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Sudden death: is there a human stress syndrome?

To the Editor.— It is still an unanswered question whether some sudden deaths, which are otherwise unexplained, are a manifestation of a "human stress syndrome" 1 related to malignant hyperthermia. Three deaths, ruled to be cardiac, but lacking an anatomic cause, and three other deaths (two ruled as heat stroke and one ruled as rhabdomyolysis) reported by Phillips et al 2 may be related to malignant hyperthermia. It is unfortunate that the clinical descriptions of these deaths do not permit a retrospective judgment of the question whether malignant hyperthermia played a role. We believe that it would be worthwhile to investigate the unclear cases further. Such an investigation might include an examination of the families of the victims. Recently, Ranklev et al 3 were able to demonstrate susceptibility to malignant hyperthermia in a family in which two young boys had suddenly died with no apparent anatomic cause. Both heat stroke 4 and rhabdomyolysis