Causes of Sudden Death Related to Sexual Activity : Results of a Medicolegal Postmortem Study from 2001 to 2005

Abstract

Sexual activity (SA), combined with organic heart disease, may cause sudden death (SD). However, the causes of SD related to SA are not known well. The aim of this study was to assess the causes of SD related to SA. From August 2001 to November 2005, all autopsies (n=1,379) performed at Kyungpook National University were prospectively searched for SD cases related to SA. Fourteen cases (46±11 yr old, 9 males) of SD related to SA were found. All were heterosexual. The toxicologic study was negative in all. Ten cases were witnessed; during SA in 4 cases, just after SA in another 4 cases, 2 and 5 hr after in 1 each case. In 4 unwitnessed cases the victims were found dead less than 12 hr from the end of their SA. The partners were steady extramarital partners (n=8), prostitutes (n=2), marital partner (n=1) and unknown (n=3). The causes of the SD were as follows; coronary artery disease in 6, subarachnoid hemorrhage with ruptured berry aneurysm in 4, fibromuscular dysplasia of the atrioventricular nodal artery in 2, and unknown in 2. Coronary artery disease and subarachnoid hemorrhage with ruptured berry aneurysm were important as causes of SD related to SA.

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners

“…128 Only 19 of the fatal events occurred in the victim's home (n=16) or the home of a longtime partner (n=3). Other studies from Asia 129,130 have been consistent with Western data in that men are the major victims of sudden death in the context of extramarital relations, and their underlying CVD contributes to mortality. It is presumed that secret sexual activity in an unfamiliar setting may significantly increase blood pressure and heart rate, resulting in sudden death or cardiovascular events.…”

“…It is presumed that secret sexual activity in an unfamiliar setting may significantly increase blood pressure and heart rate, resulting in sudden death or cardiovascular events. 130 The risks, however, appear to be very low, and the increase in risk attributed to coitus was found to be far less than that associated with anger and unaccustomed physical exercise. There is no consensus on what kind of position the patient should assume for sexual activity.…”

Sexual activity as a trigger for intracranial hemorrhage

“…The majority of reported cases involve aneurysm rupture with subsequent subarachnoid hemorrhage (SAH) [7,22,29,30,34]. Hypothesized pathophysiologic mechanisms emphasize changes in transmural pressure across the aneurysm dome coincident with the physiologic changes that accompany the stages of the human sexual response [36].…”

“…Intracranial hemorrhage (ICH) is a rare, yet recognized cause of sudden death during and shortly after sexual activity [22,30]. The majority of reported cases involve aneurysm rupture with subsequent subarachnoid hemorrhage (SAH) [7,22,29,30,34].…”

Age-Related Changes in Heart Rate during Copulatory Behavior of Male Rats

“…Saito et al [25,27] demonstrated that penile reflexes and copulatory behavior in 44-week-old male rats are decreased as compared with 10-week-old male rats. Cardiovascular sudden death of elderly men during sexual activity has been reported [19,23,29] and is considered to be a serious problem. In previous studies, we reported changes in heart rate (HR) of young adult male rats and horses during copulation, as measured with a telemetry system.…”