Sudden Cardiovascular Death Associated With Sexual Activity: A Forensic Autopsy Study (1972-2004)

Abstract

In recent discussions about potency-enhancing drugs such as sildenafil, health hazards associated with sexual activity have attracted increasing attention (1). In a medicolegal postmortem study performed in the Center of Legal Medicine at the University Hospital in Frank furt/Main over a 33-year period (1972-2004), about 32,000 forensic autopsies revealed 68 (0.22%) natural deaths occurring during sexual activity. Except for 5 women (7.4%; average age 39.8 years), in most cases, men were involved (92.6%; average age 59.1 years). The most frequent cause of death was myocardial infarction (n=28; 41.2%). In three cases, pericardial tamponade accompanied by myomalacia were observed. In 20 patients (29.4%), coronary artery disease (CAD) without signs of acute myocardial infarction (MI) was diagnosed. The medical history of 19 of the deceased indicated previous MI. There were seven cerebral hemorrhages (10.3%). The annual incidence of sudden cardiovascular death during sexual activity is estimated to be 1.9 per 1000 autopsies for men and 0.16 per 1000 autopsies for women (1). It is necessary to inform patients with CAD about prodromes and risk in relation to any form of physical and/or emotional stress.

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners

“…This is based on data from a study with pathological analysis of deaths that occurred during sexual activity (n=68), in which almost all deaths occurred in men (92.6%), with the majority of the deaths occurring during extramarital intercourse (n=39). 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.…”

Death Related to Aortic Coarctation in a Young Female During Sexual Intercourse

“…The annual incidence of sudden cardiovascular death during sexual intercourse is estimated to be 1.9 per 1000 autopsies for men and 0.16 per 1000 autopsies for women. However, the cause of sudden death related to sexual activity remains obscure (4). …”

Comportamento da frequência cardíaca em adulto jovem durante exercício físico e atividade sexual

“…However, it is known that the cardiovascular demand in extra marital orgasm is higher 9 , which can be a factor which justifies the higher risk of sudden death than the relation with the habitual partner. Data of two large retrospective studies performed in over 40 thousand autopsies revealed that sexual activity was related with less than 1% of the deaths and that in both, extra marital relations represented more than 60% of the cases 10,11 . While sexual activity is responsible for triggering less than 1% of the cases of AMI 5 , high-intensity exercise responds for 7% of the acute cardiac events.…”