Are there any documented cases from say…heart failure or attack from extreme fear? I’ve always heard the old saying that most people don’t die from a high fall, but from the heart attack they have when falling. How true is this?
Apropos of this, last weekend’s New York Times Magazine section had an article about a cardiac disorder that, for want of a better term, is called broken heart syndrom, in which a person can actually die from a breakdown in cardiac function that is traceable to deep emotional tauma, often the result of the death of a loved one. The highlighted case told of a woman whose partner was killed in an auto accident and who shortly afterward experienced symptoms consistent with a heart attack, but whose lab tests showed no correlating data. She was hospitalized with a barely functioning heart, low oxygen levels and had all the appearances of someone who had had a heart attack. The doctor treated her as if she had, and was convinced that without some of those extraordinary measures, the woman would have expired. In fact, many people have died from this and there appears to be no other explanation. The body seems to undergo this peculiar response and without serious attention, the heart responds as if it has had a mycardial infarction, but there is no blockage - and person will die. Broken heart syndrome.
Thank you, kind sir. I shall use that search feature more often.
A case similar to the above happened here and was reported in the local newspaper recently. A couple had been married for many years - traveling during his military service, etc., and he passed away ( I believe from cancer). As his wife sat in the hospital chapel with their son, she said “I can’t go on without him.” And died. They were buried together.
Every time there’s an earthquake on the West Coast, the death toll includes a number of people who died of a heart attack immediately following the quake. However, they might have been close to death anyway:
I can’t document death from extreme fear, but I can answer the old saying.
People do not die from the heart attack during a high fall. People die from being smashed up when they hit the ground.
I can tell the difference between a person who was dead when he hit the ground and one who wasn’t. Colleague of mine had a case of a guy who had a heart attack while working on a scaffolding 3 stories up. Looked funny, keeled over backwards, hit the ground. The fractures and so forth had next to no bleeding in them (you need a good blood pressure to bleed into your injuries) and the abrasions were all perimortem or postmortem (red-orange to yellow instead of red). And the heart had a coronary thrombosis.
Family sued for work-related benefits, saying my friend’s autopsy was wrong and he died from the fall. Damn case went to court for seven years (civil cases do drag on) and was upheld. Law in New York was changed.
Honestly, if people died from heart attacks because of the fear of falling, how would we explain survivors? We’ve had survivors from 90-foot falls. They were scared. How would we explain parachutists who never die from fear?
Hey, I’ve got one for you that puts the stake through the old saying’s heart. Very experienced parachutist, a trainer of other parachutists, seven thousand drops and all that, jumped out of a small plane with a moment of inattention, and hit his head on the tail of the plane. Knocked himself out. (I found the bruise. He had a normal blood pressure when he bonked his forehead, you could see the normal bruising.) He fell the 3000 feet into someone’s back yard. Chute didn’t open because he, as a master at the craft, opened his own chutes, had no “dead man’s” rigging. He died of being absolutely incredibly squushed from hitting the ground. He was never awake to be afraid and could not have had a heart attack.
You know, if you think about it, Diggleblop, people probably made up that old saying because the thought of falling to one’s death scared them, and the idea that you’d die of something that isn’t violent before you hit was comforting.
False comfort.
gabriela, that makes a lot of sense about people making that saying up for comfort. Thank you for the insightful and informative post, I never knew the trick about people’s blood pressure causing different types of markings on their body. The body is truly incredible.
I have actually seen the terrible tape of a free base jumper’s shoot that didn’t open, he had a cam on his helmet and recorded the whole thing. I remember him laying there moaning after he hit the ground and was like “Hey, THAT GUY idn’t die form fear, what gives.”
So as I suspected, I’m sure there have been cases of death from fear, but not exactly that many from falling great heights.
Forensic science is pretty amazing in itself, as gabriela reminds us. As to dying of fear during a fall, there is a fairly well documented case of a tail gunner who fell about ten thousand feet, from his burning bomber w/o a chute, in WWII and survived. As I recall it, his fall was slowed by tall pines, deep snow, and a prompt rescue.
AFAIK, it’s never been determined whether singer Harry Chapin had his heart attack before or after the fatal crash with a truck that caused his car to burst into flames.
He might have been “scared to death” when he realized he was about to be creamed by a truck, or it might have happened after the crash.
Gabriella’s point notwithstanding, we don’t know if some people who have fallen to their deaths have died on the way down from heart attacks. Clearly, very few of those folks have been autopsied. The fact that in some cases the deaths were not due to the fall does not mean than no deaths were due to heart attacks. It’s just not possible to know. Not unless you examined every person who died of extreme trauma, and even in some of those cases, when a person has some indication or warning ahead of time, they might have died a few seconds before the crash / fall / whatever. No one could ever tell. It has to remain an imponderable. Having written, the fickle fingers of fate move on. xo, C.
Just curious if anyone has a cite for this story. I never heard of this before.
It’s fairly common for one person in a married couple to die soon after (100-150 days) the other. I can point to 2 relatives and several neighbors who did this. (Mostly seems to be men though; widows seem more likely to live for years.)
I’m sure there are statistics on this, but I don’t know where to find them.
Sorry, long.
