Cardiac disease, anxiety, and sexual functioning.

Despite the growing amount of reseach on cardiac disease and sexual dysfunction, few empirical studies have been published on the overlap of these 2 areas. In particular, previous research has noted that the overall attainment of social and occupational adjustment for patients with cardiac disease remains a challenge. Emotional distress of sufficient intensity to receive a psychiatric diagnosis has been estimated to be as high as 37-58% in patients after myocardial infarction (MI). In fact, numerous studies have concluded that failure to adjust socially or to return to normal activity levels is more strongly related to psychological distress than to the extent of the organic disease itself. These factors, either pre-existing or after onset of psychological morbidity, are highly likely to influence sexual adjustment of the cardiac patient. This article reviews the role of anxiety as a risk factor for the development of cardiac disease, as a comorbid condition, and the role anxiety may play in the development of sexual difficulties. The complicated association between psychological distress, previous sexual adjustment, organic factors, and existing family supports should be considered in cardiac rehabilitation.