Mental Stress-Induced Myocardial Ischemia.
Puja K MehtaAshish SharmaJ Douglas BremnerViola VaccarinoPublished in: Current cardiology reports (2022)
MSIMI can occur in patients with normal cardiac stress testing, is only weakly related to severity of coronary artery disease (CAD), and it is often silent. Among patients with CAD, MSIMI is associated with a twofold increased risk of major adverse cardiovascular events compared to those who do not have MSIMI. Certain groups such as young women with myocardial infarction and those with psychological comorbidities are more susceptible to MSIMI. Abnormal microvascular vasoreactivity and inflammation are implicated mechanisms in MSIMI. Increased brain activity in regions that modulate autonomic reactivity to emotional stress and fear is associated with MSIMI. MSIMI has important prognostic implications in patients with CAD. Stress can no longer be ignored as a risk factor in cardiology care. Clinical trials testing effective strategies to target MSIMI are needed.
Keyphrases
- coronary artery disease
- stress induced
- cardiovascular events
- percutaneous coronary intervention
- clinical trial
- left ventricular
- coronary artery bypass grafting
- healthcare
- heart failure
- oxidative stress
- palliative care
- risk factors
- cardiovascular disease
- mental health
- randomized controlled trial
- heart rate
- cardiac surgery
- heat stress
- aortic stenosis
- emergency department
- chronic pain
- depressive symptoms
- atrial fibrillation
- blood pressure
- study protocol
- prefrontal cortex
- aortic valve
- affordable care act