We often look forward to scary movies, and we’ll talk about being “scared to death.” The truly scary thing is that fear with consequences so extreme may be rare, but it can happen.
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Intense emotion can trigger a heart attack in susceptible individuals. But even people without an underlying heart problem can literally be scared (almost) to death. It is a condition called stress cardiomyopathy, and it is caused by the fight-or-flight response.
The adrenalin surge
When the body is responding to a sudden frightening, dangerous or stressful situation, it pumps out a lot of extra adrenalin – or catecholamines. This surge in hormones causes immediate physiological changes that prepare the body for physical activity—the fight-or-flight response—meaning we are either going to run fast to get away or we are going to fight hard to defend ourselves.
Some typical effects are increases in heart rate, blood pressure, blood glucose levels and a general reaction of the sympathetic nervous system that tells us whether to run or fight.
This affects the heart’s electrical system. This can cause arrhythmias, constriction of blood vessels (even when there aren’t blockages) or spasms that can cause the heart function to decline. In this instance, the heart muscle might stop squeezing and not pump blood as efficiently as it needs to.
Fortunately, in most cases, this condition is reversible, and the heart function returns to normal over time. In rare instances, it can cause sudden death.
What doctors say
“Whether you have heart disease or not, the likelihood of sudden death from a scare is incredibly rare. And it is difficult to predict who will be more likely to have such an event,” says Cleveland Clinic cardiac surgeon A. Marc Gillinov, MD.
Fear-related stress cardiomyopathy was first recorded in 1990 by Japanese physicians. While it has remained elusive through the years, cases of stress cardiomyopathy have become more commonly diagnosed since an article about them appeared in the New England Journal of Medicine in 2005.