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Michelle Spear, Professor of Anatomy, University of Bristol

Heart attacks, fainting and falls: the perils of pooping

Ivan Moreno sl/Shutterstock.com

The humble toilet seems like the least likely setting for drama. Yet throughout history, it has claimed kings, toppled celebrities and served as the scene of untimely deaths ranging from the tragic to the downright bizarre. What is it about the smallest room that makes it, occasionally, the most dangerous?

At the heart of this peril lies the Valsalva manoeuvre – the act of forcibly exhaling against a closed airway while straining, such as during defecation. This puts pressure on your chest, which reduces blood flow back to the heart. For most people, it’s harmless. But for those with heart problems, this strain can lead to “defecation syncope” (fainting), irregular heart rhythms and even sudden death.

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