Introduction Karoshi, is the result of extreme work related stress by an excess of work, presenting acute cardiovascular episodes such as the cerebrovascular disease.

Methods A case report.

Results Male 46 years old, no important family history. Smoking and alcoholism denied, diagnosed with hypertension 5 years ago, keep it stable. He is a company manager. On 07/30/2009, when he was in his work area, he received an extortion call because he was the company’s manager, he later reported to the corresponding authorities, without having any preventive action or response against it. Afterwards, because of the social and economic situation of the state, the company felt obligated to reduce the amount of workers in a very impactful manner, by which the employee starts to supply the needs of other areas in addition to his own, registering more than 20 extra activities, added to the increase of his workday hours. In 2011, he presented affective flattening, irritability, insomnia, headaches, chest pain, lower back pain, and anxiety, all of which were related to the intense physical and mental load that his labour duties required. In June 2012, while driving to his job, he made a call to his wife where he tells her where he feared that he was being followed, the call was interrupted, he is helped by public security officers which found him on his car with alterations alertness, he is taken to the hospital, where is diagnosed with a hypertensive crisis, presenting haemorrhagic cerebrovascular disease, and entering into cardiac arrest causing death.

Conclusion According to the psychosocial risk factors, and the violence in the working environment, as multiple tasks are done, for example, prolonged shifts, chronic work-related stress, and the threats against his integrity and his family; the case is qualified as a death caused by Karoshi’s syndrome.