Hello, I would be happy to help you with your question.

During intercourse, there is not doubt that this places an increased "stress" on the heart. Given your age, history and the symptoms that are associated with the "stress" of intercourse and orgasm, it might be appropriate to consider that the pain in your shoulder is actually related to something else, like your heart.

Pain can be 'referred' to areas of the body unrelated to the source of the pain. Heart pain is typically referred to the left shoulder, but it is theoretically possible that it could be referred to the right as well. Avoid further intercourse and call your doctor tomorrow and ask for a visit to discuss whether there are any concerns about your heart in this case, especially given your underlying heart disease.

I hope that this helps. Please ask if you have followup questions.

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Thank you for the followup. I have spent quite a bit of time trying to research possible causes for the shoulder pain. Approaching and during orgasm, there is a definite rise in heart rate and blood pressure. Orgasm is also associated with activation of your "autonomic" nervous system. The arousal phase is controlled by the 'sympathetic' nerves, and the orgasm itself involves activation of 'parasympathetic' nerves. While I know that this likely makes no sense to you, it is the one thing that changes when you transition from arousal to orgasm. I really have no way of connecting the activation of the parasympathetic nervous system to the shoulder pain, perhaps (given the negative cardiac workup) a Neurologist would be the correct Professional to consult on this matter.

I am sorry that I am not of more help. Perhpas the opinion for a different type of specialist (Neurology) would provide an answer to this question. I would schedule a visit in person with such a specialist.

Good luck.

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