Fact about death during intercourse:
(1) Some people view this as being embarrassing and may not care to divulge the circumstances, so it may go unrecognized and underreported.
(2) Men are more likely to be affected due to the greater level of exertion.
Groups of patients:
(1) middle aged to elderly patients of sedentary habits
(2) young to middle aged patients with congenital disease
(3) young to middle aged patients engaging in practices to heighten the experience
Physiologic factors that may contribute to the event:
(1) exertion in a person who is otherwise physically inactive
(2) increase in blood pressure
(3) cardiac arrhythmia such as ventricular fibrillation
(4) theoretically a vasovagal response (suggested but never documented)
Some of the causes of sudden death:
(1) ischemic heart disease
(2) abnormality of the cardiac conduction system
(3) subarachnoid hemorrhage following rupture of a berry aneurysm in a cerebral artery along the base of the brain
(4) possibly dissecting aneurysm affecting the origin of the coronary arteries
(5) possibly massive pulmonary embolism
In persons engaging in practices to heighten the experience:
(1) stimulant drugs
(2) asphyxiation practices such as strangulation
(3) electrical devices with electrocution (a report of one such episode is in the American Journal of Forensic Medicine and Pathology)
The introduction of Viagra may increase the number of these cases since it is of optimal benefit in a patient with underlying vascular disease.
