Electoral thuggery remains a recurrent feature of Nigerian democracy, yet its consequences for voters’ physical health have received almost no systematic attention. This multi-site political ethnography investigates the physical and socially shamed heart-related impacts of political thuggery during the March 2023 gubernatorial elections in Oyo and Benue States. It frames this as a crimino-cardiac syndemic, where political violence, intense fear, and cultural stigma combine to cause increased heart disease rates and long-term withdrawal from democratic participation. Drawing on 120 voter illness diaries, 90 in-depth interviews, eight focus group discussions, official violence logs, hospital sources, WhatsApp archives, and QGIS spatial analysis across 96 polling units, the study documents widespread exposure to intimidation and ballot disruption (62% of units in Oyo, 58% in Benue).

Three-quarters of diary entries reported somatic fear cues, with symptoms unfolding in anticipatory (76–82%), acute (68–71%), and residual (54–61%) phases that contribute to chronic allostatic load. Five dominant narrative, scripts heroic endurance, self-blame, divine justice, comedic deflection, and silent shame served to normalize distress and displace political responsibility. Shame was associated with clinic avoidance among approximately seven in ten participants who experienced symptoms and with longer-term withdrawal from electoral participation. Spatial analysis confirmed significant clustering of reported cardiac distress in thuggery-affected areas (Moran’s I = 0.68, p