Erectile Dysfunction as an Early Sign of Cardiovascular Diseases: A Holistic Approach in Family Medicine

Öz

Erectile dysfunction (ED) is not always a urological problem; it can also be an early symptom of cardiovascular disease. The present case report emphasizes that ED observed in a patient followed for hypertension has been elucidated through trust-based patient-doctor relationship and should be considered an early sign of coronary artery disease. A 57-year-old male patient, who had been followed up due to hypertension for approximately eight years, shared his ED complaints, which had developed last year, after establishing a trust-based patient-doctor relationship with his family physician. Upon presentation, his blood pressure was under control, biochemical tests were within normal limits, and his ECG showed no pathological findings. The patient, who had no known comorbidities, experienced partial improvement after discontinuing beta-blocker use. A significant improvement in symptoms was observed after the urology specialist recommended 5 mg of tadalafil, but the patient did not continue the treatment. Approximately one month later, the patient applied to a cardiologist due to angina, he had no additional findings, The coronary angiography revealed a severe narrowing in the right coronary artery, and a stent was placed. The patient's ED complaint has completely disappeared after stent placement. The patient's clinical course suggests that ED in a hypertensive patient may be an early sign of coronary artery disease. Furthermore, it demonstrates that the patient-centred clinical approach and holistic approach applied in family medicine can facilitate the discussion of sexual problems, thereby contributing to early diagnosis.

Anahtar Kelimeler

• Erectile Dysfunction
• Hypertension
• Coronary Artery Disease
• Primary Health Care
• Comprehensive Health Care

Kardiyovasküler Hastalıkların Erken Belirtisi Olarak Erektil Disfonksiyon: Aile Hekimliğinde Bütüncül Yaklaşım

Öz

Erektil disfonksiyon (ED) sadece ürolojik bir sorun olmayıp, kardiyovasküler hastalıkların erken belirtisi olarak da görülebilir. Olgumuz aile hekimliği biriminde hipertansiyon nedeniyle takip edilen bir hastada görülen ED'nin hasta-hekim güven ilişkisine bağlı olarak ortaya çıkmasını ve ED’ nin koroner arter hastalığının erken bir bulgusu olarak değerlendirilmesi gerektiğini vurgulamaktadır. 57 yaşında ve yaklaşık sekiz yıldır hipertansiyon tanısı ile takip edilen erkek hasta, son bir yıldır ortaya çıkan ED yakınmasını, aile hekimiyle güven ilişkisi kurduktan sonra paylaşmıştır. Başvuruda kan basıncı kontrol altında, biyokimyasal testleri olağan ve EKG'sinde patolojik bulgu bulunmamaktaydı. Bilinen bir komorbid durumu olmayan hastanın yakınması, bir süre beta bloker kullanımının kesilmesi ile kısmi düzelme göstermiştir. Üroloji uzmanı tarafından önerilen 5 mg tadalafil sonrası semptomunda belirgin düzelme sağlanmış ancak hasta tedaviyi sürdürmemiştir. Yaklaşık bir ay sonra anjina sebebiyle kardiyoloji hekimine başvuran ancak ek hiçbir bulgusu olmayan hastaya yapılan koroner anjiyografide sağ koroner arterde ileri düzeyde darlık saptanmış ve stent uygulanmıştır. Hastanın ED yakınması stent uygulaması sonrası tamamen ortadan kalkmıştır. Hastanın klinik süreci hipertansif bir hastada gelişen ED'nin, koroner arter hastalığının erken bir işareti olabileceğini düşündürmektedir. Ayrıca aile hekimliğinde uygulanan hasta merkezli klinik yöntem ve bütüncül yaklaşımın cinsel sorunların dile getirilmesini kolaylaştırarak erken tanıya katkı sağlayabileceğini göstermektedir.

Anahtar Kelimeler

• Erektil Disfonksiyon
• Hipertansiyon
• Koroner Arter Hastalığı
• Birinci Basamak Sağlık Hizmetleri
• Bütüncül sağlık hizmeti

Kaynakça

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