Medical professionals in the emergency department of Merit Helt Wesley Hospital in the United States reported the first documented instance of an aortic dissection triggered during orgasm in a 45-year-old woman. The finding was described in a health report within the American Journal of Case Reports.
The patient, a Mississippi resident whose identity remains confidential, arrived at the hospital with severe, stabbing chest pain rated 10 out of 10, accompanied by nausea and shortness of breath. The episodes began during sexual activity with her spouse, while she was lying on her back with her legs drawn toward her chest. She described an intense sensation described as an “explosion” emanating from the chest and radiating posteriorly at the moment of orgasm.
Upon evaluation, clinicians recorded a markedly elevated blood pressure, measuring 220/140 mmHg. A chest CT angiography was performed promptly, revealing an intramural hematoma within the aorta, a variant classified under acute aortic syndromes and consistent with a dissection process. In the emergency department, immediate management included intravenous antihypertensive therapy, which was subsequently transitioned to oral medications as the patient stabilized. Analgesia was provided with intravenous opioids to control pain, and surgical intervention was not required. After a three-day hospital stay, the patient was discharged in stable condition.
The patient had a history of arterial hypertension. Previously, she had used oral antihypertensive medications but had discontinued them more than a year before this admission. She also had a prolonged smoking history, with exposure totaling over 17 years and a current habit of smoking approximately six to seven cigarettes daily at the time of presentation.
Acute aortic syndromes encompass a spectrum of life-threatening conditions affecting the aorta. Without timely treatment, mortality rates remain high, with rapid progression and death observed in a substantial proportion of cases. While sex-related differences in cardiovascular risk factors are well recognized, this report notes that men historically exhibit a higher incidence of certain vascular conditions later in life. Notably, prior cases describing intramural hematoma of the aorta occurring during sexual activity had not been reported before this instance.