Earthquakes: another cause of heart failure?

This editorial refers to ‘The Great East Japan Earthquake disaster and cardiovascular diseases’, by T. Aoki et al. , doi:10.1093/eurheartj/ehs288 The role of acute stress in triggering cardiac events, especially in vulnerable individuals, is no longer disputed.1 The consequences of an acute and unexpected stressor have been examined during earthquakes, providing a population-based sampling methodology, the known exact timing of the stressor, and tabulation of acute cardiac events before and after the event.The first study by Leor et al .2 was conducted in the wake of the Northridge earthquake which occurred at 04:31 h on 17 January 1994, one of the strongest earthquakes ever recorded. The authors reviewed the daily mortality and determined the underlying causes of death for the 7-day period before the earthquake, the day of the quake, and 6 days thereafter. Data were compared with the corresponding period in 1991, 1992, and 1993.On the day of the earthquake, there was a sharp increase in sudden cardiac deaths immediately after the earthquake compared with the week before and after the earthquake, and with the corresponding control periods. Deaths typically occurred among people with advanced coronary atherosclerosis. Leor et al. conclude that this finding, along with the unusually low incidence of such deaths in the week after the earthquake, suggests that emotional stress may trigger cardiac emergencies in people who are predisposed to such events.2Suzuki and colleagues analysed the occurrence of acute myocardial infarction (AMI) during the Hanshin-Awaji earthquake in the Kobe region on 17 January 1995. The authors investigated the weekly frequency of MI and defined a 7-week period: 2 weeks before the earthquake, the week in which the earthquake took place, and 4 weeks after the quake. Data were compared with the corresponding period in 1992–1994. An increase in the number of …