[Sudden cardiovascular death during sexual intercourse--results of a legal medicine autopsy study]

This epidemiologic, retrospective follow-up mortality study is based on the data gathered in the department of forensic medicine at the University Hospital of Johann Wolfgang Goethe University in Frankfurt/Main. Over a period of 21 years (1972-1992), roughly 21,000 forensic autopsies revealed 39 cases (0.19%) of natural deaths occurring during sexual activity. Except for two women, all of these cases were men of an average age of 61.3 years. The most frequent cause of death was myocardial infarction (n = 21/53.8%), three of these cases involving pericardial tamponade accompanied by myomalacia. The medical history of twelve of the deceased showed a previous myocardial infarction. Most of the deaths took place during or after sexual intercourse or manual stimulation. In most cases sudden death occurred during the sexual act with a prostitute. The annual incidence of sudden cardiovascular deaths during sexual activity is estimated to be 0.2/100,000 men. The risk for women is lower by a factor of 12.