Case ReportsThree Cases of Karoshi Without the Typical Pathomorphological Features of Cardiovascular/Cerebrovascular DiseaseMiao, Qi MM∗; Li, Jing BA∗; Pan, Yu-Peng BA∗; Yu, Yan-Geng MD†; Zhang, Fu MD†; Xiao, Ning MD‡; Li, Dong-Ri MD∗Author Information From the ∗School of Forensic Medicine, Southern Medical University †Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou, Guangdong ‡Yiling Hospital of Yichang, Yichang, Hubei, China. Manuscript received April 10, 2020; accepted June 18, 2020. Funding Resources: The National Natural Science Foundation of China (grant 81772021). National Students' Platform for Innovation and entrepreneurship training program (CN) (2018121212444). Forensic Pathology Key Laboratory Fund of the Ministry of Public Security of China (BAFYBL201701). The authors report no conflict of interest. Reprints: Dong-Ri Li, MD, School of Forensic Medicine, Southern Medical University, China. E-mail: [email protected]; Ning Xiao, MD, Yi Ling Hospital of Yichang, Hubei, China. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: December 2020 - Volume 41 - Issue 4 - p 305-308 doi: 10.1097/PAF.0000000000000600 Buy Metrics Abstract Karoshi is a term used to describe unexplained sudden death associated with overwork and has become a serious public health issue in China. Cases have occurred in physicians, university professors, engineers in high-tech companies, and blue-collar workers. The mechanisms associated with death by overwork are very complex. According to most researchers, karoshi is considered to be caused by an excessive workload that induces deterioration of underlying hypertension or atherosclerosis. These conditions inevitably lead to death from cardiovascular or cerebrovascular diseases. However, in our own experience, we have found that in some cases, the victims of karoshi were in a chronic state of overwork but without a history of cardiovascular or cerebrovascular diseases. In support of this, we have found that even autopsies have revealed few positive findings except for cardiac hypertrophy. In this article, we report 3 typical cases of karoshi but without the typical pathomorphological features of cardiovascular or cerebrovascular disease. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.