Awareness of the ability of sudden emotional stress to provoke arrhythmia has been present throughout recorded history. When Jacob is told that his long-lost son Joseph is alive, "his heart fainted for he believed them not" (Genesis 45, verse 26). Despite numerous studies, however, the relationship of psychosocial factors to cardiovascular disease, and in particular sudden cardiac death, has been difficult to quantify. This has been due to several reasons:
●It is difficult to objectively quantify emotional stress
●Research has until recently been more focused on the chronic factors leading to the development of coronary artery disease rather than on the precipitation of acute coronary syndromes once such disease is present
●The division between the social science and medical science investigators have impeded dialogue
●There are inherent difficulties in accurately assessing the triggers of sudden death.