Sudden Cardiac Death: The Impact of Overwork and Stress - Cardiology

Suspected death from overwork!?

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Dear Dr.
He,
I would like to ask you some questions regarding my older brother.
He worked as a "Process Development Engineer" at Largan Precision in Taichung, putting in long hours (averaging about 15 hours a day) with very few days off for over four years.
The pressure in the R&D department of the high-tech industry is immense.
His health check-ups at the company showed no issues.
He was 33 years old (born in 1988) and had a standard build of 175 cm and 68 kg.
He did not have any bad habits, yet unfortunately, he passed away peacefully in his sleep at home on April 1st of this year.
Due to suspicions of foul play, an autopsy was performed on April 7th.
The autopsy revealed no abnormalities in any organs, leading to the testing phase.
Initially, we were informed that the test results would take about a month, but it ended up taking over two months.
We only learned the report was ready after my father called to inquire.
We found this process very strange, and even during the court proceedings, we felt the prosecutor's behavior was odd.

The test results indicated: 1.
Psychogenic shock with heart failure, 2.
Myocyte hypertrophy, 3.
Myocardial disarray.
Could these results be attributed to his long hours of work and high-stress environment? Would myocyte hypertrophy and myocardial disarray not be observable during the autopsy? Is it possible that he did not feel any discomfort at the time of the incident? His appearance was very peaceful, as if he were just sleeping.
Would heart failure not cause him to struggle for breath? The night before, he had no signs of discomfort, and when discovered around 7 AM, there were already some purple spots.
My sister-in-law saw him just before 1 AM.
The timing of his passing seems coincidental.
On the day of the autopsy, company personnel were very concerned about the results, but once it entered the testing phase, the company completely stopped inquiring.
We immediately returned to Tainan to handle the funeral arrangements after the autopsy (the incident occurred in Taichung), which made us feel that the prosecutor's procedures were quite strange.
I personally suspect that the company may have connections that influenced the process.
We have consulted some friends in the judicial system, and they also found it odd, but they mentioned that each prosecutor has their own way of handling cases, so we felt powerless to say much.
Although my father is saddened, he reassures himself that such things shouldn't happen.
However, recent news about judicial officials accepting bribes has made us question whom we can trust in Taiwan.
If even judicial officials can act unethically, how can we trust a mere prosecutor? Large companies have well-established legal departments, while we are just ordinary, kind-hearted citizens.
What can we do?
Initially, we discussed with my sister-in-law and her family about pursuing legal action against such a large company, but we realized it would be very difficult.
We also lack the energy for a prolonged battle.
As the youngest in the family, I can only respect their decisions, but I feel very discontented that such an outstanding brother has left us, leaving behind a wife and a one-and-a-half-year-old son.

Recently, during a follow-up appointment at Chi Mei Medical Center in Tainan, I casually mentioned my brother's situation to my attending physician.
I asked if his death could be attributed to overwork, and he said it was very possible.
However, he also noted that he is not a cardiologist and suggested I gather more information.
I understand that without trying, there is no chance of seeking justice for my brother.
I just want to restore his value in life.
I hope you can use your expertise to help clarify some of my doubts and questions.
P.S.
My family has no history of heart disease.
Wishing you health and happiness.
C.C.
Chen

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C.C. Chen, 20~29 year old female. Ask Date: 2010/07/21