Hey, CC.
As I’ve said in another thread before, I like the essentially scientific bent of your mind. You also have a useful fund of cynicism.
I can however offer a few facts to help you think about it. First, you’d be wrong to say very few of these folks have been autopsied. Every death that occurs by violence in the US is under the jurisdiction of the coroner or medical examiner. Jurisdictions vary as to whether office policy says to perform a full autopsy on every victim of a high fall. In New York City, where I trained, that is indeed the policy. More suicide victims in Manhattan die from high falls than from shotgun wounds or hangings or pills. In my training there I autopsied lots of’em.
Of course the fact that they fell doesn’t mean no deaths were due to heart attacks. I agree with you. However, it seems (correct me if I’m reading too much into what you imply) that you think that we can’t find a heart attack at autopsy. That there would be no difference between the body of a person who died of a heart attack on the way down, and a person who didn’t.
In some situations you might be right, and your point stands that we can’t show that nobody has ever died of a heart… problem, before smashing into the ground. The reason I changed it to heart… problem, is I’m well aware that to laypeople, “heart attack” means “anything at all wrong with the heart”. To me, a “heart attack” means “a coronary artery has developed a blood clot on a narrowed spot”, which in my world is referred to as “a thrombosis on a stenosis”, or maybe “a thrombosis on a ruptured atherosclerotic plaque”. If you die of what I call a “heart attack”, yes, I do find it at autopsy. They’re wonderful. Love’em as a gross cause of death.
There is however a large category of deaths from a heart problem that leave no trace for me to find at autopsy. This category is the fatal cardiac arrhythmias. If a person has a fatal arrhythmia in the air, they will be dead when they hit, and I will not find a thrombosis on a stenosis.
However. Very few people ever die of a cardiac arrhythmia without some predisposing cause. By far the commonest is heart hypertrophy due to hypertension, and I can weigh the heart and see just how hypertrophied it is. I can also look at sections of the left ventricle underneath the microscope, to see if individual heart cells are hypertrophied or not. I can also take a scalpel and whack out the AV node and look at it under the microscope. (Tiny boast to the members of my profession: I’m a whiz at locating and sectioning the AV node. The SA node, not so good. But then the SA node does not give rise to fatal arrhythmias.)
One problem with this solution. Cardiac arrhythmias do not kill instantly, like a bullet to the head. Cardiac arrhythmias take some time to kill you. Minutes usually. Could be seconds, but usually minutes. So a person in the throes of V fib, falling from a 40 story Manhattan building, would likely not be dead when they hit. Still alive.
And another problem. Landing wham in contact with the earth does not necessarily kill you instantly. Depends on how far you fall. That parachutist, yes (or, rather, he probably had 10 to 20 seconds between impact and complete cessation of brain and heart activity). But the LD-50 for falling is four stories; LD-95, 6 stories. Many of those people lie groaning on the ground for some time, and many of them make it to hospital. Neither cardiac arrhythmias nor heart attacks are seen with anything other than vanishing frequency.
And another problem. We can tell the difference between injuries sustained after you die, and injuries sustained before you die. Give you one example: when we, er, ah, um, when some people in some other morgues, during transfer of a body accidentally drop it off a gurney… and if it’s a large guy, and a rib or six should happen to break… When I do the autopsy, that rib fracture is bloodless. I can only find it by wiggling the cut end of the rib after I take out the sternum. Pink muscle surrounds it; there may be a tiny drop of blood or so at the fracture site if I take the scalpel and cut down, but that’s all. Whereas rib fractures that occur during CPR have small purple spills of blood into the pink muscle. Small, but present. And rib fractures that occur during life have great huge dissecting purple bruises into the pink muscle. It’s really easy to tell antemortem from perimortem from postmortem fractures. I suppose that’s why we have the three words.
Another example: road rash, or rolling contact abrasions. (Most people who fall from high places do not land in one spot. They bounce, scrape, and slide, and maybe bounce again.) Road rash in live people is bright red with blood. Road rash in dying people is faintly red, somewhat orange, because it is red crossed with yellow. Road rash in dead people scrapes off the skin to reveal the subcutaneous fat, which is yellow. Road rash in dead people is yellow because it does not bleed. It does not bleed because the person’s blood pressure is 0/0. Most people who have a heart attack have a blood pressure. It may be high at the start, which makes injuries bleed harder. It may be lower during a ventricular arrhythmia. But it ain’t nothing.
That parachutist died so fast that it would be hard to tell his antemortem from postmortem fractures (could still tell his abrasions apart). So he’s about the only one left who might have died of a cardiac arrhythmia (not a heart attack) before hitting the ground.
The rest, honestly, we really can tell.
Small editorial, away from facts: It makes about as much sense to me to think that people die of a heart attack before they hit the ground as to think that they die of a heart attack when an assailant is facing them with the gun, just before they get shot. It makes much more sense to think that the healthy living body does not interrupt its homeostasis until the homeostasis is forcibly interrupted for it by the ground. After all, the body doesn’t know, on its way down, if this fall might be one of the ones that a person survives.
I remember a comedian who said that this might be because the first one to die knew where the medicine was kept.
THANKS! Very interesting.