Psychological stress has been reported to be a risk factor for sudden cardiac death in individuals both with and without underlying structural heart disease. From a group of 80 patients presenting with life-threatening ventricular tachyarrhythmia, six were identified without underlying structural heart disease. Five of these six patients experienced marked psychological stress. Each of these five patients underwent arrhythmia evaluation, demonstrating recurrent rapid monomorphic ventricular tachycardia related to changes in tone of the sympathetic nervous system. Subsequently, solitary β-adrenergic blocker therapy was given to each patient. During therapy, four of the five patients had a marked reduction of both arrhythmia and symptoms during a follow-up ranging from 29 to 49 (mean, 38) months.
Brodsky MA, Sato DA, Iseri LT, Wolff LJ, Allen BJ. Ventricular Tachyarrhythmia Associated With Psychological StressThe Role of the Sympathetic Nervous System. JAMA. 1987;257(15):2064–2067. doi:10.1001/jama.1987.03390150080039