Sudden Death Precipitated by Psychological Stress

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Abstract
A 70‐year‐old man, taking part in a post infarction study, died suddenly out of hospital while Holter‐monitored. Death was preceded by immediate major psychological stress but there were no cardiac symptoms. ECG showed a 15 min period of sinus tachycardia with increased ventricular ectopic activity prior to the initiation of ventricular fibrillation. There were no signs of recent myocardial damage at autopsy. It is proposed that an increased catecholamine stimulation due to psychologic stress, in combination with myocardial ischemia, may have precipitated the fatal arrhythmia.