Sudden cardiac death triggered by an earthquake
J Leor1, W K Poole, R A Kloner
1Heart Institute, Good Samaritan Hospital, University of Southern California, Los Angeles 90017, USA.
The New England Journal of Medicine
|February 15, 1996
Summary
The 1994 Northridge earthquake significantly increased sudden cardiac deaths, particularly from atherosclerotic cardiovascular disease. Emotional stress, not physical exertion, appears to be a key trigger for these cardiac events.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- The 1994 Northridge earthquake was a major seismic event in Los Angeles.
- Natural disasters offer unique opportunities to study stress-related health outcomes.
- Sudden cardiac death is a critical public health concern.
Purpose of the Study:
- To investigate the relationship between the Northridge earthquake and sudden cardiac death.
- To determine if emotional stress from the earthquake triggered cardiac events.
- To analyze the timing and causes of sudden cardiac deaths around the earthquake.
Main Methods:
- Reviewed Los Angeles County Coroner records for the week before, day of, and six days after the earthquake.
- Compared death data to control periods from 1991-1993.
- Analyzed causes of death, focusing on atherosclerotic cardiovascular disease.
Main Results:
- Sudden cardiac deaths increased from a baseline of 4.6 per day to 24 on the earthquake day (P < 0.001).
- Most victims experienced symptoms within an hour of the tremor; few deaths were linked to physical exertion.
- Deaths decreased to below baseline in the week following the earthquake.
Conclusions:
- The Northridge earthquake was a significant trigger for sudden cardiac death, independent of physical exertion.
- The findings suggest emotional stress may precipitate cardiac events in predisposed individuals.
- A subsequent decrease in deaths indicates a potential 'stress mobilization' effect.
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