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

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.