Stress and sudden death: The case of the long QT syndrome

P. J. Schwartz, A. Zaza, E. Locati, A. J. Moss

Research output: Contribution to journalArticlepeer-review


The idiopathic long QT syndrome (LQTS) represents a unique clinical example of stress-related sudden cardiac death. LQTS is characterized by the association of several distinctive electrocardiographic features, among which prolongation of the QT interval is the best known, with life-threatening arrhythmias that usually occur under conditions of physical or psychological stress. Effective therapies exist and are represented by antiadrenergic interventions; β-adrenergic-blocking agents are the treatment of choice. When they fail, left cardiac sympathetic denervation has also proven to be very effective. The latter result suggests a role for α-adrenergic mechanisms in the arrhythmias of LQTS. The stressors more frequently associated with syncopal events in LQTS patients include fear, exercise fraught with emotions, swimming, and awakening because of a loud noise. Experimentally, life threatening arrhythmias have been induced during a highly emotional situation in conscious cats with normal hearts in which right stellate ganglia have been ablated, resulting in QT interval prolongation. This selective denervation creates a sympathetic imbalance of the type proposed by one of the pathogenetic hypotheses for LQTS.

Original languageEnglish
Issue number4 SUPPL.
Publication statusPublished - 1991


  • Long QT syndrome
  • Nervous system, sympathetic
  • Stress
  • Sudden death

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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