Successive cardiac death of brothers in association with stress

A 38-year-old man (Case 1) suddenly collapsed while resting. His 54-year-old brother (Case 2) came soon thereafter began to perform cardiac massage and mouth-to-mouth resuscitation. However, the elder brother suddenly died after resuscitating his younger brother for about 30 minutes. Necropsy revealed an occlusive thrombus of the left anterior descending coronary artery and coagulation necrosis of the myocardium in Case 1. Case 2 was diagnosed as sudden cardiac death on the basis of the moderate coronary sclerosis and myocardial lesions including contraction band, fragmentation, waviness, bleeding, and mild subendocardial fibrosis. Pulmonary edema in the both cases revealed the presence of left ventricular heart failure. Case 2 is a good example of the contribution of psychological and physical stress to sudden cardiac death.