BMJ 1996;312:1423 (1 June)

Letters

Myocardial infarction at work cannot be regarded as an accident

EDITOR,--M C Petch argues that sudden cardiac death or myocardial infarction occurring within hours of unaccustomed physical effort may justify a claim for benefit payments or occupational injury.1 Although the mechanism of the final thrombosis may indeed be related to exercise,2 these patients have pre-existing arterial disease, and most previous claims have been for "acceleration of heart condition" after physical exertion.3 The long term benefits of exercise in reducing the progression of atherosclerosis and risk of myocardial infarction are well established.4

It is alarming that Petch considers that "a myocardial infarction occurring at work may be regarded as an accident." Despite a routine declaration at the start of work that employees have no known heart disease, underlying coronary artery disease may well be present and would still be undetectable by a simple test such as resting electrocardiography. Should all employers who engage staff for heavy lifting duties arrange for coronary . . . [Full text of this article]


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Triggering a heart attack
M C Petch
BMJ 1996 312: 459-460. [Extract] [Full Text]

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