The coital coronary: A reassessment of the concept.

The concept of the coital coronary, that is sudden death due to cardiovascular disorder associated with sexual activity of one form or another, is reviewed and reevaluated. Research on the hemodynamic demands of coitus, the concept of stress in this regard, the etiologic role of arrhythmias and current clinical wisdom are assessed with respect to sudden sex-related deaths. The actual empirical evidence underlying prevailing beliefs is also carefully reviewed and observed to be grossly deficient. Our knowledge concerning the etiology and incidence of the condition is restructured within a hierarchical model related to the degree of scientific confirmation available, and suggestions concerning a more valid appraisal of the phenomenon are advanced.