That's what I was thinking!

HighlightsHighlights

• Multicenter design, covering a population of 20 million inhabitants over 12 years.
• Low incidence affecting mainly middle-aged males during heterosexual intercourse.
• Cardiac origin, mainly due to ischemic heart disease that remained silent in life.
• Frequent association with use of cocaine and medications for erectile dysfunction.
• Relative high of frequency of obesity and performing unusual sexual practices.

https://www.sciencedirect.com/science/article/abs/pii/S0379073823003584