Sexual intercourse unlikely cause of sudden cardiac arrest in young: JAMA

Sudden cardiac death (SCD) may occur in various circumstances, including physical exercise and sexual intercourse. A forensic study found that 0.2% of natural deaths that underwent autopsy were associated with sexual activity and predominantly involved middle-aged men.1 Using data from a large specialist cardiac pathology unit, we aimed to assess the proportion of SCDs associated with sexual activity and to describe the characteristics of this cohort and underlying causes of death.

Researchers reviewed a database of SCD cases that were referred to the center for cardiac pathology at St George's University of London between January 1, 1994, and August 31, 2020. Ethical and research governance approval for this study was granted through the Integrated Research Application System (10/H0724/38). We followed the American Journal of Ophthalmology reporting guideline.Before referral, all SCD cases underwent a detailed autopsy, including a toxicological screening, to exclude noncardiac causes. Sudden cardiac death was defined as death occurring within 12 hours of apparent well-being. Clinical information was obtained from referring coroners, who were asked to complete a detailed questionnaire. All cases underwent macroscopic and histological evaluation of the heart by expert cardiac pathologists. A minimum of 10 blocks of tissue were taken for histological analysis, as reported in a previous study.2 Results are expressed as mean (SD) for continuous variables or as number of cases (%) for categorical variables. MedCalc, version 17.4 (MedCalc Software Ltd), was used for the statistical analysis.