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Volume 334:413-419 February 15, 1996 Number 7 Next

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ABSTRACT

Background The earthquake that struck the Los Angeles area at 4:31 a.m. on January 17, 1994, was one of the strongest earthquakes ever recorded in a major city in North America. Once the life-threatening situation was over, the Northridge earthquake, so called because its epicenter was near Northridge, California, just north of Los Angeles, provided investigators an unusual opportunity to examine the relation between emotional stress and sudden cardiac death.

Methods We reviewed the records of the Department of Coroner of Los Angeles County for the week before the earthquake, the day of the earthquake, the six days after the earthquake, and corresponding control periods in 1991, 1992, and 1993.

Results On the day of the earthquake, there was a sharp increase in the number of sudden deaths from cardiac causes that were related to atherosclerotic cardiovascular disease, from a daily average (±SD) of 4.6±2.1 in the preceding week to 24 on the day of the earthquake (z = 4.41, P<0.001). Sixteen victims of sudden death either died or had premonitory symptoms, usually chest pain, within the first hour after the initial tremor. Only three sudden deaths occurred during or immediately after unusual physical exertion. During the six days after the earthquake, the number of sudden deaths declined to below the base-line value, to an average of 2.7±1.2 per day.

Conclusions The Northridge earthquake was a significant trigger of sudden death due to cardiac causes, independently of physical exertion. This finding, along with the unusually low incidence of such deaths in the week after the earthquake, suggests that emotional stress may precipitate cardiac events in people who are predisposed to such events.

Source Information

From the Heart Institute, Good Samaritan Hospital, University of Southern California, Los Angeles (J.L., R.A.K.), and Research Triangle Institute, Research Triangle Park, N.C. (W.K.P.).

Address reprint requests to Dr. Kloner at the Heart Institute, Good Samaritan Hospital, 1225 Wilshire Blvd., Los Angeles, CA 90017.

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Sudden Cardiac Death Triggered by an Earthquake
Rosenman K. D., Kloner R. A., Leor J., Poole K.
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N Engl J Med 1996; 334:1673, Jun 20, 1996. Correspondence

