Ask A Doctor - i am having heart enlargement and it is 36% - DesiMD Healthcare Services

   

i was diagnosed as heart enlarged and systolic and at 36% , i am using ramipril and cardivas 10mg and digoxin tablets as prescribed by doctors , i had angio and found no blocks in ventricles .since then iam feeling normal . my problem is i am not able to perform sex as my erection is n ot taking place. my BP is also normal 120/80 may please advise what medicines i can take to perform sex - Asked by k r on 28-May-2014 15:53:25

Answer Count: 2    Disorder Type: Cardiac disorders

  • Internal Medicine

    Answered by Dr. Suneel Vallabhaneni on 28-May-2014 20:42:23

    Thank you for giving a detailed history about your medical condition. Erectile dysfunction can be due to various causes: 1. Desire issues - conflicts with the partner can contribute to this, stress related to family, financial or social issues etc. 2. Medications - opioid pain medications like morphine, hydrocodone, OxyContin, fentanyl etc. beta blockers like cardivas you are on. But cardivas is an essential medication for you given your heart condition, so I do not want you to stop that. 3. Neurological issues like back pain effecting the nervous supply of the penis. 4. Blood supply issues to the penis - conditions like diabetes cause small vessel narrowing and decreased responsiveness of the vessels to the stimulus from the nerves due to damage to the nerves from diabetes 5. Hormonal causes - problems with the pituitary gland or testes leading to decreased testosterone production. Once the above causes are thoroughly searched for by your primary care doctor and all the possible causes like hormonal deficiencies are addressed, then you can use sildenafil (Viagra). The starting dose I would suggest for you would be 25 mg instead of 50 mg given the decreased ejection fraction for your heart and the fact that you are on 2 blood pressure medications. This should be taken once a day as needed one hour before sexual intercourse. This should be avoided if you are on any nitrates like nitro glycerine/isosorbide mono or dinitrate or if you blood pressures are running 90/70 or less as this medication will drop the pressures further and make you dizzy and loose consiousness. Common side effects are headaches, flushing of your face, heart burn like problems and low blood pressures. Let me know if this helps and do not hesitate to contact us back.
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