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

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.