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• Sotoodehnia, N., Zivin, A., Bardy, G. H, Siscovick, D. S (2001). Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research. Cardiovasc Res 50: 197-209 [Abstract] [Full Text]  
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• Kamiya, A., Iwase, S., Michikami, D., Fu, Q., Mano, T. (2000). Head-down bed rest alters sympathetic and cardiovascular responses to mental stress. Am. J. Physiol. Regul. Integr. Comp. Physiol. 279: R440-R447 [Abstract] [Full Text]  
• James, P.R, Taggart, P, McNally, S.T, Newman, S.P, Sporton, S.C, Hardman, S.M.C (2000). Acute psychological stress and the propensity to ventricular arrhythmias. Evidence for a linking mechanism. Eur Heart J 21: 1023-1028 [Abstract]  
• Krantz, D. S., Sheps, D. S., Carney, R. M., Natelson, B. H. (2000). Effects of Mental Stress in Patients With Coronary Artery Disease: Evidence and Clinical Implications. JAMA 283: 1800-1802 [Full Text]  
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• Levenstein, S. (2000). The Very Model of a Modern Etiology: A Biopsychosocial View of Peptic Ulcer. Psychosom. Med. 62: 176-185 [Abstract] [Full Text]  
• Lampert, R., Jain, D., Burg, M. M., Batsford, W. P., McPherson, C. A. (2000). Destabilizing Effects of Mental Stress on Ventricular Arrhythmias in Patients With Implantable Cardioverter-Defibrillators. Circulation 101: 158-164 [Abstract] [Full Text]  
• Greene, M., Newman, D., Geist, M., Paquette, M., Heng, D., Dorian, P. (2000). Is electrical storm in ICD patients the sign of a dying heart?: Outcome of patients with clusters of ventricular tachyarrhythmias. Europace 2: 263-269 [Abstract]  
• Christenfeld, N., Glynn, L. M., Phillips, D. P., Shrira, I. (1999). Exposure to New York City as a Risk Factor for Heart Attack Mortality. Psychosom. Med. 61: 740-743 [Abstract] [Full Text]  
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• Stone, P. H., Krantz, D. S., McMahon, R. P., Goldberg, A. D., Becker, L. C., Chaitman, B. R., Taylor, H. A., Cohen, J. D., Freedland, K. E., Bertolet, B. D., Coughlan, C., Pepine, C. J., Kaufmann, P. G., Sheps, D. S., for the PIMI Study Group, (1999). Relationship among mental stress-induced ischemia and ischemia during daily life and during exercise: the Psychophysiologic Investigations of Myocardial Ischemia (PIMI) Study. J Am Coll Cardiol 33: 1476-1484 [Abstract] [Full Text]  
• Rozanski, A., Blumenthal, J. A., Kaplan, J. (1999). Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy. Circulation 99: 2192-2217 [Abstract] [Full Text]  
• Willich, S. N (1999). Circadian variation and triggering of cardiovascular events. Vasc Med 4: 41-49 [Abstract]  
• Zipes, D. P., Wellens, H. J. J. (1998). Sudden Cardiac Death. Circulation 98: 2334-2351 [Full Text]  
• Andrews, T. C., Parker, J. D., Jacobs, S., Friedman, R., Cummings, N., MacCallum, G., Mannting, F., Tofler, G. H., Carlson, W., Muller, J. E., Stone, P. H. (1998). Effects of therapy with nifedipine GITS or atenolol on mental stress-induced ischemic left ventricular dysfunction. J Am Coll Cardiol 32: 1680-1686 [Abstract] [Full Text]  
• Pang, X., Alexacos, N., Letourneau, R., Seretakis, D., Gao, W., Boucher, W., Cochrane, D. E., Theoharides, T. C. (1998). A Neurotensin Receptor Antagonist Inhibits Acute Immobilization Stress-Induced Cardiac Mast Cell Degranulation, a Corticotropin-Releasing Hormone-Dependent Process. J. Pharmacol. Exp. Ther. 287: 307-314 [Abstract] [Full Text]  
• Shah, P. K (1998). Role of inflammation and metalloproteinases in plaque disruption and thrombosis. Vasc Med 3: 199-206 [Abstract]  
• Mustonen, P., Lepantalo, M., Lassila, R. (1998). Physical Exertion Induces Thrombin Formation and Fibrin Degradation in Patients With Peripheral Atherosclerosis. Arterioscler. Thromb. Vasc. Bio. 18: 244-249 [Abstract] [Full Text]  
• Glassman, A. H., Shapiro, P. A. (1998). Depression and the Course of Coronary Artery Disease. Am. J. Psychiatry 155: 4-11 [Abstract] [Full Text]  
• Muller, J. E., Kaufmann, P. G., Luepker, R. V., Weisfeldt, M. L., Deedwania, P. C., Willerson, J. T. (1997). Mechanisms Precipitating Acute Cardiac Events : Review and Recommendations of an NHLBI Workshop. Circulation 96: 3233-3239 [Full Text]  
• Middlekauff, H. R., Nguyen, A. H., Negrao, C. E., Nitzsche, E. U., Hoh, C. K., Natterson, B. A., Hamilton, M. A., Fonarow, G. C., Hage, A., Moriguchi, J. D. (1997). Impact of Acute Mental Stress on Sympathetic Nerve Activity and Regional Blood Flow in Advanced Heart Failure : Implications for `Triggering' Adverse Cardiac Events. Circulation 96: 1835-1842 [Abstract] [Full Text]  
• Rosenman, K. D., Kloner, R. A., Leor, J., Poole, K. (1996). Sudden Cardiac Death Triggered by an Earthquake. NEJM 334: 1673-1673 [Full Text]  
• Muller, J. E., Verrier, R. L. (1996). Triggering of Sudden Death -- Lessons from an Earthquake. NEJM 334: 460-461 [Full Text]  
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