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Death Following Physical Stress

Zenonas Danilevicius, MD
JAMA. 1978;240(16):1754-1755. doi:10.1001/jama.1978.03290160072033.
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Strenuous physical activity, such as shoveling snow, long has been suspected to be a contributing factor in a number of sudden cardiac deaths.

Vuori et al1 now provide support for this suspicion. They examined the circumstances surrounding 2,606 sudden deaths, and by reviewing the case histories and autopsy reports, they tried to establish correlation of the fatal event with the type and intensity of physical activity.

The authors defined sudden death as one occurring through natural causes while the patient was not restricted to home, hospital, or institution and when, during the preceding 24 hours, he was able to function in his normal surroundings and activities.

According to Vuori et al, a full 73% of all sudden deaths examined were caused by acute or chronic ischemic heart disease. At least one third of all these cardiac sudden deaths were associated with physical or psychological stress. Sudden deaths in connection


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