cardiac performance.
The most important long-term complication of a myocardial infarction is decreased cardiac performance leading to clinical heart failure, and hence to impaired overall physical capacity (impacting daily physical activity and sexual life).
It is important to investigate heart function by cardiac ultrasound 4-6 weeks after a myocardial infarction (to identify a possible implication in overall physical performance).
(2) Some anti-ischemic drugs, like beta-blockers, very important in myocardial infarction patients, may be responsible for decreasing further overall physical capacity. A discussion with his attending doctor should be done to adjust the most appropriate beta-blocker regimen (doses, intervals of administration, etc) to avoid as much as possible the potential implications of beta-blockers on physical status and sexual drive.
(3) A careful psychological interview by an expert (psychiatrist) should be done, as myocardial infarction patients have shown an increased level of clinical depression during the first year after suffering a myocardial infarction (up to 60%).
Depression may explain the current clinical impications on physical activity and sexual drive. A proper therapeutic strategy would avoid such symptoms from persisting.
(4) Alcohol abuse and also its withdrawal may affects several functional components (central and peripheral nervous system, liver function, cardiac function, sexual domain, psychological addiction, etc), leading to your husband's actual clinical scenario.
It is necessary to thoroughly investigate possible adverse alcohol consequences by performing a careful neurological status evaluation, liver function, etc.
You need to discuss with his attending doctor about the above mentioned issues.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
His heart was examined with ultrasound. They said it was doing very very well. He takes his pills religiously but, like I mentioned, continues to drink. He is honest with his doctor about his drinking and they have done liver tests but only at the time of his heart attack. Could the drugs damage his liver?
As for depression... He denies it but he is definately not the same as before the attack... Which is totally understandable.
As for depression... He denies it but he is definately not the same as before the attack... Which is totally understandable.
Brief Answer:
I recommend discussing with his doctor about the above mentioned topics.
Detailed Answer:
Hi again!
If a current cardiac ultrasound confirms a normal left ventricular ejection fraction (LVEF) then a direct cardiac reason to his complains is excluded.
Other potential factors should be investigated (as I mentioned you above).
Drugs couldn't damage his liver more than alcohol does. So relax!
I advise you to ask his attending doctor assistance to drive you through the differential diagnostic process.
If after this important investigation, tests results are available, feel free to upload them for a direct review and medical opinion.
Best regards,
Dr. Iliri
I recommend discussing with his doctor about the above mentioned topics.
Detailed Answer:
Hi again!
If a current cardiac ultrasound confirms a normal left ventricular ejection fraction (LVEF) then a direct cardiac reason to his complains is excluded.
Other potential factors should be investigated (as I mentioned you above).
Drugs couldn't damage his liver more than alcohol does. So relax!
I advise you to ask his attending doctor assistance to drive you through the differential diagnostic process.
If after this important investigation, tests results are available, feel free to upload them for a direct review and medical opinion.
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you!!!!
Brief Answer:
You are welcome!
Detailed Answer:
I am at your disposal whenever you need!
Best wishes,
Dr. Iliri
You are welcome!
Detailed Answer:
I am at your disposal whenever you need!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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