Questions on sexual practices should be included in a social history because of their potentially harmful effect on the heart as commonly evidenced by

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Questions on sexual practices should be asked to determine the potentially harmful effect of sexual activities on the heart; for example,the effect of intercourse on the heart may be exertional chest pain.Additionally,a vagal response can occur with anal intercourse,thus making the patient prone to syncope.Sexual activities do not usually cause the manifestations in options "b," "c," and "d." However,sexual activity does increase the cardiac workload and sympathetic stimulation.In a person with severe coronary artery disease,the extra cardiac workload can precipitate angina.

Questions on Sexual Practices Should Be Included in a Social