Emotional Stress and Sudden Cardiac Death.

Accession number;00A0581447
Title;Emotional Stress and Sudden Cardiac Death.
Author;YAMADA SHOGO(Tenjinshinryokurinikku)   TASHIRO NOBUTADA(Kyushu Univ., Grad. Sch.)   
Journal Title;Kyushu Neuropsychiatry
Journal Code:Z0180B
ISSN:0023-6144
VOL.46;NO.1;PAGE.1-9(2000)
Figure&Table&Reference;FIG.3, TBL.1, REF.64
Pub. Country;Japan
Language;Japanese
Abstract;The majority of cases of sudden death are caused by various cardiovasucular diseases. As for the direct causes of sudden death, lethal arrhythmia, cardiac arrest due to spasms of the coronary artery, and acute myocardial infarction have all been reported and such deaths are called "sudden cardiac death" (hereafter referred to the SCD). Traditionally, stress is known to affect the cardiovascular system through the autonomic and endocrine systems. Especially, emotional stress is known to induce angina pectoris, ischemic changes in electrocardiograms and arrhythmia. Emotional stress is also thought to contribute to various cardiac diseases and is also considered to be one of the important factors inducing SCD. Therefore, in this article, we reviewed the changes in the autonomic and endocrine systems induced by emotional sterss, the relationships between various electrolytes and stress, and the possible mechanisms of SCD caused by emotional stress, especially regarding lethal arrthythmia. Emotional stress induces dramatic neuroendocrine arousal through either the sympathetic-adrenal medullary system or the pituitary-adrenal cortical system, and released cortisol and cathecholamines act both cardiotoxically and arrhythmogenically. Electrolyte imbalances, especially K+ and Mg2+, may play an important role in the excitability of cardiocytes and the contractile respose of arterial smooth muscle. As a result, acute neuroendocrine arousal and an electrolyte imbalance, superimposed on a substrate of a compromised myocardium and electrical instability, may thus induce a critical fatal event such as lithal arrhythmia. In addition, the possibility that various approaches using the methods of either behavioral medicine or neuropsychiatry prevent to SCD is also presented. (author abst.)