Editing Evaluation and Management of Erectile Dysfunction (section)

=== Cardiology referral ===

* '''2018 AUA'''
** '''Men should be counseled that ED is a risk marker for underlying cardiovascular disease (CVD) and other health conditions that may warrant evaluation and treatment'''
** '''ED is as strong of a risk factor for CVD as is smoking and family history'''
** '''Sexual activity has been associated with increased risk for cardiac events, although the absolute risk is small, particularly in men who regularly engage in other physical activities'''
*** '''Low-risk patients''' (men without cardiac disease who are able to exercise with no to minimal cardiac symptoms, men with diagnosed cardiac disease who have undergone successful revascularization procedures (e.g., coronary artery stenting, coronary artery bypass graft), men with controlled asymptomatic hypertension, and men with low grade heart failure (i.e., New York Heart Association Class I and II heart failure) '''may be treated for ED without additional cardiovascular evaluation'''.
*** '''All other men with cardiovascular conditions require a cardiology consultation and additional cardiac evaluation;''' '''if there is uncertainty regarding a man’s exercise tolerance and fitness for sexual activity, then he should be referred for in-depth evaluation of cardiac reserve by a cardiologist'''
* '''2021 CUA'''
** '''Controversial whether a diagnosis of ED alone should initiate a more thorough cardiovascular evaluation'''