Scared to Death: Emotional Stress Causing Fatal Myocardial Infarction With Nonobstructed Coronary Arteries in Women

Alberto Aimo; Marco Di Paolo; Vincenzo Castiglione; Martina Modena; Andrea Barison; Matteo Benvenuti; Valentina Bugelli; Carlo Pietro Campobasso; Benedetta Guidi; Paolo G Camici; Michele Emdin

doi:10.1016/j.jaccas.2020.08.010

Scared to Death: Emotional Stress Causing Fatal Myocardial Infarction With Nonobstructed Coronary Arteries in Women

JACC Case Rep. 2020 Oct 28;2(15):2400-2403. doi: 10.1016/j.jaccas.2020.08.010. eCollection 2020 Dec.

Authors

Alberto Aimo^{1

2}, Marco Di Paolo³, Vincenzo Castiglione^{1

2}, Martina Modena¹, Andrea Barison^{1

4}, Matteo Benvenuti³, Valentina Bugelli³, Carlo Pietro Campobasso³, Benedetta Guidi³, Paolo G Camici⁵, Michele Emdin^{1

5}

Affiliations

¹ Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy.
² Cardiology Division, University Hospital of Pisa, Pisa, Italy.
³ Department of Forensic Medicine, University of Pisa, Pisa, Italy.
⁴ Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
⁵ Cardiology Division, Vita Salute University and San Raffaele Hospital, Milan, Italy.

Abstract

Myocardial infarction with nonobstructed coronary arteries (MINOCA) can be triggered by intense emotions. We report 5 cases of emotional stress-related death where forensic examination attributed myocardial infarction to a coronary spasm, with the ultimate cause of death being arrhythmias in 4 cases and cardiac rupture in the fifth. (Level of Difficulty: Beginner.).

Keywords: LV, left ventricular; MI, myocardial infarction; MINOCA; MINOCA, myocardial infarction with nonobstructed coronary arteries; emotional stress; forensic examination; hs-TnT, high-sensitivity troponin T; myocardial infarction.

Publication types

Case Reports