Is safe sex possible with moderate stenosis and a heart murmur?

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I understand your concern.

Suppose you do not have chest pain or giddiness during exertion like climbing stairs or a brisk walk. In that case, you can have sex with moderate activity. However, tablet Sildenafil is contraindicated in aortic stenosis. Also, sex without a limit can be unsafe.

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Sexual activity is acceptable in patients with no or minimal symptoms during routine activities and a low risk of cardiovascular complications. Also, it is acceptable in patients with mild or moderate valve disease, who are asymptomatic or with mild symptoms, as well as in patients with the normal function of artificial valves and those who have undergone successful transcatheter valve correction.

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Exercise stress testing can help estimate individuals with asymptomatic, moderate, or severe aortic stenosis and those with other asymptomatic severe valve dysfunction.

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It is unsafe if the stenosis is moderate to severe.

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We need to see a gradient across the valve in the echocardiogram (ECG). You must undergo surgery immediately if mean gradients across the aortic valve are 40 mm Hg and above. However, if it is 25 to 40 mm Hg, it is considered moderate stenosis, and you can wait until it becomes severe. Also, as there is aortic regurgitation (AR) along with aortic stenosis (AS), the overall cardiac function and LV (left ventricular) thickness will suggest the time for a replacement. Aortic stenosis causes left ventricular hypertrophy.

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Yes, you can go for the surgery as you are in good health now. However, a cardiologist will suggest a coronary angiogram and decide whether to go for a TAVR (transcatheter aortic valve replacement).

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Only a tissue valve can be placed by TAVR or transcatheter aortic valve replacement as it is foldable and can go through a catheter. They last up to ten years and can be replaced later if required. Also, there is no need for oral anti-coagulants after the placement of a tissue valve. Metallic valves have a significant sound. A person sitting close by can hear the clicks of a valve.

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