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    Death by Angry Outburst

    Extreme Physical Activity Can Also Trigger Fatal Attacks


    The patients noted the level of each emotion -- whether it was anger, anxiety, worry, sadness, happiness, challenge, feeling in control, or interest -- on a scale of 1 to 5.

    In 15% of the cases, anger (level 3 or higher) was the person's emotion, occurring most often while they were driving, arguing, gambling, or receiving bad news.

    "In healthy people, the heart can withstand a lot of abuse," Jain says. "But when the heart is fragile, anger stands out as the primary cause of sudden death."

    Also, in 53% of cases, the person had been involved in extreme physical activity. Though a sudden burst of physical activity may put a fragile heart at risk, "we're not saying people should refrain from exercise," he says. "They should engage in low levels of exercise under supervision, like in a cardiac rehabilitation center, where somebody can watch them. But they should not engage in high-level physical activity."

    To deal with the anger, "medications are not the answer," he says. Instead, people need to change their response to things they cannot control. "Be aware this is what certain emotional things can do to heart -- that when you get angry, you're exposing yourself to risk."

    With the help of a therapist, people can learn to contain anger or redirect their angry emotions, he says.

    "There's no easy solution because it's almost impossible to avoid stressful situations and anger in all circumstances," says Jeremy Ruskin, MD, director of the cardiac arrhythmia service at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School.

    "It is important to think about ways to blunt those responses," he tells WebMD. "That can be done with drugs like beta blockers, with relaxation techniques such as meditation. It can also be done through insight -- becoming aware that these emotions can be dangerous and short-circuiting the reaction. That would be useful for all people, but for the cardiac patient it could be lifesaving."

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