Sudden death during sexual activity [Plötzlicher tod bei sexuellen aktivitäten]

Sudden death during sexual activity can often be attributed to natural causes such as myocardial infarction, intracerebral hemorrhage or asymptomatic myocarditis. In most cases the findings at the death scene will be suspicious of an association to sexual activity, if the scene has not been changed by embarrassed (sexual) partners in order to hide the true background of the death. The spectrum of natural causes of death during sexual activity is presented taking our own case experience and a review of the literature into consideration. Pathophysiological and epidemiological factors, especially concerning cardiovascular risk factors and the delimitation from deaths due to accidental asphyxia and injuries to the internal genital organs are reviewed.