stress-induced myocardial ischemia

Posted By Robert on September 28, 1998 at 17:43:54:








My father, a 74-year old man who had suffered for several years with angina,
died of a heart attack suddenly and without a sound while driving on the high
way with my mother. An autopsy was performed, showing vessel blockages
of 75% and 25%. When I asked my father's physician why he had taken the
  attack at that moment, when he was under no physical stress at all, I was
informed that the actual event could have happened several hours earlier,
and that it's ultimate effect took place on the highway. This was the first I had
ever heard of "silent heart attacks". I recalled that several hours prior to his
death, I saw my mother crying. She explained that my father had taken a
telephone call which was very stressful to him, and (in my mother's own
words) : "he just turned gray right in front of me". She left so that he would
not see how worried she was. My first question is: What was actually
ocurring physiologically to my father when he "turned gray"? And secondly:
What is the likelihood that this event contributed to my father's death, or
perhaps even caused it? A clinician with considerable experience in this
type of situation told me that the grayness was the result of a reduction in
ejection fraction and that, while an absolute answer cannot be given, in light
of the facts my father most likely died due to a stress-induced myocardial
infarction. Is he correct?