Dear Editors,

I read with great interest the article by Y-Hassan and Tornvall [1] about the epidemiology, pathogenesis, and management of takotsubo syndrome (TS). This syndrome is also known as stress cardiomyopathy because it is often preceded by emotional or physical stress. According to the authors of the article, the syndrome is usually reversible; nevertheless, during the acute stage, a substantial number of patients develop severe complications such as arrhythmias, heart failure including pulmonary edema and cardiogenic shock, thromboembolism, cardiac arrest, and rupture [1]. In my opinion, a possible early description of TS is found in the New Testament, in relation to the acute emotional stress associated with the deaths of Ananias and his wife Sapphira (see Acts 5:1–10), who were members of the early Christian congregation of Jerusalem. Following Pentecost of 33 A.D., a common fund was set up for the physical needs of the believers who remained in Jerusalem. It was sustained by contributions from members of the congregation who sold fields and houses and then voluntarily donated the proceeds (see Acts 4:34–37). Ananias sold a field and, with his wife’s full knowledge, presented some of the proceeds while giving the impression of contributing the entire sum, no doubt to gain some commendation and esteem within the congregation. Peter pointed out that Ananias was in control of the money and could give or keep it as he saw fit, but had withheld a portion of it. Peter stated that Ananias had lied not to men, but to God. On hearing Peter’s words, Ananias fell down and died. Three hours after Ananias’ death, his wife arrived, unaware of what had happened. Peter asked her the price of the land that she and Ananias had sold, and she stated the same untruthful price that Ananias had given. Peter said to her, “How could you conspire to test the Spirit of the Lord? Listen! The feet of the men who buried your husband are at the door, and they will carry you out also.” At that moment Sapphira fell down at his feet and died. The sudden deaths of Ananias and Sapphira while the apostle Peter reproached them for their lie were probably due to sudden cardiac arrest under the acute emotional stress that they had experienced when revealing the truth, due to intense sorrow and shamefulness.  Based on the above, it cannot be ruled out that the deaths of both Ananias and Sapphira were due to TS.