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Yes, it is all related, because they're terrified. That is why the bar is filling up. It's one situation after another that's increasing the stress of the mission. That's why the levels are called "resolve," how dedicated and committed they are to getting through a fight, they are resolved to see the job through to the end. After they pass 100 is when they begin doing irrational things, hitting allies, and skipping turns. At 200 is when there's a chance of a heart attack, which lowers stress and drops hitpoints to zero. That's when your deathblow resist comes into play. At 0, any attack at all has to pass the deathblow resist or they will die. It's up to you to decide how important a mission is. If you choose to have them keep fighting, the lower the chance they will escape the mission with their lives. On the flip side, they are mercenaries, and you're paying them. It pays not to care about each and every person you send out. It's a business after all.
Just remember you can play well enough to never lose a hero if you think the skill is worth the investment. Heart attacks can be removed from the game without using mods.
If you are truly having too much trouble with it by all means disable it. But this game is about Learning the HARD way! And that's how I'd recommend it should be played. For instance. One of my first virtues I ever got was on a bounty hunter in the Weald, Problem is my team was a mark team that relied too much on the bounty hunters dmg output and I had trouble hitting back row stress dealing enemies, yes he got a Virtue but he was marked and then killed by a Spider because there higher dodge kept my Bounty Hunter from killing them fast enough. After that I learned that i needed to have other more consistent sustained damage to help back up my main dmg dealer. But to this day Mark teams are still some of my favorite teams because of it! Gotta love doing Arbalest/Musketeer(or Antiquitarian for torch less loot runs) (Occultist) (Hound Master) (Bounty Hunter) in the Warrens!
They do attack each other, depending on the Affliction they get. Paranoid is one of them iirc, they'll attack your heroes out of fear. Masochistic makes them attack themselves. Almost all afflictions (if not all of them) makes them abuse other heroes verbally, increasing their stress when they do anything, from getting a kill to missing a hit. They'll even abuse your heroes when it's their own turn.
When someone is afflicted, nothing happens to other heroes at that moment, but if they get another 100 stress after the 100 that caused their Affliction, they'll have a heart attack, putting them to Death's Door, unless they were already there, in which case they'll instantly die, no matter their resistance to killing blows. They'll also massively stress other heroes out when they have heart attacks, and some afflictions actually increase the amount of stress dealt to you, in addition to the difficulty of the mission you're undertaking (higher level missions cause more stress on everything, even entering the dungeon).
This means that if everyone is afflicted or at 150 stress, 1 hero having a heart attack could set off a chain reaction, increasing someone else's stress to 200 and making them have a heart attack as well, and so on, and so forth, until everyone eventually dies without giving you a turn to fix it or retreat from battle before everyone dies. Their stress does reset to 150 after a heart attack, but they get a debuff that can't be removed if they receive a heart attack, in addition to the death's door debuff. I don't know if these debuffs increase stress.
And lastly, retreating from combat also stresses your heroes out, which means the chain reaction could still happen if you retreated way too late, killing all of your heroes (except maybe 1, depends on their stress resistance).
About mods though, use whatever you want. If you want to use a mod for a hero that has 10000% virtue chance, bleed resistance and blight resistance, 99% Deathblow resistance, and a full 4-man AoE attack that deals 50 damage without even having buffs, that's your right. But it will diminish a lot of the game's mechanics, making the experience very straight forward and often blander than the vanilla experience.
So remove heart attacks if you want, but it will invalidate anything that happens above 100 stress, and the stress mechanic won't really be anywhere near as terrifying as it is, opening the doors to ooga booga comps that one shot everything using OP relics that typically have a stress-related drawback.
It will also increase your gold reserves, as you don't really have to fix someone's affliction using the Tavern or the Abbey, as well as invalidating quirks like Tippler, which restricts a hero to only using the Bar in the Tavern for stress relief. Locking the Tippler quirk instead of removing it in this case would also mean you can only get 4 other negative quirks, who could have similar mechanics, invalidating the negative quirk system. You also have someone like a Flagalent, whose affliction actually makes them more powerful, increasing their damage and their speed, and you won't have a reason to remove it without Heart Attacks.
A lot of things happen when you invalidate a mechanic. These are just a few examples.
There's idiots here who will cry and scream and preach about a 'pure vanilla' being 'the only right experience', but frankly, they've no right to tell others what to do with their own gaming. I've got my own self-imposed rules about playing DD, but I don't demand or expect anyone else to abide by them. Why would/should I?
So mod it up and play. If you change your mind later, you can always turn the mods off, or swap them for something else. Or stick to vanilla, but let it be your choice, and own it.