Hemoptysis during sexual intercourse. Unusual manifestation of coronary artery disease.

Sexual activity increases physiologic demands on the cardiovascular system. A patient with stable angina pectoris experienced recurrent bouts of hemoptysis caused by left ventricular failure that occurred only during sexual activity. Severe atherosclerotic coronary vascular disease was confirmed by cardiac catheterization. The patient underwent successful coronary artery bypass grafting; nine months after surgery, he is sexually active and symptom-free.