Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=128137
Story Retrieval Date: 10/25/2014 3:38:13 PM CST

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Fear of death: Can it kill you?

by Melissa Suran
May 06, 2009


SCAREDTODEATH

Boo! Did I scare you? Probably not, but if I had, what’s the chance that I would literally be able to scare you to death?

In January, officials charged Larry Whitfield with homicide – for scaring 79-year-old Mary Parnell to death. Police said Parnell died of a heart attack induced by terror after Whitfield broke into her North Carolina home.

So, can you really be scared to death? Well, it depends who you ask. Abraham Kocheril, a cardiac electrophysiologist at the University of Illinois at Chicago, said it is possible, but highly unlikely.

“It’s usually not the heart giving out, but the mind,” he said.

That is, unless your heart is already sick.

“People who have weakened hearts from heart attacks or cardiomyopathy (heart disease), those are the folks that are at risk for dying suddenly,” he said.

According to Kocheril, stress and fear can trigger epinephrine, more commonly known as the hormone adrenaline, levels to escalate, increasing the fight or flight response. This causes the heart rate and blood pressure to increase dramatically.

“The sicker the heart is, the more likely you are to have extra beats leading to serious rhythm disturbances,” Kocheril said.

Irregular heartbeats can be trouble. If you have a damaged heart, it may receive electrical impulses unevenly resulting in a lack of oxygen to the muscle. This condition is ischemia and it can lead to death.

“If your heart beats too rapidly for too long, your heart muscle can deteriorate,” Kocheril said. “As long as the heart has time to recover, it will be fine.”

In fact, Kocheril said, a little fear translating into stress occasionally is good for you – and your heart. Stimulation of the sympathetic nervous system, which is responsible for the fight-or-flight response, leads to increased heart rate. It’s basically exercise for the heart. Too much fear, however, is bad for you.

But we still like a little fear in our lives. That’s why even though many claim to dread haunted houses and roller coasters, both industries are still in business.

“Shriek and shock is getting sympathetic stimulation very quickly,” Kocheril said. “It’s not just the mental need for an adrenaline rush, it’s also good for your heart.”

But according to one neurologist, just because dying of fear is not very common doesn’t mean it can’t happen.

Ricardo Kohn of West Suburban Hospital Medical Center in Oak Park warned being scared to death could happen to anyone at anytime.

“You don’t need to be under stress for a long period of time to be in trouble,” he said.

Kohn believes that stress and fear induce the same reactions in the body, and the human body does not fare well under extreme conditions of any kind.

“We’re talking about extremely stressful situations, not the daily stress of life,” Kohn said. “And fear produces stress.”

Kocheril insists the heart is built for major wear and tear. While we are prone to injuries like nicks and bruises, our heart can take a beating (no pun intended). The heart sits in a cushioned sack of fluid, so the body can suffer a lot of trauma without affecting the heart.

“It’s unusual for most types of trauma to damage the heart,” Kocheril said. “It’s not like your leg bones that if you fall, you’ll take a beating.”

Kohn believes otherwise.

“There are many instances where people who appear perfectly healthy experience a traumatic incident and die,” he said.

To explain this, Kohn revisited an incident that occurred in 1874. Conjoined twins Chang and Eng Bunker were born in Thailand in 1811. During that time, Thailand was known as Siam, hence the term “Siamese twins.”

Both men produced healthy children and lived long, healthy lives until Jan. 17, 1874, when Chang died of pneumonia. Eng was physically healthy and refused an emergency separation and died of what physicians believed to be shock – and fear.

Kohn said everything in the body is interconnected and that your mental state affects your physical state. Each moving part, such as your arms and legs as well as your vision and speech, is represented in the brain.

“There is also representation in the brain of the heart in the insular area,” Kohn said. “So that means that if there is a physical stress to the brain…there can be cardiac manifestations too.”

Although he believes it’s unlikely that someone would die from fear, Kocheril said it is quite possible that someone would pass out.

There’s a certain reflex when the pressure goes up in the heart called the Bezold-Jarisch reflex. A pressure receptor in the left ventricle of the heart sends messages to the brain, which sends messages back. This causes the heart rate and blood pressure to drop, resulting in the person dropping as well.

This reflex is commonly seen during an episode called “the voodoo death.” In 1942, Harvard Medical School professor Walter Bradford Cannon published “’Voodoo’ Death” in American Anthropologist. The paper tries to find links to modern incidents of sudden death. It describes the phenomenon that occurs when someone, such as a medicine man, who claims to have the power to cause a paranormal death, actually causes someone to die. But the death is caused not by the medicine man’s power but by his victim’s fear – fear that the victim has no control over his or her own fate.

“A tribal elder, believed by the tribe to have magical powers, can point a stick at someone who did something bad and say ‘you’re going to die’ and the person passes out,” Kocheril said. “They don’t die all the time, but they certainly drop.”

Kohn added that Cannon studied events independent of each other and found the same thing happened every time. People would be so frightened that they died on the spot.

“It’s pretty unlikely (to be scared to death),” Kocheril said. “I’ve been practicing for 16 years and I’ve never seen people die from a fearful event.”

But yes, it can still happen.

“Although you might want to try the voodoo death on your annoying little brother,” Kocheril said.