ReviewsAcute psychosocial stress and cardiovascular events*,**
Section snippets
Experimental studies
Mental stress produces significant increases in heart rate and blood pressure that may lead to increased myocardial oxygen demand and plaque disruption.14 In addition, to an increase in the rate pressure product, there is also evidence that mental stress may lead to a primary reduction in myocardial oxygen supply. Whereas coronary arteries of normal patients dilate during mental stress, impaired dilatation and even vasoconstriction has been shown in atherosclerotic arteries.15 Although not all
Clinical studies
An increase in cardiovascular events has been associated with disasters. An increased relative risk for cardiovascular death (relative risk, 2.6) and a sharp increase in number of admissions for acute myocardial infarction (relative risk, 1.8) were observed after the 1994 Los Angeles earthquake, which occurred in the early morning, compared with the week before the disaster.10, 11 Sixty-five percent of those who died from atherosclerotic cardiovascular disease were men and their average age was
Conclusions
An extensive literature review supports a role for mental stress as a trigger of myocardial infarction. Because stressors provoking anger are frequently unavoidable, benefit may be gained through interrupting the link between the stressor and the cardiovascular event by nonpharmacologic and pharmacologic means. Aspirin and β-blockers may be warranted in selected populations, particularly at times of increased stress such as after bereavement. Moreover, although the proportion of individuals
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Cited by (53)
Acute Psychological Stress is a Trigger for Stroke: A Case-Crossover Study
2020, Journal of Stroke and Cerebrovascular DiseasesCitation Excerpt :The interview schedule sought information on demographic details of patients, known risk factors, medical history, signs and symptoms of stroke, time of onset of stroke, data on exposure to triggering factors during hazard periods and control periods. The pro-forma had been pretested in a previous study.9 Patients were interviewed within 7 days after the event.
Psychopharmacology and Cardiovascular Disease
2018, Journal of the American College of CardiologyAcute restraint stress provokes sudden cardiac death in normotensive rats and enhances susceptibility to arrhythmogenic effects of adrenaline in spontaneously hypertensive rats
2016, Legal MedicineCitation Excerpt :High incidences of cardiovascular events and sudden cardiac death (SCD) have been reported following unexpected acute psychosocial stress [1–6].
Philemon and Baucis syndrome: Three additional cases of double deaths of married couples
2013, Forensic Science InternationalCitation Excerpt :This specificity was well explained by Ciesiolka et al. [1] and can lead to acute psychological stress. Severe psychological disturbance may be the trigger for acute coronary or rhythmic disorders [10]. Many experimental and clinical observations have been made, especially during mass disasters.
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Address reprint requests to Ruth Stalnikowicz, MD, Hadassah University Hospital, Mount Scopus, PO Box 24035, Jerusalem, 91240 Israel.
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