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in collaboration with
Dr Gérald Kierzek (Medical Director of Doctissimo)
Medical validation:
August 14, 2022
Originally from Mississippi, the woman was hospitalized in emergency after a sexual relationship. She suffered from an aortic intramural hematoma, bleeding from the wall of an artery.
It is a report that could have been fatal to him. A 45-year-old American had a bad surprise in the middle of sexual intercourse: during orgasm, she felt a sharp chest pain. This extremely rare case was the subject of a publication in the American Journal of Case Reports.
A “pop” in the chest
“Just prior to the onset of her symptoms, the patient was having sex with her husband, and during her orgasm she felt a ‘pop’ in her chest with radiation to her back“, point out the authors.
His sexual position (his legs were pressed against his heart) would have favored the appearance of this chest problem.
“Sexual intercourse can be the occasion of vascular problems linked to hypertensive flare-ups“, confirms Dr. Kierzek.
At the hospital, the doctors confirmed the atypical presence of a ” Aortic intramural hematoma of the distal aortic arch and descending thoracic aorta in this patient. It would be a spontaneous bleeding emitted by the small vessels present in the wall of the aorta.
Another worrying observation: the blood pressure of the young hospitalized woman proved to be abnormally high (220/140 mmHg). To reduce it, doctors prescribed emergency treatment: intravenous antihypertensives, then oral agents.
“Aortic intramural hematoma in a 45-year-old woman during sexual intercourse is not a commonly reported event. Understanding the physiological changes and stress of intercourse and their effects on hemodynamics may help predict adverse effects in patients with pre-existing cardiovascular risk factors“, conclude the scientists.
Intramural aortic hematoma: what causes?
The main risk factor is high blood pressure. “This disease is present in 84% of patients”, specifies The Swiss medical journal.
“The main prevention mechanism is to check your blood pressure or treat it.”reminds Dr. Kierzek in this regard, before adding “That in the event of a report, any violent headache or chest pain should lead to urgent consultation“.
Finally, other risk factors can also be the cause of an aortic intramural hematoma: connective tissue diseases (Marfan syndrome), Turner syndrome, congenital anomalies of the aortic valve, coarctation of the aorta, aneurysm aortic, aortitis, pregnancy and excessive cocaine.
In all cases, the risk of mortality remains high. This is why the aortic intramural hematoma, like the aortic dissection, must be operated on urgently.