Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

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2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes.

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines

ACC
: American College of Cardiology
ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
AF
: atrial fibrillation
AGNES
: Arrhythmia Genetics in the Netherlands
AHA
: American Heart Association
AMIOVIRT
: AMIOdarone Versus Implantable cardioverter-defibrillator:

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2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)

2015 ESC Guidelines for the Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

/pdf/2015-esc-guidelines-for-the-management-of-patients-with-4lhfmy4xir.pdf

2015 ESC Guidelines for the Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.

/pdf/2015-esc-guidelines-for-the-management-of-patients-with-3w5q5u8zhj.pdf

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).

Sexual counseling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP)

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners A Consensus Document From the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP)

After a cardiovascular event, patients and their families often cope with numerous changes in their lives, including dealing with consequences of the disease or its treatment on their daily lives and functioning. Coping poorly with both physical and psychological challenges may lead to impaired quality of life. Sexuality is one aspect of quality of life that is important for many patients and partners that may be adversely affected by a cardiac event. The World Health Organization defines sexual health as ‘… a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences ….’1(p4) The safety and timing of return to sexual activity after a cardiac event have been well addressed in an American Heart Association scientific statement, and decreased sexual activity among cardiac patients is frequently reported.2 Rates of erectile dysfunction (ED) among men with cardiovascular disease (CVD) are twice as high as those in the general population, with similar rates of sexual dysfunction in females with CVD.3 ED and vaginal dryness may also be presenting signs of heart disease and may appear 1–3 years before the onset of angina pectoris. Estimates reflect that only a small percentage of those with sexual dysfunction seek medical care;4 therefore, routine assessment of sexual problems and sexual counselling may be of benefit as part of effective management by physicians, nurses, and other healthcare providers.

Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP).

The purpose of this study was to examine the screening of depression among pregnant and postpartum participants in a community-based program. This cross-sectional study used archival data from 98 women participating in a community-based visiting nurse program in a midwestern U.S. city. Depression screening was accomplished using the Center for Epidemiologic Studies Depression scale (CES-D) and Edinburgh Postnatal Depression scale (EPDS); both instruments ask respondents to answer questions regarding their mood during the past week. The CES-D identified more pregnant and postpartum women as depressed than did the EPDS. A standard regression analysis using previous pregnancies, history of depression, married versus nonmarried, presence of support, and breast-feeding as predictor variables did not produce statistically significant findings for predicting depression among the pregnant and postpartum women in this study. This finding underscores the value of brief depression screening instruments for nurses working with pregnant and postpartum women.

Screening for depression among pregnant and postpartum women

BACKGROUND AND RESEARCH OBJECTIVE Healthcare providers are expected to provide information and support as myocardial infarction (MI) patients resume normal activities, including sexual relations. The healthcare literature, however, suggests that few providers follow through with the assessment of understanding, provision of appropriate information, and support for patients with MI in resuming their sexual activity. The purpose of the study was to examine trends in sexual concerns of patients with MI and patterns of sexual concerns in early, middle, and later recovery periods. SAMPLE AND METHODS Archival data were analyzed using thematic content analysis. Narrative comments from 3 samples of patients with MI spanning the time periods of 1995 to 2002 (N = 302) were unitized into sentences and phrases. A total of 346 units of analysis were coded using the concept of sexual integrity and examined across time: (a) sexual concerns from 1995 to 2002 and (b) sexual concerns in early, middle, and later recovery after MI. FINDINGS AND CONCLUSIONS Predominant themes included alterations in self-identity, specifically physical and psychological health state. Communication issues involved a lack of sexual information and intimacy concerns. Perception of patients with MI on family concerns, particularly the influence of spouses upon return to sexual activity, was reflected within the comments. Trends in early, middle, and later recovery periods were similar to findings across the 8-year period. All 3 determinants of sexual integrity were represented in the data. Our findings clearly illustrate the need for sexual counseling for patients with MI by healthcare professionals and help to inform providers about content for patient education.

Victoria Mosack

Papers

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners A Consensus Document From the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP)

Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP).

Screening for depression among pregnant and postpartum women

Trends in sexual concerns after myocardial infarction.

Trends in sexual concerns after myocardial infarction